Comparing subjunctive binocular vision measurements using vivid vision and traditional methods

Background: Vivid Vision Clinical is a new vision therapy software program that utilizes a virtual reality headset to help provide vision therapy for patients with strabismus, amblyopia and other binocular vision anomalies. In addition to therapy games, the device has the ability to measure subjective phoria, ocular dominance, and flat fusion. As this program is new technology, there are no studies evaluating the accuracy of results, or preliminary findings. As such, we decided to look at the simplest information to see if these digital methods of measurement compare to traditional methods of measurement. The question addressed in this research is whether there is a significant difference in results between measurements on the Vivid Vision and traditional clinical measurements.
Methods: A sample size of 30 optometry students had subjective distance phoria measurements taken using Maddox Rod, Worth 4 Dot testing performed at 10 feet, and ocular dominance testing by viewing a small target letter at distance through a hole between their hands. The same three measurements were then taken using the Vivid Vision device (distance phoria, flat fusion, and ocular dominance), and results between the two methods were compared.
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Results: Ocular dominance measurements showed a 63.33% accuracy between testing methods, and flat fusion measurements showed 80% accuracy with Vivid Vision compared to clinical measurements. Average clinical horizontal phoric posture was measured at 0.61Δ ± 7.49Δ exo and average Vivid Vision posture was 5.47Δ ± 3.93Δ eso, which was a statistically significant difference. Average clinical vertical phoric posture was measured at 0.081Δ ± 0.39Δ and average Vivid Vision posture was 0.037Δ ± 0.92Δ, which was not statistically significant.
Conclusions: We found a statistically significant difference in horizontal phoria measurements for our subject population, with the Vivid Vision showing a more eso posture. This may be attributable to a strong stimulus for proximal convergence, or the nature of the program itself. Worth four dot and ocular dominance measurements were also inconsistent, indicating that clinical values and Vivid Vision measurements should not be used interchangeably in a clinic or therapy setting.