VR in Ophthalmology: Slow Adoption, Emerging Applications & Future Potential

Virtual reality is steadily moving beyond gaming and entertainment, finding increasingly practical applications in healthcare. While adoption has been slower in some specialties, ophthalmology is beginning to see the benefits of this technology, from surgical training to patient education and even remote screening. Recent advancements are aiming to address some of the barriers to wider implementation, including cost and integration into existing clinical workflows.

A Growing Toolkit for Eye Care

In the last two years, virtual and augmented reality have taken steps toward more practical applications in eye care. Companies are introducing devices and programs designed to improve both the educational experiences for surgeons and the understanding patients have of their treatment options. Immersive IOL simulators, like the Immersive IOL Simulator from VirtuaLens and InSightVR from Greenman, allow patients to preview their potential vision after cataract surgery and intraocular lens (IOL) implantation. This can be a powerful tool in shared decision-making, helping individuals choose the lens that best suits their lifestyle and visual needs. VirtuaLens launched the Immersive IOL Simulator in September 2025, simulating scenarios like golf courses, nighttime driving, and home kitchens to give patients a realistic sense of how different lenses might perform.

Beyond IOL selection, VR is being used for screening purposes. Applications are available for detecting relative afferent pupillary defects and for performing visual field testing. Last year, the FDA cleared Luminopia, a VR-based therapeutic for children with amblyopia (lazy eye). Virtual Vision Health is also expanding the capabilities of its Virtual Eye Pro, adding pupillography, color vision testing, and live eye streaming to its portable, cloud-based VR perimeter.

Challenges to Wider Adoption

Despite these advances, ophthalmology still lags behind other medical specialties in embracing virtual and augmented reality, according to Sharon Fekrat, MD, FACS, FASRS, of Duke Eye Center. “This proves still somewhat on the fringes of clinical care,” she said. “Real-world adoption and implementation have been slow. There is some inertia as well as some challenges in incorporating this technology given how busy the clinics are.”

S.K. Steven Houston III, MD, CEO of MetaMed, a virtual reality health care education platform, agrees that VR adoption rates are relatively low in ophthalmology, but he regularly uses it for educational purposes. He notes that much of the current application is focused on surgical education and telementoring, with emerging possibilities for use directly in the operating room.

One significant hurdle is cost, particularly for smaller practices and academic settings. “What do you bring in, and what value does it provide?” Fekrat asks. She emphasizes the importance of having a “physician champion” within an institution to advocate for the technology and identify ways to integrate it into daily clinical care.

Academia’s Role in Innovation

Fekrat highlights the three core missions of academic institutions – clinical care, education, and research – and believes virtual reality can contribute to all three. For training future ophthalmologists, VR offers a safe and efficient way to develop and refine surgical skills. Systems like the Eyesi surgical training simulator (Haag-Streit) allow trainees to practice procedures in a controlled environment, receiving real-time feedback on their performance. “That is a much easier, cleaner and more efficient process than learning on porcine eyes,” Fekrat explained. “The simulator offers built-in training modules where trainees can start out with the basics, and then when each level is mastered, they progress to more complex skill learning.”

Beyond surgical skills, virtual reality can enhance didactic education, particularly for trainees at remote locations. Fekrat envisions a future where trainees and faculty can participate in lectures and discussions together in a virtual “metaverse” setting, regardless of their physical location. This could improve access to educational opportunities and foster collaboration.

Enhancing the Patient Experience

Virtual reality also holds promise for improving the patient experience. Instead of relying solely on traditional educational materials, patients could use VR headsets to learn about their conditions and treatment options in a more immersive and engaging way. For example, a patient could experience a simulation of what it’s like to have macular degeneration or glaucoma, gaining a better understanding of the challenges faced by those with vision loss. Fekrat also suggests the potential for remote screening, envisioning a “retina selfie” taken with a VR headset to streamline the imaging process and reduce wait times.

New Technologies in the Operating Room

Recent innovations are bringing VR directly into the operating room. Anil Vedula, MD, of Your Eye Specialists, has had success with the Heru VF for visual field testing, noting that it is faster, more comfortable, and more intuitive for patients than traditional methods. Studies have shown the Heru VF demonstrates strong validity for visual field testing, particularly for glaucoma monitoring.

Eric D. Rosenberg, DO, of SightMD, recently performed cataract surgeries using the Apple Vision Pro, integrating it with a program called ScopeXR. This system overlays critical surgical information onto the surgeon’s field of view, allowing for real-time access to patient data and potentially enabling remote collaboration with colleagues. The system can integrate with cloud-based services like SMARTCataract (Alcon) to provide immediate access to biometry measurements and IOL selection tools. Rosenberg believes this technology will ultimately become standard practice, offering surgeons a more efficient and intuitive surgical experience.

What Lies Ahead

The future of virtual and augmented reality in ophthalmology appears bright, but several factors will influence its widespread adoption. Continued innovation, coupled with a reduction in cost and improved integration into existing clinical workflows, will be essential. The development of robust clinical evidence demonstrating the benefits of VR in terms of improved patient outcomes and surgical precision will also be crucial. As these technologies mature, they have the potential to transform eye care, enhancing both the quality of care and the patient experience.

For more information:

• Sharon Fekrat, MD, FACS, FASRS, of Duke Eye Center, can be reached at [email protected].
• S.K. Steven Houston III, MD, of Florida Retina Institute, can be reached at [email protected].
• Eric D. Rosenberg, DO, of SightMD in New York, can be reached at [email protected].
• Anil Vedula, MD, of Your Eye Specialists in Florida, can be reached at [email protected].