Ophthalmologist and Physician-Scientist
New Glaucoma Test Relies on Virtual Reality Technology

New Glaucoma Test Relies on Virtual Reality Technology

Glaucoma, a group of diseases caused by elevated intraocular pressure, destroys the eye’s optic nerve and slowly erodes vision without warning. Even in the advanced age of information and technology, there are still more than 3 million people living with glaucoma in the US alone. If not caught at its early stages, the disease can cause permanent low vision or blindness and lead to a host of serious side effects.

While there is still no cure, early diagnosis of glaucoma offers the patient the best chance of maintaining their vision long term. Glaucoma diagnosed in its early stages can be treated with oral medications, eye drops, surgeries, or a combination of these, though any vision loss is permanent. Because of this, eye health researchers are focused on finding more successful methods of glaucoma detection.

The National Eye Institute (NEI), part of the National Institutes of Health and representing the field of eye health, has supported the invention and development of drugs and treatment methods to address some of the world’s most serious eye diseases, including glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy. In its role as a pioneering source of funding for research on vision loss, its current funding goals center on understanding the biology of eye diseases, developing gene-based therapies and treatments for diseases that cause vision loss and using stem cell therapy to restore sight.


A new, virtual tool for glaucoma detection

In conjunction with broader research goals, the NEI also allocates funding to convergent healthcare research. This includes research on technologies that may enable earlier diagnosis of eye diseases with greater accuracy and simplicity than ever before. Recently, the NEI announced its intention to support further research into one such project focused on earlier diagnosis of glaucoma. As announced in a press release in late January 2019, the NEI is supporting a clinical study on the ability of the NGoggle device to more accurately diagnose glaucoma at early stages.

The NGoggle is a non-invasive brain-computer interface (BCI) device designed to serve multiple diagnostic functions. Though the technology is still in its early phases of development, NGoggle Inc. notes its all-in-one platform can be used to assess neurodegenerative diseases such as CTE or Alzheimer’s disease and to make glaucoma diagnoses in a highly effective, non-invasive manner.

The NGoggle measures brain signals in response to visual stimulation to gather data on neural activity and loss of vision. The NGoggle system captures the data through a wearable headset equipped with wireless electroencephalography (EEG) and a virtual reality (VR) screen. The VR screen strategically displays light designed to target specific areas within the wearer’s visual field. The EEG software captures brain activity in response to the light, and the data is processed through a specialized algorithm to determine each eye’s ability to communicate with the brain. If the results show diminished activity, this may indicate the patient’s eye has damage from undiagnosed, early-stage glaucoma.

Comparing current methods with the NGoggle

The value of NGoggle is its ability to increase the efficacy of glaucoma diagnosis and the fact that it’s easy to use. Current standard methods of glaucoma diagnosis are considered by many within the ophthalmology field to be insufficient, especially considering the potential severity of the disease.

Currently, the primary method of testing for glaucoma is an eye pressure exam called a tonometry test. Although elevated intraocular pressure (IOP) is glaucoma’s primary risk factor, not all people with the disease show this particular symptom. According to Felipe A. Medeiros, MD, PhD, co-founder of NGoggle Inc., glaucoma screenings that rely on one IOP measurement may fail to detect 80 percent of early-stage glaucoma cases. Additionally, IOP can fluctuate depending on a variety of factors, increasing the likelihood that the patient’s measurements will differ depending on the time or even the day of the week they are tested.

Tests measuring the progression of glaucoma and informing treatment also have a high degree of unreliability. The conventional test used to monitor glaucoma, known as standard automated perimetry (SAP), relies on patient interaction to generate results. In SAP screenings, the patient is instructed to press a button when a light briefly flashes in their peripheral vision. The test is meant to tell the physician how much of a patient’s peripheral vision has eroded. However, because it depends on patient input, which is subjective, the test leaves much to be desired in terms of objectivity and reliability.

Why NGoggle may be the future of glaucoma diagnosis

Because it relies on brain activity and visual stimulation, NGoggle avoids the inefficiencies associated with the narrow focus of tonometry tests and the subjectivity of patient participation in SAP tests. In an NGoggle screening, the eyes react naturally to the virtual reality simulation presented to them, and the device generates results based on the body’s natural response. Additionally, the NGoggle headset may allow ophthalmology professionals to screen for glaucoma with VR films or video games, which would make screenings much more engaging for patients — and potentially less intimidating. All this would encourage patients to obtain the preventive eye care needed.