Comparative Evaluation of Activities of Daily Living Using Virtual Reality Simulation in Glaucoma and Non-Glaucoma Patients.

ABSTRACT

Purpose: To compare the performance of activities of daily living (ADL) in Primary open-angle glaucoma patients and non-glaucoma normal controls using virtual reality (VR) simulation at the Lagos State University Teaching Hospital. Materials and Methods: This was a comparative clinical analysis involving primary open-angle glaucoma (POAG) patients. A total of 86 patients were enrolled (43 cases and 43 normal non-glaucoma). Each participant completed four VR simulation tasks. Chi-square/Fisher exact test was used to compare variables. The confidence interval was set at 95% for all statistical tests, and a P value of <0.05 was considered significant. Results: The mean age of participants in the glaucoma group was 60.3 years, and the mean age in the normal non-glaucoma group was 56.5 years. The number of clicks in the driving task in the normal non-glaucoma and glaucoma group differed by 4.84 clicks (mean normal 21.00, confidence interval [CI], 19.96-22.14, mean glaucoma 16.16, CI, 14.30-18.03, P < 0.001). The number of newspapers seen differed by 0.88 (mean normal 9.74, CI, 9.40-10.09; mean glaucoma 8.86, CI, 8.21-9.51, P = 0.020). The mean time taken to complete the bus stop simulation task differed by 41.23 s (mean normal 29.72 s, CI, 25.02-34.42; mean glaucoma, 70.95 s, CI, 53.26-88.65, P < 0.001). The mean time taken to complete the best dress task differed by 14.39 s (mean normal 9.49, CI, 8.18-10.80; mean glaucoma 23.88, CI, 10.03-37.74, P = 0.038). Patients with advanced and severe stages of glaucoma took longer to complete the VR task than those with early glaucoma. Conclusions: The VR simulation used in assessing the performance of ADL among POAG participants highlights limitations that vary with varying severity of glaucoma. The conventional clinical investigation used in assessing glaucoma severity might not define the real-time social effect of the disease.