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Virtual reality gives ophthalmology students chance to view pupil abnormalities

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Passive learning from textbooks and online content is of some value, but through interaction, reflection, and experiential learning, retention is improved.

Pupil examination is clearly central to ophthalmic evaluation, but it is also very relevant for people who manage a range of emergency, neurological, and general medical symptoms.

Medical students can practice pupil examinations with each other, but they respond normally. Another option is pharmacologically scalable simulated patients, but they are limited resources and cannot simulate other abnormalities.

The challenge is to identify various pupil abnormalities before the student enters the small room with the actual patient. So, they are sent to as many clinical settings as possible, hoping that they all have ample opportunity to see, and perhaps even examine abnormal pupils. It works in general, but is opportunistic to see the extent of the pupil’s anomaly. One solution seems obvious: virtual reality.

Dr. Michael Williams of Medicine, Dentistry and Biomedicine at Queen’s University Belfast in Belfast, Northern Ireland, has worked with a VR coding company to develop an application for pupil examination.

In a study published in eye,1 Williams said the app was developed for the Oculus headset. The user starts in the drawing room of the clinic and chooses one of 12 different options. 10 different pupil abnormalities (right APD, fixed dilated pupil with left ptosis, fixed dilated pupil with right ptosis, etc.), random and normal options.

“Then they enter the clinical room, where patients are waiting for any pupillary abnormalities selected,” Williams said in a study. “The user’s perspective can be cast to any device on the same WiFi network. The user picks up the pen torch, turns it on and examines the student. For example, the same physical as it is used in real life. Use sloppy movements, shake the torch between the eyes, and move towards the patient to scrutinize. “

Williams said the VR option was used by more than 250 final-year medical students at Queen’s University in Belfast as part of a session called “Simulated Ophthalmology Clinic.”

Studies have shown that most students have never used VR before a session and often had a pleasant and surprising reaction when they put on their headsets and began interacting with virtual patients.

“I learned how to get students to be instructed and inspected within 30 to 60 seconds,” writes Williams. “For example, I learned something obvious at first glance, such as displaying only two buttons on the controller before putting on the headset and first selecting the pupil abnormality myself. So the students were in front of the patient. The students worked in pairs, so the first student to do it taught the second. “

Williams then stated that within 10 minutes per pair, more than 250 students were able to test for afferent pupil defects and dilated pupils fixed with red eyes, or acute glaucoma. In addition, in a survey, 96% of 69 respondents said that even this short experience improved their knowledge and confidence in examining students.

One student said he was given the opportunity to see an APD that he had never seen before. Another said that playing in front of classmates would remove anxiety.

Williams said in this study that VR is a tool and should be used as part of an overall educational strategy to deliver specific learning outcomes, rather than being fascinated by its novelty. rice field. It may also be used for evaluation.

In the study, Williams also stated that practice continues to be the best way to learn skills, depending on repetition, intentionality, faith, and fun.

However, VR does provide a cost-effective option for students to practice clinically relevant and prudent exercises. The SP does not get tired and can cause abnormalities.

“It’s not a substitute for learning with real patients, it’s a tool for accelerating preparations to meet real patients,” Williams concludes in a study.

Dr. Michael Williams

[email protected]

Williams has a commercial interest in this app. There was no external funding for the development of the app.


Williams, M. Virtual reality in ophthalmology education: simulation of pupil examination. eye (2022). https://doi.org/10.1038/s41433-022-02078-3

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