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Virtual reality (VR), the computer-generated creation of a complete immersive virtual environment, and augmented reality (AR), the computer-based augmentation of real-world scenes, have emerged in the last decade as leading technologies buoying many industries through different applications. VR and AR tools effectively help people train, solve problems, and carry out tasks in fully or semi-alternate realities. The AR, VR, and mixed reality market exceeded $28 billion in 2021, and is expected to reach $250 billion by 2028 1. However, these technologies are to be used in moderation given their potentially adverse consequences on human health, and eye health in particular.
Increasing evidence has recently highlighted the negative impacts of VR and AR technologies on eye health. Medical professionals have warned that VR and AR may result in eye strain because the brain is forced to process visual stimuli in a novel, abnormal way. Users themselves have also complained about nausea and dizziness when using headsets. This is generally attributed to the way in which a user perceives the space surrounding them, which can lead to motion sickness. Facebook-owned Oculus stipulates in its handbook, for example, that one in 4,000 may suffer “dizziness, seizures, eye or muscle twitching.” It recommends users suffering from these symptoms to discontinue using the headset and consult a doctor.
Interestingly, effects have been found to affect children more severely, and most VR headset manufacturers have put in place warnings specifically for children. This is critical because a child’s visual system continues to develop throughout their childhood. Extended exposure to VR headsets can alter the development of tracking, focusing, and depth perception 2.
Nonetheless, the Association of Optometrists has not yet identified any firm evidence to this end, stating: “We currently do not have any reliable evidence that VR headsets cause permanent deterioration in eyesight in children or adults. There have been some studies looking into the effects of short-term use of VR headsets only; these did not reveal a deterioration in eyesight. However, some people do suffer from temporary symptoms such as nausea, dry, irritable eyes, headache or eyestrain” 3.
The Association for Optometrists has, however, laid forth a number of user recommendations. First, naturally, the number of hours of headset use in a day should take into account their binocular vision status and the task they are engaged in. Individuals are recommended to consult their optometrists to this end. However, as clarified, “If you spend all day in VR without a break, you’ll need time to readjust to the light and the different visual environment of the real world. I would suggest taking a five-to-ten minute break each hour, using that time to move about, blink and look out of a window, or take a short walk” 3.
Although they must be used in moderation and in a well-informed manner, VR and AR technologies can also be applied for health promotion. For example, VR headsets have been adapted to help improve eyesight. To this end, the start-up GiveVision created SightPlus, a device aiming to restore vision to individuals having lost their eyesight by projecting a video of the real world into the working part of their retinas. A recent clinical trial with 60 participants found that the device significantly improved visual acuity, contrast sensitivity, and reading performance, with nearly half of participants noting that they would wear the device to watch TV, read, or go to the theater 4. In parallel, other systems have also been developed to improve visual acuity in patients with amblyopia and to enhance eye-hand coordination, reaction time, eye coordination, and depth perception 2. In support of this, a recent investigation revealed that patients had demonstrably improved understanding of glaucoma and the importance of eye screening after using immersive tools for eye health promotion 5.
VR and AR technologies are advancing at a rapid pace, with new applications emerging on a regular basis. For now, individuals should pay particular attention to VR/AR headset warnings, limit their time spent in the virtual world, and ensure that they undergo regular, comprehensive eye examinations with an optometrist.
References
1. VR/AR market size 2024 | Statista. Available at: https://www.statista.com/statistics/591181/global-augmented-virtual-reality-market-size/.
2. Are Virtual Reality Headsets Dangerous for Our Eyes? | The Canadian Association of Optometrists. Available at: https://opto.ca/health-library/are-virtual-reality-headsets-dangerous-for-our-eyes.
3. Developer warns VR headset damaged eyesight | BBC. Available at: https://www.bbc.com/news/technology-52992675
4. Crossland, M. D. et al. Benefit of an electronic head-mounted low vision aid. Ophthalmic and Physiological Optics. (2019). DOI: 10.1111/opo.12646
5. Gunasekeran, D. V. et al. Population eye health education using augmented reality and virtual reality: Scalable tools during and beyond COVID-19. BMJ Innov. (2021). DOI: 10.1136/bmjinnov-2020-000522
