Glaucoma detection may soon become easier and more reliable with a wearable brain-based device called NGoggle. The unit uses virtual reality to diagnose early and prevent vision loss.

The device, which is not yet FDA approved, consists of head-mounted virtual reality goggles that stimulate targeted areas in patient’s visual field with light. NGoggle’s portability means that it could potentially be used in variety of environments: in an eye care provider’s office, a community center, or in a person’s home.
“Screening for glaucoma based on single intraocular pressure measurements may fail to detect up to 80 percent of the patients with the disease.“
“Current methods for glaucoma screening and monitoring are relatively primitive,” said Felipe Medeiros, M.D., Ph.D., a co-founder of NGoggle, Inc., and a professor of ophthalmology at Duke University School of Medicine.

Unreliable IOPs

The standard screening test for Glaucoma uses tonometry to track intraocular pressure (IOP). While an elevated IOP is the main risk factor, not all cases are associated with high pressure. Optic nerve damage may occur at a relatively low intraocular pressure. In addition, pressure fluctuates widely throughout the day and on different days, which thwarts diagnosis and screening. Conversely, high intraocular pressure may never inflict optic nerve damage in some patients.

The problem with perimetry

Many ophthalmologists employ standard automated perimetry (SAP) to monitor glaucoma progression, which depends on patients to click when they see light in their periphery.

On average, seven years of annual testing would be needed to detect disease progression. Upping the test frequency to three times annually cuts the time to five years. But achieving this number of clinic visits in a single year is not realistic for most patients because it means calling in patients several times a year.

NGoogle Works without Patient Input

In contrast to SAP, the NGoggle objectively assesses peripheral loss of vision without subjective input from the patient. The device gauges brain activity in response to signals received from the eyes. Diminished activity may indicate functional loss from glaucoma.

The virtual reality goggles are integrated with wireless electroencephalography (EEG). Within a few minutes, the NGoggle algorithm captures and analyzes enough data to report how well each eye communicates with the brain across the patient’s field of vision.

Could Glaucoma Testing Actually be Fun?

Because patients can be tested for glaucoma as they play a VR-based video game or explore a virtual art gallery, NGOOGLE hopes to make glaucoma testing entertaining. The goal is to make an engaging experience that would encourage more testing, and help people get the treatment they need.

Let the Trials Begin

Researchers at Duke are currently conducting studies to validate the NGoggle’s diagnostic accuracy and reproducibility. They will compare NGoggle results to SAP and OCT to find out how well it discriminates between the different stages of Glaucoma. The researchers will also conduct longitudinal studies to validate the ability of the device to detect disease progression.
This story was based on information from the National Institutes of Health https://www.nei.nih.gov.