• VR Headsets May Be Safe for Young Children

    Written By: Lynda Seminara
    Selected By: Richard K. Parrish II, MD

    Journal Highlights

    American Journal of Ophthalmology, January 2020

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    Safety warnings that come with virtual reality (VR) 3D binocular headsets state that their use is banned for chil­dren under 13 years of age. However, quantitative studies of the effects of these headsets on children are lacking. Tychsen and Foeller performed a study in 4- to 10-year-olds and found no meaningful adverse effect on visuomo­tor function. After use of the device, participants had no significant postural instability or maladaptation of the vestibulo-ocular reflex.

    For this prospective study, the researchers included 50 children (29 boys) whose mean age was 7.2 years. Participants were required to have logMAR corrected distance visual acuity (CDVA) of 20/50 or better and stereoacuity of 800 seconds of an arc or better.

    Multiple parameters were docu­mented for each child before and after each of two sequential play sessions.

    The sessions, which lasted 30 minutes each, involved a 3D flying game (Eagle Flight) that requires head movements to control flight direction (i.e., pitch, yaw, and roll axes). Each VR session was followed by testing of binocular CDVA, refractive error, binocular eye alignment (strabismus), stereoacuity, and postural stability. Visually induced motion sickness was assessed using a questionnaire. Five children also underwent before-and-after testing of visual-vestibulo-ocular reflex (V-VOR) adaptation. Any change from baseline in a visuomotor measure represented a safety concern.

    Of the 50 children, 46 (92%) com­pleted the entire study. There were no significant changes from baseline in binocular CDVA (p = .89), refractive error (p = .36), binocular eye align­ment (p = .90), or stereoacuity (p = .45). Postural stability degraded 9% (on average) from baseline to 60 min­utes following VR exposure (p = .06). From pre- to post-trial, scores on the questionnaire increased by a mean of 4.7% for all four symptom categories: fatigue (p = .03), head/neck discomfort (p = .03), eye discomfort (p = .02), and motion sickness (p = .01). V-VOR gain remained stable in the five children tested. No child who finished both sessions asked to stop the game, and most were disappointed when the play ended.

    Three children (6% of participants) stopped playing in the first 10 minutes of the initial session: two girls (aged 5 and 6) and one boy (aged 7). The girls cited discomfort consistent with mild motion sickness; the boy said he was bored and the headset was uncomfort­able. No child experienced aftereffects such as flashbacks in the days following the study.

    The authors concluded that young children seem to tolerate immersive 3D VR play well without any noteworthy effects on visuomotor function.

    The original article can be found here.