Evaluate if Virtual Reality Visual Field (VR) testing can serve as a reliable method for assessing patients with Idiopathic Intracranial Hypertension (IIH) in a comprehensive neurology setting.

IIH is frequently referred to comprehensive neurologists, who typically do not have the visual field equipment necessary to care for this disorder. Visual fields are used to diagnose progressive visual loss in IIH, because visual acuity can remain unaffected in IIH. Regrettably, this can result in progressive visual field loss while waiting for neuro-ophthalmology confirmation. The gold standard, Humphrey Visual Field (HVF) is costly and challenging to integrate into neurology clinical practice. Ophthalmology literature has shown that VR testing provides a portable, easy to learn alternative. VR competency requires a 30 minute tutorial and is far less expensive than HVF to acquire. We have found no data regarding VR testing by comprehensive neurologists.

The authors have no proprietary interests to report. After IRB approval and patient consent, 30 consecutive patients clinically diagnosed with IIH underwent both HVF testing and VR testing. HVF was administered first, followed by VR testing after approximately a 20 minute interval. Pointwise pattern deviation values and Pattern Standard Deviation (PSD) were evaluated.

30 patients (56 eyes) diagnosed with Idiopathic Intracranial Hypertension (IIH) were reviewed in our study. Across 63 matched HVF-VR tests, VR testing demonstrated strong pointwise agreement with HVF, with pointwise pattern deviation analysis revealing a Pearson correlation of 0.802 (R² = 0.643). Furthermore, mean PSD values were comparable between HVF (−2.84 dB) and VR (−2.80 dB).

VR testing represents a cost-effective method, empowering comprehensive neurologists to independently evaluate and initiate management in IIH patients, thereby improving access to timely visual care and ultimately reducing the danger of a prolonged referral to neuro-ophthalmology.