Refining Functional Vision Assessment: Challenges in Adapting Orientation and Mobility Tests to Virtual Reality

The evaluation of functional vision in ophthalmology is challenging, often halting therapy development despite patient-reported Quality of Life (QoL) improvements. Orientation and Mobility (O&M) tests, which are difficult to be reproduced and costly due to their physical setup, can be enhanced using virtual reality (VR). This paper details a VR-based O&M test protocol that facilitates flexible design and access to extensive behavioral data. We addressed the challenge of creating an appropriate scoring system, identifying distinct error types and analyzing the contributing environmental and human factors. A refined scoring method was proposed, capturing the subtleties of functional vision beyond mere error counting. Our findings highlight the differences in behavior between VR scenarios and real-world settings, underscoring the importance of careful test design. This study offers new insights for future VR-based O&M test development and underscores the potential of VR in bridging the gap between virtual assessments and real-world functionality.