Diagnosing Amblyopia Using Virtual Reality: A Comparative Analysis with Visual Acuity Tests

Amblyopia, commonly referred to as "lazy eye," is a neurological disorder that leads to diminished vision in one eye due to the brain's inability to properly process visual information. Traditional diagnosis primarily relies on visual acuity tests, which measure the sharpness or clarity of vision through charts like the Snellen eye chart, Tumbling E chart, or pictorial representations. In this study, we developed a Virtual Reality (VR) simulation of the custom-sized Tumbling E visual acuity test using the Unity Game Engine. Participants were placed in a controlled virtual environment and interacted with the environment using VR controllers, while a custom C# algorithm provided real-time feedback and analysis of the user inputs. Fifty subjects underwent both the VR-based test and traditional physical acuity testing concurrently for comparative analysis. Statistical validation included a paired t-test, Bland- Altman analysis, and Pearson correlation to assess accuracy Results indicated a strong correlation (0.984) and no significant difference between the two methods, demonstrating the potential of VR for accurate visual acuity testing.