Using virtual reality to learn about the eye

OT  speaks with Dr Andrew Wilson about Birmingham City University’s innovative approach to teaching trainee doctors


Academics at Birmingham City University are teaching trainee doctors about the eye using a mobile phone application and virtual reality headset. The app has had more than 500 downloads internationally, from countries as far afield as Alaska, South America and Indonesia. Associate professor, Dr Andrew Wilson, talks with OT about the technology.

What do trainee doctors learn with the technology?

We have used a game-based approach in our app that is used to encourage the trainee doctors to challenge themselves to learn how to correctly perform routine eye examinations. The app is made up of mini levels each exploring and teaching different aspects of the eye examination process. First, we train them how to use the app with simple and fun tutorials that teach them how to control it.

Then we go systematically through how they would perform an eye examination and how to navigate important landmarks of the eye, like the optic disc. In the next level, they receive audiovisual feedback on the types of pathology that might exist in the eye, for example, diabetic eye disease and head trauma. They can then take a quiz to test their knowledge of what they have learnt.

They are taken through a series of random images that may be either healthy or have abnormalities. The trainees have to correctly diagnose what they see using the processes they have been taught earlier. As an added challenge, they can do this in a set timeframe to test how quickly they can accurately perform the diagnosis. As the app was developed for standard mobile phones and cheap affordable virtual reality headsets, they can go away and practise diagnosing different conditions whenever they like.

What are the advantages of using virtual reality over more traditional teaching methods? 

With more traditional ways of learning, there is limited time that the more experienced clinicians have to spend with students. Students have to practise on each other with an ophthalmoscope. If they just don’t get it or don’t understand what they are looking for, they just give up. With this sort of approach, they can practise anytime, anywhere and are exposed to images of eyes exhibiting pathologies which they would not normally encounter by practising on healthy subjects. We have had people from medical institutes around the world saying that they were interested in this approach because they do not have sufficient time to spend with medical students.

It’s not a replacement for traditional learning, it’s a complementary system. This is an enjoyable and affordable way of people learning something quite complicated. Going forward, we would like to create a way for the doctors who are instructing them to also see what the students are looking at inside the virtual reality systems so that they can provide guidance and feedback too. I think there is a lot more potential for this approach to help students learn many different types of important clinical skills.

Like any technology, we have to be a bit cautious about what we are going to do with it and not just do it for the sake of it. It’s expensive to develop and it can be expensive to implement. With every technology I have been involved in developing we always look at what the benefit is over the traditional approach. If a pen and paper approach is effective, it’s a lot cheaper, so there may be no point in developing a new way. However, our research work with the doctors and medical students at Birmingham City Hospital (Sandwell and West Birmingham NHS Trust) has shown that this is a well-received learning and teaching approach for them.

Could this technology be used by optometrists?

We would welcome taking this work forward with optometrists. We are all for doing something unique and novel.

A demonstration version of the app is available online, while a research paper on the technology is published in The Clinical Teacher.