Head-Cancelled Virtual Reality for Ocular Cranial Nerve Palsies

Purpose

This study is investigating whether eye exercises for abducens palsy and internuclear ophthalmoplegia increase ocular range of motion in the paretic direction when performed in virtual reality under head-cancelled compared to head-active conditions.

Conditions

  • Internuclear Ophthalmoplegia
  • Palsy, Abducens

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • Presence of OCNP in one eye with 50% range-of-motion limitation or worse - Able to provide informed consent and will be able to fluently read and understand spoken English OCNP Group

Exclusion Criteria

  • Presence of bilateral OCNP - Range of motion better than 50% - Visual acuity worse than 20/100 in either eye - Greater than 4-line difference in visual acuity between the eyes, - Structural anomalies or sensory sensitivities (e.g. visual motion sensitivity) that would prevent them from wearing or tolerating a VR headset Participants will be excluded if they are unable to participate if inclusion criteria are not met. Normal Group Inclusion Criteria: - Absence of OCNP or other neurological or neuro-ophthalmic diseases - No strabismus - Have normal or near-normal vision with glasses or contact lenses. - Be able to provide informed consent and will be able to fluently read and understand spoken English Normal Group Exclusion Criteria: - Visual acuity worse than 20/100 in either eye - Greater than 4-line difference in visual acuity between the eyes - Structural anomalies or sensory sensitivities (e.g. visual motion sensitivity) that would prevent them from wearing or tolerating a VR headset - Known inability to tolerate visual testing of at least 20 minutes continuously.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Crossover Assignment
Intervention Model Description
Subjects perform study tasks under head-active conditions, and then are crossed over to the head-cancelled condition.
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Head Cancelled
Study tasks performed in head-cancelled conditions
  • Behavioral: Head-cancelled virtual reality
    Scene in virtual reality moves with the head while performing visual tasks.
No Intervention
Normal
Study tasks performed in normal conditions.

Recruiting Locations

Brooks Rehabilitation Hospital
Jacksonville, Florida 32216
Contact:
Hannah Grimes
904-345-7373
Hannah.Grimes@Brooksrehab.org

Vision Source of Worcester
Worcester, Massachusetts 01610
Contact:
Kevin E Houston, OD
508-753-5103
khouston@wsvisionsource.com

More Details

Status
Recruiting
Sponsor
Kevin Houston

Study Contact

Kevin Houston, OD
508-753-5103
khouston@wsvisionsource.com

Detailed Description

Participants with abducens palsy or internuclear ophthalmoplegia, two common types of ocular cranial nerve palsies, will perform 3 different tasks in virtual reality under head-cancelled and head-active conditions. Head active is the normal state, where gaze can be shifted by moving the head, the eyes, or a combination of the two. Head-cancelled refers to the condition where the scene moves with the head, rendering head movement ineffective to shift gaze. In this condition, the eyes must move in order to shift gaze. The hypothesis is that this requirement for eye movement will result in larger eye movements, which could be therapeutic. The tasks performed under the two conditions will include horizontal transposition of coins, repetitive horizontal saccades, and game play. The primary analysis will be a within subject's comparison of eye movement amplitude in head-cancelled (experimental) versus head-active (control) conditions. Additionally, as a control comparison for secondary analysis, a group with normal vision will also perform the tasks under both conditions.