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Review of portable visual field devices shows higher patient preference over table-mounted analyzers in rural glaucoma carePortable eye tests beat old machines for rural patients

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Key Takeaway
Consider portable perimetry for telemedicine glaucoma monitoring in resource-limited settings based on patient preference data.

This mixed methods review examined patient preferences for future visual field testing among 271 respondents across three Federally Qualified Health Centers in Alabama. The study compared portable visual field devices, including tablet-based Melbourne Rapid Fields and virtual reality-based VisuALL perimeters, against a table-mounted Humphrey Field Analyzer within the AL-SIGHT study setting.

Key findings demonstrate that 50.6% of respondents preferred VR-based testing, compared to 35.1% for tablet-based and 14.4% for table-mounted devices (Cramers V = 0.31, p<0.001). Satisfaction scores followed a similar trend, with 56.9% very satisfied with VR-based testing versus 49.4% for tablet-based and 38.0% for HFA. Additionally, the VR-based perimeter was selected as the most comfortable device by 55.7% of participants (V = 0.34, p<0.001) and the easiest to use by 54.6% (V = 0.36, p<0.001).

The authors observed that preferences did not vary significantly across demographic variables (all p>0.05). Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. The review concludes that portable perimetry may enhance patient-centered glaucoma monitoring within telemedicine programs and access in resource-limited settings, though clinical outcomes were not evaluated.

People living in rural areas often struggle to get regular eye care. For those with glaucoma, a common eye disease, getting tested can be hard. A new look at how patients feel about testing shows that new portable devices might help. Researchers asked 271 people at three health centers in Alabama what they thought about different testing tools. They compared a new virtual reality device, a tablet-based tool, and the standard table-mounted machine used for decades. The results were clear. More than half of the patients chose the virtual reality device for their next test. They also said it felt the most comfortable and was the easiest to use. Satisfaction scores were highest for the virtual reality option, followed by the tablet and then the older machine. These portable tools could make it easier for people in remote places to get the monitoring they need without traveling far. The study did not find differences based on age or other personal details. While this study looked at what patients prefer, it did not prove that these new tools find disease better or faster. Still, if patients feel more comfortable, they might be more willing to come in for regular checks. This could be a big step forward for care in places with fewer resources.

What this means for you:
Rural glaucoma patients preferred portable virtual reality eye tests for comfort and ease of use.

Study Details

EvidenceLevel 5
PublishedApr 2026
View Original Abstract ↓
Purpose To evaluate patient satisfaction and preferences for portable versus table-mounted visual field (VF) devices in a rural telemedicine setting and identify influencing factors. Methods We conducted a sequential explanatory mixed methods study at three Federally Qualified Health Centers (FQHCs) within the Alabama Screening and Intervention for Glaucoma and eye Health through Telemedicine (AL-SIGHT) study. Participants completed VF testing with table-mounted Humphrey Field Analyzer (HFA), tablet-based Melbourne Rapid Fields (MRF), and virtual reality (VR)-based VisuALL perimeters. Participants rated satisfaction, comfort, ease of use, and future testing preference. Chi-square tests assessed differences in device preferences. Twelve participants completed semi-structured interviews to explore reasons underlying preferences. Qualitative data were analyzed in NVivo 14 using reflexive thematic analysis. Results Among 271 respondents (mean age 60.4 years; 62.4% women), 50.6% preferred VR-based, 35.1% tablet-based, and 14.4% table-mounted for future testing ({chi}2 (2) = 53.52, p<0.001, Cramers V = 0.31). Satisfaction was highest for VR-based (56.9% very satisfied), followed by tablet-based (49.4%), and HFA (38.0%). VR-based perimeter was most frequently selected as the most comfortable (55.7%; {chi}2 (2) = 63.33, p<0.001, V = 0.34) and easiest to use (54.6%; {chi}2 (2) = 71.96, p<0.001, V = 0.36). Preferences did not vary significantly across demographic variables (all p>0.05). Qualitative themes identified four key drivers: comfort and physical experience, visual experience, ease of use and interaction, and psychological and motivational factors. Portability and community suitability were valued. Conclusion Rural underserved patients strongly preferred portable visual field devices, particularly VR-based, over table-mounted HFA. Comfort, ergonomic flexibility, immersive visual experience, and simplicity of interaction were central determinants of preference. Portable perimetry may enhance patient-centered glaucoma monitoring within telemedicine programs and access in resource-limited settings.
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