Jonathan Myers, M.D., on home VR perimetry and glaucoma reimbursement

Virtual reality goggles could let patients with glaucoma track their visual fields from home, but the lack of insurance reimbursement remains one of the major barriers to adoption, according to Jonathan Myers, M.D., chief of Glaucoma Service at Wills Eye Hospital in Philadelphia.

Myers and his colleagues presented the data at the 2026 American Academy of Ophthalmology in a poster session titled ‘High-Frequency Home Monitoring of Glaucoma With Virtual Reality Perimetry: A 2-Year Prospective Longitudinal Study.’

Myers and colleagues conducted a two-year study of home virtual reality perimetry in 53 patients with glaucoma, using a headset platform from Olleyes, one of roughly two dozen commercially available virtual reality perimetry systems. Participants completed nearly 4,800 home tests over the study period, alongside more than 750 traditional visual field tests in the office. The team is continuing to analyze the data. At 24 months, adherence was 87% by the study’s measure, with most participants still testing at least monthly.

Earlier work from Myers' group and other investigators found that virtual reality goggles produced results similar to conventional desktop perimetry when used in the office. The open questions, he said, are whether the test performs as well at home without an ophthalmic technician coaching patients to stay engaged, whether patients will keep testing as directed over time, and whether more frequent testing can detect worsening sooner. Because visual field results fluctuate from test to test, a larger volume of tests may help clinicians spot progression earlier. “Maybe if we do more tests, we’ll be able to tell earlier if people are getting worse from glaucoma,” Myers said.

There is currently no insurance code for home perimetry, Myers noted, which means no reimbursement pathway for the hardware, the software, the physician’s interpretation or patient counseling. He compared the situation to home blood glucose and blood pressure monitoring, which now have durable medical equipment and physician billing codes that support patient access. “We need that in glaucoma for home perimetry,” he said.

Myers acknowledged that most physicians are cautious about adopting new technology until it is proven safe and effective and said the science is not yet fully there for many of these devices. Insurers may make a similar argument against funding home testing, a concern the two-year study was designed in part to address. “So hopefully we now have a data set that can really speak to the concerns of the insurers in terms of the value,” he said.