The accessibility of commercial off-the-shelf VR for low vision users: a macular degeneration case study

Virtual Reality is demonstrating increasing potential for therapeutic benefit in elderly care, but it is still generally considered to be the domain of the visually unimpaired. Even where VR and AR are being explored for use with low-vision, it is generally with a focus on creating bespoke software and hardware. However, the properties of even commercial off-the-shelf (COTS) headsets, such as high luminance, may render them accessible even to very low vision users.
Using a case-study approach, we explored the differences in visual perception from baseline to pass-through AR and commercial VR applications for an elderly female (Mrs M) with advanced age-related macular degeneration (AMD).
We found notable improvements in object, face and colour recognition, particularly with higher display brightness. Furthermore, Mrs M was able to engage fully and enthusiastically with a number of (unmodified) VR applications, providing detailed descriptions of both static and moving elements.
We suggest that the high luminance available in COTS VR may support more stable fixation closer to the fovea, improving visual resolution. Furthermore, the improvements we noted in colour perception support previous suggestions that increasing luminance may improve photosensitive by reducing the uptake of limited oxygen by the rod cells.
We conclude that low vision should not automatically preclude users from engaging in virtual reality research or entertainment, and that they may be able to use well-illuminated VR applications without any special modifications.