Article Text

Download PDFPDF
Population eye health education using augmented reality and virtual reality: scalable tools during and beyond COVID-19
  1. Dinesh Visva Gunasekeran1,2,3,
  2. Rebecca Low1,4,
  3. Ruvendren Gunasekeran5,
  4. Benedict Chan1,
  5. Hong Ya Ong1,
  6. Dhananjay Raje6,
  7. Helen Mi4,
  8. Carlos Pavesio2,
  9. Quan Dong Nguyen3,
  10. Rupesh Agrawal2,4
  1. 1 National University of Singapore, Singapore
  2. 2 Ophthalmology, Moorfields Eye Hospital, London, London, UK
  3. 3 Ophthalmology, Stanford Medicine, Palo Alto, California, USA
  4. 4 National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
  5. 5 School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore
  6. 6 MDS Bioanalytics, Nagpur, India
  1. Correspondence to Dr Dinesh Visva Gunasekeran, National University of Singapore, Singapore 119077, Singapore; dineshvg{at}; Professor Rupesh Agrawal, NHG Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore; rupesh_agrawal{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Summary box

What is already known?

  • Immersive technology such as augmented reality (AR) and/or virtual reality (VR) could be applied for health promotion in a scalable manner.

What are the new findings?

  • This investigation highlights the potential role of immersive technology such as augmented reality (AR) and/or virtual reality (VR) for scalable health promotion.

  • There were no safety issues encountered, and patients did not report any symptoms such as motion sickness with use of AR and/or VR.

  • Patients had demonstrably improved understanding about glaucoma and the importance of eye screening after utilisation of these immersive tools for eye health.

  • This can positively impact healthcare by improving patient understanding about the importance of screening if such solutions are made available when patients are waiting in primary care and/or ophthalmic clinic settings whereby busy practitioners may not have the bandwidth to discuss screening in detail.

  • These can be made available in primary care and/or ophthalmic clinic waiting rooms, where busy practitioners may not have the bandwidth to discuss screening in detail.


The COVID-19 outbreak has had a massive impact on healthcare systems, with over 12 million infected individuals as of 10 July 2020.1 This has necessitated operational overhaul in ophthalmology and other clinical specialties in accordance with public health measures such as physical distancing and cancellation of non-urgent clinical services.2 The downstream impact of these measures include the disruption of healthcare functions including preventive programmes such as eye screening, which serve a crucial role to detect disease at early stages before the onset of irreversible morbidity such as visual impairment (VI).

VI is already a growing problem even in developed countries.3 By 2020, estimates show that 230 million individuals will be affected by VI,4 and that 20 million across Asia are already severely affected to the point of blindness.5 Studies have attributed an increased risk of death to VI6 7 …

View Full Text


  • DVG and RL are joint first authors.

  • Contributors RL, RG, BC, HYO and DVG contributed to the conception of the research, collection of data and drafting of the manuscript. DR contributed to the data analysis and drafting of the manuscript. HM, CP, QDN and RA contributed to the study design, data interpretation and drafting of the manuscript.

  • Funding The study was partially funded by Tan Tock Seng Hospital (TTSH), Singapore which supported the research staffing hours contributed by study team members employed by the hospital (Funding/grant number: nil).

  • Disclaimer Funders played no part in design and conduct of the study, collection of the data, preparation or approval of the manuscript, nor the decision to submit the manuscript for publication.

  • Competing interests RL, BC and HYO are supported by grants from the National Youth Council (NYC) of Singapore and the Medical Grand Challenge (MGC) of the National University of Singapore (NUS). DVG reports investment in DoctorBell (acquired by MaNaDr, Mobile Health), VISRE, AskDr and Shyfts. He declares receipt of travel funding from the Mobile Health Education grant, Commonwealth Fellowship in Innovation award and National Youth Fund award, for clinical research training and collaborations at Oxford University and Stanford University. He reports serving as senior lecturer and faculty advisor to the medical innovation program of NUS.

  • Provenance and peer review Not commissioned; externally peer reviewed.