頭戴式虛擬實境對於年輕成年人之雙眼視覺及眼球表面影響及調查

目的：藉由調查年輕人玩虛擬實境(Virtual Reality, VR)一段時間後的雙眼視覺是否有差異及疲勞程度去推測對生活的影響。方法：我們招募了30位年齡20至35歲之間且無任何眼睛受損或手術，並進行20分鐘VR遊戲。於使用VR遊戲之前(基準值)與之後進行相關檢測包含視力、瞳孔間距、主利眼(Dominant eye)、眼內壓(Intraocular pressure, IOP)、遮蓋測試、馬篤式鏡(Maddox rod)、眨眼頻率、調節幅度(Accommodative amplitude, AA)、調節靈敏度(Accommodative facility, AF)以及非侵入性淚膜破裂時間(NIKBUT)。利用HTC VIVETM 頭戴式(Head mounted display, HMD)VR進行遊戲。將NIKBUT檢測放置於基準值檢測中最後一項及使用VR完後的第一項。此外，主觀表現透過問卷形式去評估日常使用電子產品之習慣和使用完VR後的感知影響。結果：視覺檢測上視力值於右眼近距離有顯著上升(p = 0.031)，眼內壓也同樣於使用後右眼有明顯下降(p = 0.024)；在雙眼視覺上，使用馬篤式鏡發現於遠距離水平有往外隱斜位的方向偏移(p = 0.024)，雖近距離也有如此趨勢，但其並不顯著；對於調節力而言，調節幅度（Amplitude）於兩眼使用VR後並無太大改變(皆p > 0.05)，不過靈敏度(Facility)方面於雙眼及左眼皆顯示有明顯上升的現象(分別為p = 0.029及p = 0.013)；眼表面相關檢查上雖然NIKBUT於兩眼中皆有下降趨勢，但並不顯著。而眨眼頻率發現有明顯之增加(p ＝ 0.011)；於主觀之調查上發現有超過一半認為使用後之視覺清晰度是差不多，25.8%為稍微模糊。有32.3%不會有暈眩狀況，其餘則有不同程度之頭暈現象。只有19.4%不會有視覺疲勞之症狀，眼睛整體評估有32.3%認為與使用前之狀態一樣好。結論：使用20分鐘VR後對於視力值與眼內壓有一定影響，雙眼視覺上客觀之眼位於遠距離有往外偏移之現象，但並不出現於近距離上。調節力於靈敏度上有上升之趨勢，而眨眼頻率也會增加。雖然視覺清晰度並無太大改變，但暈眩及疲勞程度占大多數，顯示VR對眼睛主觀感受有一定的負擔，未來使用時應注意使用習慣及配合相關眼睛照護人員之檢測結果來達到兼具娛樂及保護眼睛之功效。

Purpose：Investigate and compare with the effect in binocular vision and ocular surface using virtual reality (VR) head set among young adults.Methods：We recruited 30 participants which aged 20 to 35 without any ocular injure or surgery to perform a VR game for 20 minutes. Examinations include visual acuity (VA), interpupil distance, dominant eye, intraocular pressure (IOP), cover test, Maddox rod, flipper, blink rate, amplitude of accommodation (AA) and non-invasive keratograph break up time (NIKBUT) before (baseline) and after the exposure of VR game using HTC VIVETM headset device. We arranged the NIKBUT as the last test in baseline and the first after VR exposure. Furthermore, subjective performances through questionnaires to evaluate the habitual of using electronic devices and the perceptional effect after the VR game.Results：Right eye VA was significantly improved at near (p = 0.031). So as right eye IOP dropped after exposure (p = 0.024); On binocular vision, horizontal phoria with Maddox rod had exophoric shift at distance (p = 0.024), though same trend was found at near with not significant.; There were no significant change on AA in both eye (p > 0.05), but the AF in binocular and left eye were increased (p = 0.029 and p = 0.013, respectively).; NIKBUT in ocular surface were dropped in both eye but not significant. Blink rate was found to increase (p ＝ 0.011).; With subjective evaluation, over half subjects felt no difference in visual clarity, 25.8% felt little blur. 32.3% did not have dizziness and the rest had various giddiness. Only 19.4% had no visual fatigue and 32.3% felt the same as before exposure.Conclusions：There was a certain influence on VA and IPO after using 20 minutes of VR. The objective phoria showed an exophoric shift at distance but not at near. AF had an increasing trend, so did blink rate. Visual clarity did not change much but dizziness and fatigue in majority. This showed that VR would have certain impact on subjective ocular feelings. One must pay attention to the usage of VR and cooperate with ocular relative professionals to make sure to protect our eye while having fun.