Learning through Immersive Experiences: Simulating Cerebral Visual Impairment

Understanding how illness and disease might be experienced by another person is easier said than done. Yet, with the advent of virtual reality (VR), there are growing possibilities. Virtual reality transcends physical boundaries, allowing users to immerse themselves in interpretations of the lived experiences of others, often shedding new light on misconceptions.

A flourishing interdisciplinary team based in the School of Medicine is using VR to improve awareness of a complex form of visual impairment due to brain processing difficulties. The disorder is called cerebral visual impairment or CVI.

There are many brain processes dedicated to creating vision. These allow us to see clearly in colour, recognise people, places and things as well as move safely and reach for objects accurately.  CVI arises when one or several of those processes are not working properly.

A major NHS funded study found as many as one in thirty children in mainstream schools might be affected by CVI.  This can lead to difficulties at school with learning and friendships leading to stress and anxiety. Premature birth and complications around the time of birth can cause CVI. As neonatal care improves, more children survive with brain injuries and CVI is becoming increasingly common. The national register for visual impairment in Scotland shows the leading cause of low vision amongst children to be due to some form of CVI. This is also being reflected in lower resource regions where better early childhood health care is leading to lower mortality rates with more infants surviving but with brain injury.

Although CVI is common, it is poorly understood. There is consequently a clear need for accessible resources to help understand the lived experience of CVI. This can encourage increased awareness and empathy translating into improvements in support.

To this end, an interdisciplinary team was formed to establish resources to improve the public understanding of CVI through VR simulations. Dr Andrew Blaikie, is a consultant ophthalmologist in NHS Fife and Senior Lecturer in the School of Medicine, working in the Infection and Global Health Division. Helen St Clair Tracy is Honorary Lecturer in the School of Medicine and runs the International NGO CVI Scotland.  Helen’s son has CVI.  From the School of Computer Science, Dr Alan Miller, also of Smart History and Open Virtual Worlds, brings his expertise in virtual reality technology. The charity CVI Scotland brought their global network of professionals, and critically, the CVI Community, including parents of children with CVI and adults affected by CVI to engage with the project.  From this collaboration, the project grew, with the CVI Community central to all developments, to become CVI-SIM.

The team have developed simulations of many different forms of CVI which can be experienced in a variety of virtual environments, including a mainstream school, a special school, a museum with a professionally curated climate change exhibition, houses and the great outdoors, with more exciting additions currently in development. The programme is a world first and has been designed to create vision based on descriptions of the experiences of the CVI community.

The team have short videos to demonstrate the project’s developments

The programme, shared through many short videos made by the team, has received overwhelmingly positive feedback from teachers, ophthalmologists, parents, carers, therapists and charity workers. Through demonstrations, different groups have had the opportunity to experience these VR environments and ‘see’ how the world may be perceived by those with CVI. CVI-SIM has been showcased around the world, including at international conferences and many teacher training days.  As the resource is a visual simulation, it is a common language, so suitable for all. Parents are now regularly using videos from the project to show their child’s teachers to help explain their need for support.

The ultimate aim of the CVI-SIM project is to improve the care provided to, and quality of life of those affected by CVI. This project is not only raising awareness of CVI but building a platform for new and innovative research regarding the condition. The resources developed, through the CVI Scotland website, are used in nearly every country in the world.  Some have even identified undiagnosed CVI in themselves through watching CVI-SIM videos.

VR is used to demonstrate how visual perception may be influenced by CVI

Through their collaborative efforts, the teams in Medicine and Computer Science, with their partner CVI Scotland, are promoting good health and wellbeing in line with the SDG 3. In addition, through their integration of the climate change museum in the virtual environment and engaging with educators, this project also addresses SDG 4 – quality education.

VR has been deemed the “ultimate empathy machine” due to the way it elicits presence and engages its users, and is identified as one of the best resources to evoke empathy towards poorly understood groups. This new immersive experience is therefore a powerful pathway to understanding CVI and generates empathy for those who live with it.  Through further planned developments, including a free app, more people around the world will be able to easily try the simulations, and translate their understanding of CVI from the immersive experience into improvements in support and care. The CVI-SIM team exemplifies the transformative potential of immersive technology in promoting health and well-being, crossing barriers of  where those affected live in the world, what resources they have and educational abilities, making it both inclusive and accessible.