Broadcast Retirement Network’s Jeffrey Snyder discusses virtual eye exams with UC Davis Health’s Allison Liu, M.D., Ph.D.
Jeffrey Snyder, Broadcast Retirement Network
Two. One. Joining me now is Dr. Allison Liu of UC Davis Health. Dr. Liu, it’s so great to see you. Thanks for joining us this morning.
Yin Allison Liu, M.D., Ph.D., UC Davis Health
Thank you for having me.
Jeffrey Snyder, Broadcast Retirement Network
And they say the eyes are the window into your soul, but doctor, they’re also, in all seriousness, they are the windows into our overall health.
Yin Allison Liu, M.D., Ph.D., UC Davis Health
Yes, that’s very true. We use the eyes to look at a lot of things. We look at some certain diseases, systemic diseases that presents with eye issues.
We also look at cognitive issues that could present with difficulty seeing.
Jeffrey Snyder, Broadcast Retirement Network
Right. And you and your team have done extensive work in this area. You’re actually using virtual reality to help detect Alzheimer’s disease.
Can you talk a little bit about how this works? Is it as easy as putting on a pair of metaglasses, as an example, to kind of see the world? And how does it work?
Yin Allison Liu, M.D., Ph.D., UC Davis Health
So the concept started with us feeling that there is a barrier to diagnosing eye-related cognitive dysfunction because the appointments are booked. Some of the senior citizens cannot really make it to the doctor’s office easily. And the visits in the office tend to be very long.
So a lot of us with back issues or transportation issues, we can’t stay in the office for hours to complete the whole set of testing. So we identified these barriers. And my colleague, Dr. Alberto Gonzalez, is also a neuro-ophthalmologist and glaucoma specialist trained in UC system, now has a company that develops technologies to make these tests easier and portable in the VR platform. So we worked together on building a suite, including most of the testing that we would have done in the office. And we bring this set built in a set of VR goggles to the community. So our senior citizens can sit at their comfortable place, such as we meet them in the gym, we meet them in the library, we meet them by the poolside.
Within 15 to 20 minutes, depending on how many tests we end up doing, how many times we have to repeat, we can give them a screening report of the overall eye health.
Jeffrey Snyder, Broadcast Retirement Network
This way- I’m sorry to interrupt. I was gonna ask you, I mean, it sounds like there is some specialized equipment, but it also sounds like when you, instead of having them come to you or your offices, you can actually deploy someone to go visit the patient. Do I have that correct, doctor?
Yin Allison Liu, M.D., Ph.D., UC Davis Health
Yes. For now, we have medical students who are interested in the field of ophthalmology and neurology. They wanted to learn how we can help the community as doctors.
That’s the first thing, why we become doctors, we want to help people. So then they get to see these participants. Sometimes they are patients, sometimes they are normal, healthy controls, we call them controls, but they are healthy people who just wanted to contribute to the study.
So they get to meet the people where they live. I think it’s a really good way for the medical students to do this because everybody is a person first. Not everybody who’s sitting in our chair, in the bed, on the table, is a patient.
Everybody has a story. So they get to meet with people and also do an eye exam using VR goggles. So it’s a cool project for the medical students to do.
Eventually, we’re hoping to train caregivers or even deploy these devices to the patient’s homes. And as a matter of fact, this device has been deployed to people’s homes to do repeated monitoring of their vision conditions. But for this project, we are deploying ourselves to the community with the technology.
Jeffrey Snyder, Broadcast Retirement Network
Right, and that is a very good goal, obviously, to get this in the hands of more people. One of the things I thought was really interesting is that the ability to detect early signs of Alzheimer’s disease. I’m aware of, I think there’s an FDA-approved blood test that’s out that you can see if you have this, I guess, predisposition.
How does the VR, without going into too many technicalities, how does the VR actually look at the eye? How does looking at the eye actually figure out whether or not you have this dreaded disease?
Yin Allison Liu, M.D., Ph.D., UC Davis Health
So first of all, I’m not an Alzheimer’s disease specialist. My understanding is that in order to formally diagnose Alzheimer’s disease or any kind of cognitive impairment due to Alzheimer’s disease, we’ll need a battery of testing. It’s not just looking at the eyes or looking at your questionnaires or looking at a PET CT or looking at whatever brain imaging that will give you the diagnosis, same thing as a blood marker.
Everything will come together and we need to have an Alzheimer’s disease or a cognitive neurologist to make the final diagnosis with us. But a large chunk of the brain function is to help us see and also help us hear. And because of the sensory input is so important to the brain.
The reason why we can see is not because the eyeballs can see, it’s because the eyeball, the optic nerve and the brain, they have to work together for us to see something, capture the image and interpret what we are seeing. So lots of the brain dysfunction, including cognitive dysfunction, could reflect in the visual tests. So we have done a study which concluded that unexplained visual acuity loss, meaning that I just cannot see, I cannot read, but the eyeballs exam could be fine.
The eye exam could be fine. That’s because the brain cannot interpret this unexplained decreased visual acuity by an eye exam and also decreased color interpretation. So sometimes people would have difficulty interpreting different shades of colors.
That’s also because a certain part of the brain does that kind of function. And also peripheral vision loss. You know, the left side of the brain controls the right side of the peripheral vision.
The same thing in the right side of the brain controls the left side of the peripheral vision. If there’s focal brain atrophy and we could technically see unexplained visual field defect, meaning that the person did not have a stroke, did not have brain tumor, did not have MS, not anything on a traditional MRIs or CTs, but they have a peripheral vision loss. And sometimes they have depth perception issues.
So we can check that on stereo perception. So those are the starter screening set that we do through this VR set. We’re not really looking at the eyes to begin with.
We are actually just looking at the function of the entire visual system. So it looks like we’re doing an eye exam, but we are actually doing the brain function screening. And the next steps, if we have any difficulties, then we will do an eye exam through a mobile clinic where we bring simple equipments to see whether this is just a simple cataract, whether when we dilate the eyes, this is glaucoma, retinal issues such as age-related macular degeneration.
Then we will talk about potential intervention and follow up from there.
Jeffrey Snyder, Broadcast Retirement Network
Yeah. I mean, it’s just amazing how far the technology can be applied and really anyone can access these tests. All they need to do is sign up, get an appointment, and then get these tests.
And you have, like I said before, kind of this open window into a person’s overall health. It really could potentially be a game changer in terms of eliminating chronic disease and also extending longevity. Dr. Liu, we’re going to have to leave it there. It’s so great to see you. Congratulations on all the great work. And we look forward to having you back on the program again very soon.
Yin Allison Liu, M.D., Ph.D., UC Davis Health
Thank you.