A technology that changed jobs
Virtual reality headsets were built to show scenes, and the first customers that paid for them were researchers and then game players. Medicine became interested for practical reasons. A headset can place a person in a controlled situation that is hard to arrange in real life, and it can record where the person looks and moves. This article describes how the technology moved across, as history only. It is not advice, and it makes no claim about what any treatment can do. Reports of benefit in this field come from research studies, and many are small or preliminary.
Early medical visualization
Some of the first medical interest in the 1980s and 1990s concerned visualization and training, not therapy. Research groups explored virtual models of anatomy, planning of operations from scan data and simulated surgical procedures. Data from medical imaging, such as computed tomography scans, could be turned into three-dimensional models that a surgeon might inspect from any angle. Early surgical simulators used headsets or stereoscopic screens with force-feedback devices intended to mimic the feel of tissue. Hardware was costly and graphics were limited, so these were mostly research systems.
The related field of surgical robots shared some of the same ideas, including three-dimensional viewing and remote control, though it developed on its own track.
The 1990s clinical experiments
Mid-1990s psychology laboratories began testing whether virtual environments could be used in treatment research. Groups such as the one at the Georgia Institute of Technology reported early studies on fear of heights using a headset in 1995, and researchers elsewhere explored fear of flying and other anxiety problems. At about the same time, rehabilitation researchers used virtual environments to study movement training. The ideas and results of that early research are described in the separate article on early therapy research.
These projects typically relied on expensive equipment and graphics hardware borrowed from entertainment and military research. A hospital or university had to budget for a computer worth many thousands of dollars along with a headset, which limited studies to well-funded centers.
Crossover after the consumer wave
The consumer headsets of 2016 changed the economics. Displays, sensors and graphics hardware made in large volume for gaming were now available for a small fraction of earlier prices. Researchers could buy off-the-shelf headsets, and developers could use the same game engines and software tools as entertainment studios. As a result, the number of clinical VR studies and pilot projects rose sharply during the 2010s and early 2020s, covering areas such as pain distraction during procedures, anxiety, rehabilitation and training for clinicians.
The technology has also supported eye-tracking research, balance and vision tests, and the simulation of environments for patients’ cognitive assessment. Controllers developed for games became useful for tracking hand movement in rehabilitation studies. Related research on prosthetic limbs and brain-computer interfaces sometimes uses virtual environments for practice and testing, since a virtual arm is safer and cheaper to experiment with than a physical one.
Training clinicians
Training is often described as the least controversial use. Medical students and nurses can rehearse emergency procedures, patient communication and operating-room routines in a virtual setting. Simulation has a long medical tradition, from anatomical models to mannequins, and headsets are the latest addition. Studies suggest simulation can help learners practice, but the evidence for headsets compared with other kinds of simulation is still developing.
Regulation and caution
Whether a VR application counts as a medical device depends on what it claims to do and on the rules in each country. Some software has received regulatory clearance for specific uses, while many products sold to the public are for wellness or entertainment and are not intended to treat conditions. Anyone with a health concern should speak with a qualified professional, not rely on a headset program.
Known drawbacks include motion sickness, eye strain and disorientation in some users, and the cost of equipment and hygiene procedures in clinics. Research also faces problems with study design: it is hard to run blinded trials when participants know they are wearing a headset.
The crossover pattern
This history follows a familiar pattern in technology. A device developed for one market becomes cheap through volume, and another field adopts it. The same happened with graphics chips, which drive both video games and medical imaging software, and with smartphone sensors. For VR, the move from gaming to clinics has been driven largely by cost and availability, and the long-term clinical value is still being studied.