Smartphone-Driven Augmented Reality Headset for Low-Light Mobility Assistance in Retinitis Pigmentosa

Purpose: To evaluate the effectiveness of a smartphone-driven augmented reality (AR) headset in expanding the functional visual field and improving mobility performance under low-light conditions in patients with retinitis pigmentosa (RP). Design: Prospective, single-center before-and after study. Subjects: Thirty-two patients (18 females, 14 males; median age: 55.5 years) with genetically confirmed typical RP, a binocular uncorrected distance visual acuity (BUVA) of ≥ 20/200, and VF restricted to < 10 degrees in both eyes. Methods: Participants were assessed at baseline and under AR-assisted conditions. The AR system consisted of XREAL One glasses paired with an iPhone 15. Visual function was evaluated through ETDRS visual acuity, Pelli-Robson contrast sensitivity, and tangent screen perimetry. Functional mobility was assessed using the Multi-Luminance Mobility Test (MLMT). Data were analyzed using paired t-tests and Wilcoxon signed-rank tests. Main outcome measures: The primary outcome was the change in MLMT score, secondary outcomes included changes in binocular visual field area, contrast sensitivity, and uncorrected binocular visual acuity (BUVA) with and without the AR device. Results: Use of the AR headset resulted in a ∼3.4-fold enlargement in binocular VF (P < .001) and a median improvement of 3 points in MLMT score (from median 3 to 6; P < .001). The proportion of patients able to complete the MLMT at 1 lux increased from 0% to 88%. While standard minification mode reduced BUVA by 0.58 logMAR (P < .001), the 4 × mode maintained baseline acuity (P = .166) and improved contrast sensitivity (P < .001). Conclusions: This study demonstrates that a consumer-grade AR headset combined with a smartphone can deliver substantial improvements in low-light mobility and visual field function for RP patients, offering a scalable and affordable alternative to conventional low-vision aids. These findings highlight the potential of leveraging consumer technologies for accessible, patient-centered visual rehabilitation.