Evaluation of the Deep Reality Viewer for teaching slit lamp examination of the anterior segment and the optic nerve head.

PURPOSE: A major challenge in teaching slit-lamp biomicroscopy is providing adequate depth perception and anatomical detail; the Deep Reality Viewer (DRV) addresses this by enabling stereopsis. This study evaluated the utility of DRV for slit-lamp examination (SLE) teaching and compared it with 2-dimensional monitors. METHODS: In this single-centre prospective comparative study, 33 medical learners completed a qualitative assessment comparing DRV versus 2-dimensional (2D) monitors for SLE of the anterior segment and optic nerve head (ONH). Perceived educational value and task-specific utility were compared across 16 Likert-scale (1-5) parameters in 4 domains: image quality, anatomical visualization, user experience, and teaching utility. The primary outcome was the comparison of teaching utility ratings between modalities. Secondary outcomes included composite domain scores, trainee-level differences, and intermodality agreement for ONH assessments. RESULTS: Median [IQR] DRV was rated significantly higher than 2D monitors for image quality (4.3 [4.0-4.6] vs 3.5 [3.3-4.2]; p < .001), anatomical visualization (4.4 [4.0-4.8] vs 3.6 [3.2-4.3]; p < .001), and teaching utility (5.0 [4.5-5.0] vs 4.0 [3.8-4.8]; p < .001). Cup-to-disc ratio estimates showed minimal systematic bias (mean differences -0.01 to 0.03) with no significant difference in variability between DRV and 2D monitors (all p > .05). Subjective ratings of ONH visual quality did not significantly differ between modalities (all p > .05). CONCLUSIONS: DRV may be a useful tool to improve SLE teaching, as its perceived image quality and depth perception appear superior to 2D monitors.