Effect of 360° VR and 2D Videos on Patient Anxiety in Outpatient Ophthalmologic Care

Background Previous research on ambulatory care pathways has identified recurring issues such as high patient anxiety, disorientation, and insufficient information, all of which negatively impact the patient experience. However, evidence remains limited regarding how different preparatory media may effectively mitigate these factors in real clinical settings.

Objectives The present study aims to assess whether viewing a video of an outpatient ophthalmologic pathway prior to the day of surgery-either as a conventional 2D video or as a 360° immersive video experienced in virtual reality (VR)-reduces patient anxiety and disorientation compared with a control condition without media support. In addition, the study aims to determine which medium is most effective and to explore how anxiety, orientation, and information can be assessed in ecological clinical settings.

An in-the-wild user study is planned with approximately 180 patients undergoing outpatient ophthalmologic surgery. Participants will be assigned to one of three groups: a control group (no video), a 2D video group, or a 360° VR video group. Preoperative state anxiety will be measured using a Visual Analog Scale for Anxiety (VAS-A) at two time points: baseline (preoperative consultation) and immediately before surgery. The primary outcome will focus on the proportion of patients whose preoperative anxiety is lower than baseline anxiety. Disorientation, perception of signage, and patient information will be assessed using post-operative questionnaires. Secondary outcomes will include perceived anxiety during hospitalization, perceived quality of information, and reported feelings of disorientation during the ambulatory pathway.

Inclusion criteria

• Participants should be over 18
• Have all the cognitive and mental abilities
• Speak french
• Have a programmated ophthalmology surgery in outpatient
• Have binocular corrected visual acuity > 5/10 (20/40 Snellen)

Exclusion criteria

• Persons referred to in Articles L.1121-6 to L.1121-8 of the French Public Health Code (CSP) (guardianship, trusteeship, legal protection, etc.)
• Patients undergoing surgery under general anesthesia
• Patients undergoing emergency surgery
• Surgery not performed within one month following the preoperative appointment (except for the control group)

For the group participating in the VR experiment:

• Any medical condition preventing immersion in virtual reality (e.g., epilepsy, dizziness/vertigo, psychiatric history, use of medication or substances with psychoactive effects, etc.)