Virtual Reality-Real Life Health Problem

In Neal Stephenson's 1992 seminal science fiction novel Snow Crash, characters traverse the metaverse, an imaginative network of virtual realities, where they are often judged by the technical quality of their avatars. What Stephenson does not reveal is how his characters manage to get past the problems of cyber-sickness and other health-related side effects of virtual reality that our real-life medical community is just now trying to wrap its collective mind around.

If you have never worn a virtual reality (VR) headset, trust me, you will soon enough. At the most recent Consumer Electronics Show this January in Las Vegas, VR was the technology. Big-name international gadget manufacturers like Samsung, Sony and Microsoft unveiled new gear that, frankly, was overwhelming in its capacity to create animmersive experience. And therein lies the problem.

Cyber-sickness, sometimes called virtual reality sickness or sim-sickness, looks to be a not insignificant hurdle for the nascent VR industry to vault. Indeed, Samsung, manufacturer of probably the best known of the VR hardware -- “The Gear VR,” the device powered by Oculus Rift tech – provides buyers with a lengthy disclaimer about side effects. It warns, in part, about seizures, loss of awareness, eye strain and nausea.

The famous inventor and futurist Ray Kurzweil once opined that “By the 2030s, virtual reality will be totally realistic and compelling and we will spend most of our time in virtual environments... We will all become virtual humans.” If Dr. Kurzweil's future is to be a healthy one, we are going to have to step up our game against cyber-sickness.

So why exactly do we get ill traipsing around in cyberspace? The physiology behind it is not completely understood, but most researchers use sensory conflict theory as their jumping-off point. The premise there is that we spend our lives with our senses in perfect synchronicity, which is the way our brain likes it, but virtual environments fracture that harmony. The real world, it should come as no surprise, has a perfect “refresh rate.” Those screens in front of your eyes in that VR headset? Not so much. When our visual perception of a virtual world lags behind what the brain expects, we can experience symptoms similar to those suffering from motion sickness. These include headache, nausea, fatigue, increase in appetite, increased bowel movements, and drowsiness, among others.

The brain coordinates vestibular data – information it receives from our five senses – with data received from our proprioceptors, which reconcile where we are—or should be—based upon how our muscles are moving. This “sense of movement” is often called kinesthesia, and originates in what we commonly refer to as our inner ear. In short, cyber-sickness is caused by our eyes seeing one thing, and our inner ear believing something else.

In studies performed at the UCLA Keck Center for Neurophysics, 60 percent of the neurons in lab rats' hippocampuses simply “shut down” while the beasts experienced virtual reality. The hippocamus is the part of a rat's brain – and our own – which is responsible for mapping location in space. Why the shutdown? And what are the long-term consequences? More research is still needed for these answers. Interestingly, the earliest research in the area of cyber-sickness comes from NASA and the military, but this yielded more statistics than it did solutions.

Is there hope on the horizon? With the amount of money at stake in the burgeoning industry of virtual reality, with applications in movies, games, medicine, and so much more, you bet your goggles there is! One such hopeful glimmer can be found in new headset technology known as retinal projection. Embedded in the headsets manufactured under the name “The Glyph” by Avegant, this tech reduces eyestrain by using reflected light, instead of direct exposure. The company's co-founder and Chief Technical Officer, Allan Evans, claims the process makes better use of the brain's role as an image processor. It is worth noting that “The Glyph” won “Best of CES” this year.

Manufacturers are also turning to software to address some of the cyber-sickness issues. Perhaps taking a cue from World of Warcraft, EverQuest, and other such immersive fantasy games, some VR user experience designers are replacing running and walking to virtual destinations with teleportation.

As usual, common sense plays a part in prevention as well. Both Samsung and Oculus warn that travelers to virtual worlds should limit their stay to 10 minutes.

One thing author Neal Stephenson does get right, from a medical point of view, is that for VR to have a truly healthy future, it must be communal. Current VR experiences now are mostly isolated. Sure, the promise of VR is that you can stroll down a street in Paris or climb the side of a mountain in Tibet or enjoy almost any travel experience imaginable, but never forget that Homo Sapiens is a social species. There is a justifiable concern that, as virtual worlds become more customizable, more tailored to users' individual needs and fantasies, our desire to experience first hand, with others, what we then can experience virtually on our own, will diminish.  

Remember: That baby you saw today being pushed along in a carriage at the mall will grow up in a world where VR is as pervasive in their life as the Internet has become for today's millennials. This generation of medical researchers, software developers and gadget manufacturers has an obligation to ensure that their virtual worlds will be safe ones.