Vestibular-Ocular Reflex Testing Using Commercially Available Mixed-Reality Headsets

Silas W. Acker et al.
Fri, 17 Apr 2026 10:45:00 PDT

The Vestibulo-Ocular Reflex (VOR) stabilizes vision during head movements through a coordinated interaction between the vestibular apparatus’s ability to sense position and acceleration and the ocular muscles that move the eye. Vestibular hypofunction can cause dizziness, blurred vision, create the perception of movement in stationary objects, dizziness, and nystagmus, a condition where the eye moves involuntarily. The presence and extent of dysfunction are typically assessed by evaluating the movement of the eye during tracking and target acquisition tasks. In addition to dedicated clinical equipment specifically designed to track eye movements, currently available mixed reality headsets are also able to perform these tasks. Although designed for non-scientific functions, the available headsets readily allow developers to record and extract the eye-tracking results.

This study aims to evaluate whether the eye tracking capabilities of commercially available mixed reality headsets(HTC Vive Focus, Meta Quest Pro), can generate clinically acceptable measurements during standardized vestibular-ocular testing.

We replicated the testing sequence of a well-validated laboratory-grade system(Interacoustics Visual Eyes), for administration in the immersive virtual reality systems. Participants (n= 20) completed identical vestibular-ocular testing on the three systems. The tests assessed the point of gaze, accuracy to target, saccade duration and latency, and visual gain during the following tasks: stationary gaze, smooth pursuit, random saccade, and dark-room nystagmus. Participants completed the testing in a randomized order for devices. Time-series eye-position data were exported from the respective systems and analyzed in custom-developed software.