Virtual reality (VR) and augmented reality (AR) technologies are transforming the way ophthalmologists learn cataract, retinal and other microsurgical procedures, a new review shows.
The review highlights how VR and AR are emerging as powerful tools in ophthalmic surgical education, offering trainees a safer and more accessible way to develop surgical skills before operating on patients.
Published in Clinical Ophthalmology on 25 May 2026, it also identifies areas where further validation is needed.
Researchers from Oregon Health and Science University, Florida Atlantic University and the Veterans Affairs Portland Health Care System in the US authored the paper entitled Virtual Reality in Ophthalmic Surgical Education: Current Innovations and Future Perspectives.
They say traditional ophthalmic training relies heavily on wet-lab practice using model or cadaver eyes, followed by supervised surgery on live patients. But although effective, they say these approaches can be resource-intensive and carry higher complication risks when surgeons are at the start of their learning curve.
“Virtual reality technologies offer a structured learning environment in which ophthalmology residents can practice independently without relying on senior supervision or live patients,” the researchers wrote.
The review examined a growing range of VR platforms, from ophthalmology-specific simulators such as Haag-Streit’s Eyesi, HelpMeSee and the Alcon Fidelis, to consumer devices including Apple Vision Pro and Meta Quest.
Among established systems, Eyesi remains the gold standard, say the researchers who report no conflicts of interest. The simulator has been widely adopted by residency programs worldwide and is supported by extensive evidence showing it improves surgical performance, trainee confidence and reduces complications, they say.
HelpMeSee has also demonstrated promising results, particularly for manual small-incision cataract surgery (MSICS). Studies cited in the review found trainees using the platform made significantly fewer surgical errors and that the simulator could reliably distinguish between novice and experienced surgeons.
Newer technologies
Newer technologies are broadening the scope of training, they found. The Apple Vision Pro, paired with ZEISS Surgery Optimizer software, enables trainees to review cataract surgery recordings in three dimensions, creating an immersive experience that closely mimics looking through a surgical microscope.
While they found that formal validation studies are still lacking, the technology may enhance learning by allowing residents to analyse their own procedures and observe surgeries performed by experts.
Meta Quest-based applications are also gaining attention. RetinaVR, designed for vitreoretinal surgery training, has shown preliminary evidence of construct validity, with experienced surgeons outperforming novices on measures of precision and safety.
The American Academy of Ophthalmology’s VR Education app allows trainees to practise diagnosing and managing retinopathy of prematurity in a virtual environment.
The reviewers say one advantage of consumer headsets is affordability. Dedicated simulators such as Eyesi can cost more than A$235,000, while devices like Apple Vision Pro and Meta Quest offer a lower-cost entry point for training institutions.
They believe artificial intelligence could further enhance VR education by automatically assessing surgical skill, identifying complications and providing personalised feedback based on surgical recordings.
They caution that many emerging platforms still lack robust validation studies and long-term clinical outcome data, and larger studies and standardised evaluation methods are needed before VR can fully realise its potential.
They conclude that immersive technologies are poised to play an increasingly important role in ophthalmic education, making surgical training more efficient, scalable and accessible worldwide.
“VR platforms are expanding ophthalmic education, with some, but not all, technologies already demonstrating promising validity,” they conclude. “The future may involve integration of AI-driven analytics and 3D surgical environments capable of simulating complex intraoperative scenarios ranging from shallow chambers to zonular dialysis.
“With continued validation, VR-based platforms could significantly elevate the scope and effectiveness of ophthalmic surgical training.”
