Western University of Health Sciences students and faculty are getting the first look at a game-changing Eye Movement Simulator that will help health care professionals across all disciplines learn about extraocular muscles and how to perform an eye exam.

WesternU’s 3D Educational Technology department designed the Eye Movement Simulator (SimEye), a realistic 3D web application that simulates the movement of extraocular muscles (EOMs) and pupillary responses. The app simulates the physical examination of EOMs by dragging the computer mouse as the focal point for the eyes. Pathologies can be reproduced using simple checkboxes to activate or deactivate the individual extraocular muscles and cranial nerves that control them. The realistic rendering in 3D provides pupillary responses, as well as blinking by the eyelids. You can test the desktop version at: http://edtech.westernu.edu/3D-eye-movement-simulator/

WesternU is providing the SimEye to all WesternU students and employees as a free app. Click here to download the app: https://edtech.westernu.edu/es2.

“It was really difficult to develop the eye simulator because it involved a lot of complex equations we had to code into the app, but now it gives us confidence to keep working in challenging and interesting projects that will help our students learn and the University be recognized as an innovative institution,” said Sunami Chun, manager of 3D Educational Technology.

The SimEye will soon be launched as a paid app in all app stores, but WesternU students and employees can download the app for free, and also become part of its development. Everyone who uses the app is encouraged to click on the “Feedback” icon on the bottom right.

“That’s part of how we develop things, through collaborations with students and faculty members,” Chun said.

The development of the SimEye started as a collaboration with faculty. WesternU Center for Academic and Professional Enhancement Director Tim Wood, DHSc, PA-C, used a desktop eye simulator application developed by UC Davis when he was a WesternU physician assistant student in the early 2000s, and it left a lasting impression. But the technology that supported that version became obsolete, so Wood came to 3D Educational Technologies with the project concept to create a new eye movement simulator updated for touch screens. Former College of Optometry Assistant Professor Munish Sharma, MD, OD, provided his ocular expertise and technical specifications of ocular muscle movement.

WesternU faculty are incorporating the SimEye into their lessons. College of Optometry Assistant Professor Naida Jakirlic, OD, introduced the SimEye to her students as she explained the positions and fields of action of the extraocular muscles.

“I am using the simulator to demonstrate normal eye movements and to demonstrate how the eye movements would look if a particular cranial nerve is affected,” Jakirlic said. “It should help the students integrate basic anatomy of the head and neck with clinical presentations.”

Optometry students must understand each muscle’s primary and secondary actions. The SimEye has separate controls for each muscle in each eye, and the user can turn off a muscle to see how that impacts eye movement.

First-year College of Optometry students learn about the Eye Movement Simulator from Assistant Professor Naida Jakirlic, OD. (Alyssa Estersohn, WesternU)

“What you can do is you can also click different cranial nerve palsies and see how that would look when you assess the EOMs,” Jakirlic told her students. “You should use this to help you understand everything we talked about, so when the gaze is directed to the right and then you want to test the superior rectus, you would then direct the patient to look up.”

A sixth cranial nerve palsy causes esotropia, where one or both eyes turn inward. The SimEye allows students to see how various muscle function or non-function affects its presentation.

“This is a really fun tool to play around with,” Jakirlic told her students. “You obviously can’t do this to your lab partners. You can’t give them a nerve palsy. This is a great way for you to figure out, ‘Where would the eye be if my third cranial nerve wasn’t working, if my fourth cranial nerve wasn’t working. What would that look like clinically?’ It’s a much different experience if you’re able to visualize it, almost like there is an actual patient in front of you.”

College of Health Sciences Instructor Lesa Maugh MS, PA-C, DFAAPA, introduced the eye simulator to her first-year Master of Science in Physician Assistant Studies students. First-year Physician Assistant student Demy Tabangcura said he will use the simulator to help him study and to test himself.

“It helps us visualize what’s going on when you obstruct the use of one of the cranial nerves,” he said. “The hard part of learning is seeing what is going on. If I do this to this nerve, the eye is going to do this. It’s more than memorizing a list of nerves and where they go. We’re learning the structure and function of the nervous system.”

First-year Master of Science in Physician Assistant Studies student Demy Tabangcura tries out the Eye Movement Simulator. (Jeff Malet, WesternU)