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With innovations in the field of gaze and eye tracking, a new concentration of research in the area of gaze-tracked systems and user interfaces has formed in the field of Extended Reality (XR). Eye trackers are being used to explore novel forms of spatial human–computer interaction, to understand human attention and behavior, and to test expectations and human responses. In this article, we review gaze interaction and eye tracking research related to XR that has been published since 1985, which includes a total of 215 publications. We outline efforts to apply eye gaze for direct interaction with virtual content and design of attentive interfaces that adapt the presented content based on eye gaze behavior and discuss how eye gaze has been utilized to improve collaboration in XR. We outline trends and novel directions and discuss representative high-impact papers in detail. 

The expression of human emotion is integral to social interaction, and in virtual reality it is increasingly common to develop virtual avatars that attempt to convey emotions by mimicking these visual and aural cues, i.e. the facial and vocal expressions. However, errors in (or the absence of) facial tracking can result in the rendering of incorrect facial expressions on these virtual avatars. For example, a virtual avatar may speak with a happy or unhappy vocal inflection while their facial expression remains otherwise neutral. In circumstances where there is conflict between the avatar's facial and vocal expressions, it is possible that users will incorrectly interpret the avatar's emotion, which may have unintended consequences in terms of social influence or in terms of the outcome of the interaction. In this paper, we present a human-subjects study (N = 22) aimed at understanding the impact of conflicting facial and vocal emotional expressions. Specifically we explored three levels of emotional valence (unhappy, neutral, and happy) expressed in both visual (facial) and aural (vocal) forms. We also investigate three levels of head scales (down-scaled, accurate, and up-scaled) to evaluate whether head scale affects user interpretation of the conveyed emotion. We find significant effects of different multimodal expressions on happiness and trust perception, while no significant effect was observed for head scales. Evidence from our results suggest that facial expressions have a stronger impact than vocal expressions. Additionally, as the difference between the two expressions increase, the less predictable the multimodal expression becomes. For example, for the happy-looking and happy-sounding multimodal expression, we expect and see high happiness rating and high trust, however if one of the two expressions change, this mismatch makes the expression less predictable. We discuss the relationships, implications, and guidelines for social applications that aim to leverage multimodal social cues. 

Extended reality (XR) technologies, such as virtual reality (VR) and augmented reality (AR), provide users, their avatars, and embodied agents a shared platform to collaborate in a spatial context. Although traditional face-to-face communication is limited by users’ proximity, meaning that another human’s non-verbal embodied cues become more difficult to perceive the farther one is away from that person, researchers and practitioners have started to look into ways to accentuate or amplify such embodied cues and signals to counteract the effects of distance with XR technologies. In this article, we describe and evaluate the Big Head technique, in which a human’s head in VR/AR is scaled up relative to their distance from the observer as a mechanism for enhancing the visibility of non-verbal facial cues, such as facial expressions or eye gaze. To better understand and explore this technique, we present two complimentary human-subject experiments in this article. In our first experiment, we conducted a VR study with a head-mounted display to understand the impact of increased or decreased head scales on participants’ ability to perceive facial expressions as well as their sense of comfort and feeling of “uncannniness” over distances of up to 10 m. We explored two different scaling methods and compared perceptual thresholds and user preferences. Our second experiment was performed in an outdoor AR environment with an optical see-through head-mounted display. Participants were asked to estimate facial expressions and eye gaze, and identify a virtual human over large distances of 30, 60, and 90 m. In both experiments, our results show significant differences in minimum, maximum, and ideal head scales for different distances and tasks related to perceiving faces, facial expressions, and eye gaze, and we also found that participants were more comfortable with slightly bigger heads at larger distances. We discuss our findings with respect to the technologies used, and we discuss implications and guidelines for practical applications that aim to leverage XR-enhanced facial cues. 

When medical caregivers transfer patients to another person’s care (a patient handoff), it is essential they effectively communicate the patient’s condition to ensure the best possible health outcomes. Emergency situations caused by mass casualty events (e.g., natural disasters) introduce additional difficulties to handoff procedures such as environmental noise. We created a projected mixed reality simulation of a handoff scenario involving a medical evacuation by air and tested how low, medium, and high levels of helicopter noise affected participants’ handoff experience, handoff performance, and behaviors. Through a human-subjects experimental design study (N = 21), we found that the addition of noise increased participants’ subjective stress and task load, decreased their self-assessed and actual performance, and caused participants to speak louder. Participants also stood closer to the virtual human sending the handoff information when listening to the handoff than they stood to the receiver when relaying the handoff information. We discuss implications for the design of handoff training simulations and avenues for future handoff communication research. 

Given the inherent visual affordances of Head-Mounted Displays (HMDs) used for Virtual and Augmented Reality (VR/AR), they have been actively used over many years as assistive and therapeutic devices for the people who are visually impaired. In this paper, we report on a scoping review of literature describing the use of HMDs in these areas. Our high-level objectives included detailed reviews and quantitative analyses of the literature, and the development of insights related to emerging trends and future research directions. Our review began with a pool of 1251 papers collected through a variety of mechanisms. Through a structured screening process, we identified 61 English research papers employing HMDs to enhance the visual sense of people with visual impairments for more detailed analyses. Our analyses reveal that there is an increasing amount of HMD-based research on visual assistance and therapy, and there are trends in the approaches associated with the research objectives. For example, AR is most often used for visual assistive purposes, whereas VR is used for therapeutic purposes. We report on eight existing survey papers, and present detailed analyses of the 61 research papers, looking at the mitigation objectives of the researchers (assistive versus therapeutic), the approaches used, the types of HMDs, the targeted visual conditions, and the inclusion of user studies. In addition to our detailed reviews and analyses of the various characteristics, we present observations related to apparent emerging trends and future research directions.