The definition
VR motion sickness, also called cybersickness or visually induced motion sickness, is the discomfort that appears during or after headset use when what the eyes see does not match what the inner ear senses (Kennedy and colleagues, 1993). It is measured with the Simulator Sickness Questionnaire (SSQ), which Kennedy's team built from data on 10 US Navy simulators.
Several names cover overlapping ground. Simulator sickness is the branch studied by the US military in vehicle simulators, and cybersickness was proposed by McCauley and Sharkey in 1992 for any sickness associated with virtual environments, simulator sickness included; Steven LaValle, who recounts both in his book on virtual reality, prefers VR sickness. To explain it, LaValle counts sensory conflict theory among the most relevant tools while noting that no single accepted theory covers it all, and the review by Saredakis and colleagues reads its data the same way, citing Reason and Brand (1975). The conflict that matters most in VR involves accelerations and appears with vection, the sense of self-motion produced by the image, when the eyes register movement that the vestibular system does not. It is the reverse of reading a book as a passenger in a car, where the body feels the acceleration and the eyes see none.
Robert Kennedy, Norman Lane, Kevin Berbaum and Michael Lilienthal published the SSQ in 1993 in The International Journal of Aviation Psychology. They describe simulator sickness as less severe and less frequent than sickness caused by physical motion, and as originating in the visual display and in the interaction between vision and the vestibular system. They derived the questionnaire from more than 1,100 motion sickness questionnaires collected on 10 Navy simulators, and its subscales for nausea, oculomotor symptoms and disorientation add up to a total score. The reference cut-offs were set with military personnel in flight simulators: above 20 points, a simulator counts as a problem. In 2020, Saredakis and colleagues pooled 55 articles that measured headsets with the SSQ, 3,016 participants in all, and found a total mean of 28.00, high against those cut-offs. Across the 46 experiments that reported dropouts, an average of 15.6% of participants dropped out of an experiment because of VR sickness; the authors note the figure may be inflated, since 22 studies did not report dropouts and some of them may have had none. Content weighed in: games gave the highest mean among content types, and controller-driven locomotion the highest among ways of moving. Exposures under 10 minutes had lower nausea and disorientation scores, though the link with time was not linear, and 35% of the articles used earlier generations of headsets.
Latency, the time between a head movement and the updated image (motion-to-photon latency), was for decades named one of the greatest causes of VR sickness. LaValle writes that it is no longer the main problem in most VR systems, thanks to newer tracking and display hardware, and that vection and optical aberrations now weigh more; Fyware's post on VR training for airlines puts modern headsets at 90 to 120 Hz with latency under 20 ms. Frame rate is a separate issue. If the application cannot draw as many frames per second as the headset requires, the rate drops or varies, and that causes discomfort; LaValle gives 90 frames per second for the Oculus Rift and the HTC Vive as an example of that requirement.
In training, design decides much of the risk. LaValle recommends experiences with little or no virtual locomotion, because moving the body through the scene produces vection even on an ideally functioning headset, and so the posture of each exercise matters: standing in place, walking on one's own feet and sitting while the scene moves, as in a vehicle simulator, are different exposures. When the headset or the content is new, Meta suggests short sessions and long breaks, at first a maximum of 30 minutes followed by 15 minutes of rest, limiting high-movement experiences and lengthening time gradually. Anyone who feels discomfort takes the headset off and does not go back until it is gone. While symptoms last, Meta says to avoid activities that require unimpaired balance and hand-eye coordination, which on a plant floor includes driving a forklift or working at height. Meta also asks people to see a doctor before use if they are pregnant or elderly, have binocular vision abnormalities, psychiatric disorders or a heart condition, or have had a seizure.