Using Eye Tracking to Assess Reading Performance in Patients with Glaucoma: A Within-Person Study

Reading is often cited as a demanding task for patients with glaucomatous visual field (VF) loss, yet reading speed varies widely between patients and does not appear to be predicted by standard visual function measures. Thiswithin-personstudy aimed to investigate reading duration and eye movements when reading short passages of text in a patient’s worse eye (most VF damage) when compared to their better eye (least VF damage). Reading duration and saccade rate were significantly different on average in the worse eye when compared to the better eye (P<0.001) in 14 patients with glaucoma that had median (interquartile range) between-eye difference in mean deviation (MD; a standard clinical measure for VF loss) of 9.8 (8.3 to 14.8) dB; differences were not related to the size of the difference in MD between eyes. Patients with a more pronounced effect of longer reading duration on their worse eye made a larger proportion of “regressions” (backward saccades) and “unknown” EMs (not adhering to expected reading patterns) when reading with the worse eye when compared to the better eye. A between-eye study in patients with asymmetric disease, coupled with eye tracking, provides a useful experimental design for exploring reading performance in glaucoma.

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Does Inverting Text Improve Reading Performance in Homonymous Hemianopes?

Perception ◽

10.1068/v970039 ◽

1997 ◽

Vol 26 (1_suppl) ◽

pp. 77-77

Author(s):

M R Baker ◽

J Henderson ◽

A Hill

Keyword(s):

Eye Movements ◽

Low Vision ◽

Reading Speed ◽

Leading Edge ◽

Visual Field Loss ◽

Reading Performance ◽

Sensory Level ◽

Eye Tracker ◽

Cognitive Component ◽

The Right

Anecdotal information from rehabilitation practice of reading performance and low-vision practice suggests that where right homonymous parafoveal field loss impairs reading at the visual-sensory level, an improvement in reading speed can be achieved by inverting the text. This is because whilst left-field loss is considered to impair return eye movements to the beginning of a line, right-field loss is considered to reduce the spatial size of the perceptual window and increase its temporal extent by prolonging fixations times, reducing the amplitudes of saccades to the right, and introducing frequent regressive saccades. Inverting the text was thought to reverse these effects as the leading edge of the perceptual window is ‘returned’ to the sighted field so that in-line saccades can be visually guided. Here we report that this does not appear to be the case. In our study we measured the eye movements of patients with right homonymous hemianopia and others with peripheral loss due to retinitis pigmentosa as well as normal controls using an infrared video eye-tracker. All groups display a similar proportional prolongation of fixations times, reduction of saccadic amplitude, and proportion of regressive saccades when asked to read inverted text, which suggests a cognitive component of impairment independent of visual field loss in right homonymous hemianopes.

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Reading with Visual Field Defects

Perception ◽

10.1068/v970025 ◽

1997 ◽

Vol 26 (1_suppl) ◽

pp. 11-11 ◽

Cited By ~ 1

Author(s):

S Trauzettel-Klosinski

Keyword(s):

Eye Movements ◽

Visual Field ◽

Reading Ability ◽

Reading Speed ◽

Visual Fields ◽

Zero Point ◽

Normal Subjects ◽

Visual Field Defects ◽

Video Tape ◽

Field Defects

The influence of different visual field defects on the reading performance was examined with potential adaptive strategies to improve the reading process in mind. By means of an SLO, the retinal fixation locus (RFL) was determined with the use of single targets and text, and eye movements scanning the text were recorded on video tape. Additionally, eye movements were monitored by an Infrared Limbus Tracker. Visual fields were assessed by the Tübingen Manual and/or automatic perimetry. Normal subjects, and patients with central scotomata, ring scotomata, and hemianopic field defects (HFD) were examined. The main pathological reading parameters were an increase of saccade frequency and regressions per line, and a decrease of reading speed. In patients with field defects involving the visual field centre, fixation behaviour is significant for regaining reading ability. In absolute central scotoma, the lost foveal function promotes eccentric fixation. The remaining problem is insufficient resolution of the RFL, which can be compensated for by magnification of the text. In patients with insufficient size of their reading visual field, due to HFD and ring scotoma, it is crucial that they learn to use a new RFL despite intact foveolar function. Preconditions for reading have been found to be: (1) sufficient resolution of the RFL, (2) a reading visual field of a minimum extent, and (3) intact basic oculomotor function. In patients with visual field defects involving the centre, a sensory-motor adaptation process is required: the use of a new RFL as the new centre of the visual field and as the new zero point for eye-movement coordinates.

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The Monocular Duke of Urbino

Ophthalmology and Eye Diseases ◽

10.4137/oed.s40918 ◽

2016 ◽

Vol 8s1 ◽

pp. OED.S40918

Author(s):

Stephen G. Schwartz ◽

Christopher T. Leffer ◽

Pamela S. Chavis ◽

Faraaz Khan ◽

Dennis Bermudez ◽

...

Keyword(s):

Eye Movements ◽

Visual Field ◽

Visual Function ◽

Italian Renaissance ◽

Nasal Surgery ◽

Piero Della Francesca ◽

Historical Figure ◽

Eye Motion ◽

The Subject

Federico da Montefeltro (1422–1482), the Duke of Urbino, was a well-known historical figure during the Italian Renaissance. He is the subject of a famous painting by Piero della Francesca (1416–1492), which displays the Duke from the left and highlights his oddly shaped nose. The Duke is known to have lost his right eye due to an injury sustained during a jousting tournament, which is why the painting portrays him from the left. Some historians teach that the Duke subsequently underwent nasal surgery to remove tissue from the bridge of his nose in order to expand his visual field in an attempt to compensate for the lost eye. In theory, removal of a piece of the nose may have expanded the nasal visual field, especially the “eye motion visual field” that encompasses eye movements. In addition, removing part of the nose may have reduced some of the effects of ocular parallax. Finally, shifting of the visual egocenter may have occurred, although this seems likely unrelated to the proposed nasal surgery. Whether or not the Duke actually underwent the surgery cannot be proven, but it seems unlikely that this would have substantially improved his visual function.

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What are the characteristics and progression of visual field defects in patients with Leber hereditary optic neuropathy: a prospective single-centre study in China

BMJ Open ◽

10.1136/bmjopen-2018-025307 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025307

Author(s):

Hong-Li Liu ◽

Jia-Jia Yuan ◽

Zhen Tian ◽

Xin Li ◽

Lin Song ◽

...

Keyword(s):

Visual Field ◽

Optic Neuropathy ◽

Visual Function ◽

Visual Field Defect ◽

Visual Field Defects ◽

Leber Hereditary Optic Neuropathy ◽

The Difference ◽

Field Defect ◽

Hereditary Optic Neuropathy ◽

Field Defects

ObjectiveTo study the characteristics and progression of visual field defects in patients with Leber hereditary optic neuropathy.DesignProspective study.Setting3-A-class hospital in China; single-centre study.ParticipantsFrom 100 patients diagnosed with Leber hereditary optic neuropathy, 80 (160 eyes; 68 men and 12 women; youngest patient, 6 years; oldest patient, 35 years) were recruited.ExposureAll patients were followed up for at least 12 months. Each patient underwent at least three visual field examinations. Patient groups 1–6 were created according to the time of visual field data acquisition. Patient group 7 included patients with a different onset of disease between eyes. Group 8 was composed of patients with a course of disease of 12–24 months when one of the examinations performed. Patients who performed the third examination made up patient group 9.Primary outcome measuresPrevalence of the different visual field defect types on the basis of severity in groups 1–6. Mean of the difference of visual function between eyes in group 7.ResultIn groups 1–6, the prevalences of defects classified using Visual Field Index values were significantly different between groups 1 and 3. In group 7, with the prolongation of the course of the disease, the mean of the difference of visual function between eyes decreased. There was no significant correlation between age and the severity of visual field defect. There was significant correlation between visual acuity and the severity of visual field defect.ConclusionVisual field defects in patients with Leber hereditary optic neuropathy (G11778A) may continuously progress within 6 months of disease development, and remain stable after 9 months. With the progression of the disease, the differences in visual function between eyes may decrease. The severity of visual field defect seems to be independent of age; however, could be related to visual acuity.Trial registration numberNCT03428178,NCT01267422.

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Eye-tracking-based visual field analysis (EFA): a reliable and precise perimetric methodology for the assessment of visual field defects

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2019-000429 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000429

Author(s):

Michael Christian Leitner ◽

Florian Hutzler ◽

Sarah Schuster ◽

Lorenzo Vignali ◽

Patrick Marvan ◽

...

Keyword(s):

Eye Movements ◽

Visual Field ◽

Eye Tracking ◽

Field Analysis ◽

Visual Field Defects ◽

Test Duration ◽

Automated Perimetry ◽

The Individual ◽

The Right ◽

Field Defects

ObjectiveSeveral studies report evidence for training-related neuroplasticity in the visual cortex, while other studies suggest that improvements simply reflect inadequate eye fixation control during perimetric prediagnostics and postdiagnostics.Methods and analysisTo improve diagnostics, a new eye-tracking-based methodology for visual field analysis (eye-tracking-based visual field analysis (EFA)) was developed. The EFA is based on static automated perimetry and additionally takes individual eye movements in real time into account and compensates for them. In the present study, an evaluation of the EFA with the help of blind spots of 58 healthy participants and the individual visual field defects of 23 clinical patients is provided. With the help of the EFA, optical coherence tomography, Goldmann perimetry and a Humphrey field analyser, these natural and acquired scotomas were diagnosed and the results were compared accordingly.ResultsThe EFA provides a SE of measurement of 0.38° for the right eye (OD) and 0.50° for the left eye (OS), leading to 0.44° of visual angle for both eyes (OU). Based on participants’ individual results, the EFA provides disattenuated correlation (validity) of 1.00 for both OD and OS. Results from patients suffering from cortical lesions and glaucoma further indicate that the EFA is capable of diagnosing acquired scotoma validly and is applicable for clinical use.ConclusionOutcomes indicate that the EFA is highly reliable and precise in diagnosing individual shape and location of scotoma and capable of recording changes of visual field defects (after intervention) with unprecedented precision. Test duration is comparable to established instruments and due to the high customisability of the EFA, assessment duration can be shortened by adapting the diagnostic procedure to the patients’ individual visual field characteristics. Therefore, the saccade-compensating methodology enables researchers and healthcare professionals to rule out eye movements as a source of inaccuracies in pre-, post-, and follow-up assessments.

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Text Font Affects Reading Speed at a Low Luminance but Not at a High Luminance

Perception ◽

10.1068/v970053 ◽

1997 ◽

Vol 26 (1_suppl) ◽

pp. 51-51

Author(s):

D Yager ◽

K Aquilante ◽

R Plass

Keyword(s):

Eye Movements ◽

Visual Field ◽

Low Vision ◽

Reading Speed ◽

Visual Presentation ◽

High Luminance ◽

Low Luminance ◽

Significant Difference ◽

Simulation Results ◽

Parameter Values

We are beginning a series of studies in which we shall investigate which characteristics of text fonts may be successful in allowing text to be read with different kinds of degradations that may be experienced by low-vision patients. As a first attempt to simulate one of the problems that certain patients might have, we measured reading speeds with two proportionally spaced fonts at a high photopic luminance (146 cd m−2) and at a very low luminance (0.146 cd m−2). We used the RSVP (rapid serial visual presentation) reading method, which eliminates the need for scanning eye movements. The two fonts were ‘Swiss’, a simple sans-serif font, and ‘Dutch’, a serif font similar to Times Roman, both presented at the 20/80 size; letters were white on black, with a contrast of 0.94. Subjects were young, normally sighted high-school and optometry-college students. The reading speed results from 47 subjects were as follows, for four conditions: high luminance, Swiss 531 and Dutch 540 words min−1; low luminance, Swiss 479 and Dutch 429 words min−1. At the high luminance, there is no significant difference between reading rates. There is a significant advantage for the Swiss font at the low luminance: p=0.005. There may be a significant difference in reading speed with different fonts when the patient's perceptions are degraded by disease and/or aging processes. Other parameters to be investigated with this method include contrast, size, blur, and visual field position. The simulation results will suggest parameter values to test on low-vision patients.

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Optic nerve appearance as a predictor of visual outcome in patients with idiopathic intracranial hypertension

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313329 ◽

2018 ◽

Vol 103 (10) ◽

pp. 1429-1435 ◽

Cited By ~ 6

Author(s):

Jonathan A Micieli ◽

Beau B Bruce ◽

Caroline Vasseneix ◽

Richard J Blanch ◽

Damian E Berezovsky ◽

...

Keyword(s):

Visual Acuity ◽

Visual Field ◽

Intracranial Hypertension ◽

Optic Disc ◽

Visual Function ◽

Idiopathic Intracranial Hypertension ◽

Visual Outcome ◽

Mean Deviation ◽

Cotton Wool Spots

Background/aimsIt remains unclear whether the presence of optic disc haemorrhages (ODH) or cotton wool spots (CWS) at presentation in patients with papilloedema from idiopathic intracranial hypertension (IIH) has prognostic value. The aim of this study was to determine if optic disc appearance at presentation predicts visual outcome in patients with IIH.MethodsRetrospective study of 708 eyes of 360 consecutive patients with IIH who had baseline optic disc photographs before or within 30 days of their diagnostic lumbar puncture and initiation of medical treatment. Optic disc photographs were independently graded by three ophthalmologists in a standardised manner. Visual function was assessed using Snellen converted to logMAR visual acuity, Humphrey mean deviation and visual field grade.ResultsAt least one ODH was found in 201 (28.4%) eyes, at least one CWS was found in 101 (14.3%) eyes and 88 eyes had both ODH and CWS (12.4%). At presentation, Frisén grade was associated with the presence and severity of ODH and CWS (p<0.001). ODH were associated with a worse visual acuity and CWS were associated with a worse visual field grade and mean deviation at presentation (p<0.05). Frisén grade was associated with worse visual function at presentation and final follow-up (p<0.001). Neither ODH nor CWS at presentation were associated with visual function at final follow-up when controlling for the Frisén grade.Conclusions and relevanceODH and CWS at baseline are not independent predictors of final visual function in IIH when controlling for the severity of papilloedema.

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Random Spray Retinex Extensions Considering Region of Interest and Eye Movements

Journal of Imaging Science and Technology ◽

10.2352/j.imagingsci.technol.2019.63.6.060403 ◽

2019 ◽

Vol 63 (6) ◽

pp. 60403-1-60403-6

Author(s):

Midori Tanaka ◽

Matteo Paolo Lanaro ◽

Takahiko Horiuchi ◽

Alessandro Rizzi

Keyword(s):

Information Processing ◽

Eye Movements ◽

Visual Field ◽

Eye Tracking ◽

Mathematical Description ◽

Visual Information ◽

Tracking System ◽

Region Of Interest ◽

Tracking Data ◽

Proposed Model

Abstract The Random spray Retinex (RSR) algorithm was developed by taking into consideration the mathematical description of Milano-Retinex. The RSR substituted random paths with random sprays. Mimicking some characteristics of the human visual system (HVS), this article proposes two variants of RSR adding a mechanism of region of interest (ROI). In the first proposed model, a cone distribution based on anatomical data is considered as ROI. In the second model, the visual resolution depending on the visual field based on the knowledge of visual information processing is considered as ROI. We have measured actual eye movements using an eye-tracking system. By using the eye-tracking data, we have simulated the HVS using test images. Results show an interesting qualitative computation of the appearance of the processed area around real gaze points.

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Studying the role of 10-2 visual field test in different stages of glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672119836904 ◽

2019 ◽

Vol 30 (4) ◽

pp. 706-713 ◽

Cited By ~ 1

Author(s):

Reham Hosny Tomairek ◽

Safaa Awadallah Aboud ◽

Mansour Hassan ◽

Alyaa H Mohamed

Keyword(s):

Visual Field ◽

Visual Function ◽

Precise Measurement ◽

Mean Deviation ◽

Visual Field Test ◽

Glaucoma Diagnosis ◽

Prospective Comparative Study ◽

The Mean ◽

Early Damage

Objective: To assess the role of 10-2 visual field (VF) test in different stages of glaucoma. Methods: In our prospective comparative study, 24-2 and 10-2 VF tests were done for 115 eyes with different stages of glaucomatous damage or glaucoma suspects. Optical coherence tomography (OCT) was performed in 79 eyes. We compared field changes of the central 10° on 10-2 and 24-2 tests and studied the correlation between the mean deviation (MD) measured by the two tests. Results: In seven glaucoma suspects, glaucoma diagnosis was missed by 24-2 test but was detected by 10-2 test and confirmed by OCT. In the eyes with early damage, there was no correlation between 10-2 and 24-2 tests regarding the MD of the central 10º. In moderate and severe stages, there was a significant correlation between the results of 24-2 and 10-2 tests. Conclusion: We concluded that 10-2 test could help confirm glaucoma diagnosis in glaucoma suspects missed by 24-2 test before resorting to the more expensive OCT. In early glaucoma, we noted that 10-2, as confirmed by OCT, was a beneficial addition to 24-2 test for precise measurement of the MD and detection of defects of the central 10º missed by 24-2 test, where more intense treatment should be considered to preserve the threatened central visual function. In moderate and severe cases, the role of 10-2 test was not as pivotal as in early cases, but still it was useful for assessment of residual central visual function in severe cases with absolute central 10º defects on 24-2 test for proper management.

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Processing focus in native and non-native speakers of English: an eye-tracking study in the visual world paradigm

Applied Psycholinguistics ◽

10.1017/s0142716421000230 ◽

2021 ◽

pp. 1-32

Author(s):

Haoyan Ge ◽

Iris Mulders ◽

Xin Kang ◽

Aoju Chen ◽

Virginia Yip

Keyword(s):

Eye Movements ◽

Eye Tracking ◽

Real Time ◽

Native Speakers ◽

Visual World ◽

Visual World Paradigm ◽

L2 Processing ◽

Multiple Interfaces ◽

Native Speakers Of English ◽

The Difference

Abstract This “visual-world” eye-tracking study investigated the processing of focus in English sentences with preverbal only by L2 learners whose L1 was either Cantonese or Dutch, compared to native speakers of English. Participants heard only-sentences with prosodic prominence either on the object or on the verb and viewed pictures containing an object-focus alternative and a verb-focus alternative. We found that both L2 groups showed delayed eye movements to the alternative of focus, which was different from the native speakers of English. Moreover, Dutch learners of English were even slower than Cantonese learners of English in directing fixations to the alternative of focus. We interpreted the delayed fixation patterns in both L2 groups as evidence of difficulties in integrating multiple interfaces in real time. Furthermore, the similarity between English and Dutch in the use of prosody to mark focus hindered Dutch learners’ L2 processing of focus, whereas the difference between English and Cantonese in the realization of focus facilitated Cantonese learners’ processing of focus in English.

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