We used Goldmann kinetic perimetry to compare how training and congenital auditory deprivation may affect the size of the visual field. We measured the ability of action video game players and deaf observers to detect small moving lights at various locations in the central (around 30 degrees from fixation) and peripheral (around 60 degrees ) visual fields. Experiment 1 found that 10 habitual video game players showed significantly larger central and peripheral field areas than 10 controls. In Experiment 2 we found that 13 congenitally deaf observers had significantly larger visual fields than 13 hearing controls for both the peripheral and central fields. Here the greatest differences were found in the lower parts of the fields. Comparison of the two groups showed that whereas VGP players have a more uniform increase in field size in both central and peripheral fields deaf observers show non-uniform increases with greatest increases in lower parts of the visual field.

The altered sensory experience of profound early onset deafness provokes sometimes large scale neural reorganisations. In particular, auditory-visual cross-modal plasticity occurs, wherein redundant auditory cortex becomes recruited to vision. However, the effect of human deafness on neural structures involved in visual processing prior to the visual cortex has never been investigated, either in humans or animals. We investigated neural changes at the retina and optic nerve head in profoundly deaf (N = 14) and hearing (N = 15) adults using Optical Coherence Tomography (OCT), an in-vivo light interference method of quantifying retinal micro-structure. We compared retinal changes with behavioural results from the same deaf and hearing adults, measuring sensitivity in the peripheral visual field using Goldmann perimetry. Deaf adults had significantly larger neural rim areas, within the optic nerve head in comparison to hearing controls suggesting greater retinal ganglion cell number. Deaf adults also demonstrated significantly larger visual field areas (indicating greater peripheral sensitivity) than controls. Furthermore, neural rim area was significantly correlated with visual field area in both deaf and hearing adults. Deaf adults also showed a significantly different pattern of retinal nerve fibre layer (RNFL) distribution compared to controls. Significant correlations between the depth of the RNFL at the inferior-nasal peripapillary retina and the corresponding far temporal and superior temporal visual field areas (sensitivity) were found. Our results show that cross-modal plasticity after early onset deafness may not be limited to the sensory cortices, noting specific retinal adaptations in early onset deaf adults which are significantly correlated with peripheral vision sensitivity.

This study investigated peripheral vision (at least 30° eccentric to fixation) development in profoundly deaf children without cochlear implantation, and compared this to age-matched hearing controls as well as to deaf and hearing adult data. Deaf and hearing children between the ages of 5 and 15 years were assessed using a new, specifically paediatric designed method of static perimetry. The deaf group (N = 25) were 14 females and 11 males, mean age 9.92 years (range 5-15 years). The hearing group (N = 64) were 34 females, 30 males, mean age 9.13 years (range 5-15 years). All participants had good visual acuity in both eyes (< 0.200 LogMAR). Accuracy of detection and reaction time to briefly presented LED stimuli of three light intensities, at eccentricities between 30° and 85° were measured while fixation was maintained to a central target. The study found reduced peripheral vision in deaf children between 5 and 10 years of age. Deaf children (aged 5-10 years) showed slower reaction times to all stimuli and reduced ability to detect and accurately report dim stimuli in the far periphery. Deaf children performed equally to hearing children aged 11-12 years. Deaf adolescents aged 13-15 years demonstrated faster reaction times to all peripheral stimuli in comparison to hearing controls. Adolescent results were consistent with deaf and hearing adult performances wherein deaf adults also showed significantly faster reaction times than hearing controls. Peripheral vision performance on this task was found to reach adult-like levels of maturity in deaf and hearing children, both in reaction time and accuracy of detection at the age of 11-12 years.

Following auditory deprivation, the remaining sense of vision has shown selective enhancement in visual cognition, especially in the area of near peripheral vision. Visual acuity is poor in the far periphery and may be an area where sound confers the greatest advantage in hearing persons. Experience with a visuospatial language such as British Sign Language (BSL) makes additional demands on the visual system. To test the different and separable effects of deafness and use of a visuo-spatial language on far peripheral visual processing, we investigated visual reaction times (RTs) and response accuracy to visual stimuli, between 30° and 85° along the four cardinal and four inter-cardinal meridians. We used three luminances of static, briefly illuminated stimuli in visually normal adults. The cohort tested included profoundly congenitally deaf adults (N = 17), hearing fluent BSL users (N = 8) and hearing non-signing adults (N = 18). All participants were tested using a peripheral forced choice paradigm designed previously to test deaf and hearing children (Codina et al., 2011a). Deaf adults demonstrated significantly faster RTs to all far peripheral stimuli and exceeded the abilities of both signing and non-signing hearing adults. Deaf adults were significantly faster than BSL interpreters, who in turn were significantly faster than hearing non-signing adults. The differences in RT demonstrated between groups were consistent across all visual field meridians and were not localized to any one region of the visual field. There were no differences found between any groups in accuracy of detecting these static stimuli at any retinal location. Early onset auditory deprivation appears to lead to a response time visual advantage in far peripheral responses to briefly presented, static LED stimuli, especially in the right visual field. Fluency in BSL facilitates faster visuo-motor responses in the peripheral visual field, but to a lesser extent than congenital, profound deafness.

Normative visual field area, feasibility and repeatability using (Octopus) semi-automated kinetic perimetry are reported in 221 healthy volunteers aged 5-22 years. I4e and I2e stimuli assessed the visual field at 5 /second ( /s) or 3 /s. Blind spot was assessed with I2e at 2 /s. Reliable visual fields were plotted in 23% of participants 510 years, 64% of 10-12-year-olds, and 98% aged 13-22 years. Visual field areas were unchanged with age using 5 /s, but increased using 3 /s for I2e (p = 0.028). Blind spot area was unchanged with age. Reaction times reduced with age (p50.004). There was no learning effect. A test speed of 5 /s is recommended.