The BRVT is a simple and efficient test of spatial vision that, with 13 increments, extends the range of measurement from the limits of the letter chart up to light perception.
Detecting and avoiding obstacles while navigating can pose a challenge for people with low vision, but augmented reality (AR) has the potential to assist by enhancing obstacle visibility. Perceptual and user experience research is needed to understand how to craft effective AR visuals for this purpose. We developed a prototype AR application capable of displaying multiple kinds of visual cues for obstacles on an optical see-through head-mounted display. We assessed the usability of these cues via a study in which participants with low vision navigated an obstacle course. The results suggest that 3D world-locked AR cues were superior to directional heads-up cues for most participants during this activity.
Successful goal-directed actions require constant fine-tuning in response to errors introduced by changes in the body and environment. This implicit adaptive process has been assumed to operate in a statistically optimal fashion, reducing its sensitivity to errors when sensory uncertainty is high. However, recent work has shown that visual uncertainty attenuates implicit adaptation for small errors, but not large errors, a result that is at odds with an optimal integration hypothesis. This error size interaction has motivated a new hypothesis that sensory uncertainty impacts the distribution of the perceived error locations but not the system's sensitivity to errors. To examine these competing hypotheses, previous studies have experimentally manipulated uncertainty. But it is unknown which hypothesis best describes motor adaptation to sensory uncertainty experienced during daily life. To address this question, we recruited individuals with low vision due to diverse clinical conditions impacting visual uncertainty and matched controls. The groups were tested on visuomotor tasks designed to isolate implicit adaptation and maintain tight control over the error size. In two experiments, low vision was associated with attenuated implicit adaptation only for small errors, but not for large errors. Taken together with prior work in which visual uncertainty was experimentally manipulated, these results support the notion that increasing sensory uncertainty increases the likelihood that errors are mis-localized but does not affect error sensitivity, offering a novel account for the motor learning deficits seen in low vision.
Successful goal-directed actions require constant fine-tuning of the motor system. This fine-tuning is thought to rely on an implicit adaptation process that is driven by sensory prediction errors (i.e., where you see your hand after reaching vs. where you expected it to be). Individuals with low vision experience challenges with visuomotor control, but whether low vision disrupts motor adaptation is unknown. To explore this question, we assessed individuals with low vision and matched controls with normal vision on a visuomotor task designed to isolate implicit adaptation. We found that low vision was associated with attenuated implicit adaptation only for small visual errors, but not for large visual errors. This result highlights important constraints underlying how low-fidelity visual information is processed by the sensorimotor system to enable successful implicit adaptation.
SIGNIFICANCEUnderstanding longitudinal changes in why individuals frequent low-vision clinics is crucial for ensuring that patient care keeps current with changing technology and changing lifestyles. Among other findings, our results suggest that reading remains a prevailing patient complaint, with shifting priorities toward technology-related topics.PURPOSEThis study aimed to understand changes in patient priorities and patient care in low vision over the past decade.METHODSWe conducted a retrospective study of examination records (2009 to 2019, 3470 examinations) from two U.S. low-vision clinics. Automated word searches summarized two properties of the records: topics discussed during the case history and types of rehabilitative devices assessed. Logistic regression was used to model the effects of examination year, patient age, patient sex, and level of visual impairment.RESULTSCollapsing across all years, the most common topic discussed was reading (78%), followed by light-related topics (71%) and technology (59%). Whereas the odds of discussing reading trended downward over the decade (odds ratio, 0.57; P = .03), technology, social interaction, mobility, and driving trended upward (odds ratios, 4.53, 3.31, 2.71, and 1.95; all P's < 0.001). The most frequently assessed devices were tinted lenses (95%). Over time, video magnifier and spectacle assessments trended downward (odds ratios, 0.64 and 0.72; P = .004, 0.04), whereas assessments of other optical aids increased. The data indicate several consistent differences among patient demographics.CONCLUSIONSReading is likely to remain a prevailing patient complaint, but an increase in technology-related topics suggests shifting priorities, particularly in younger demographics. “Low-tech” optical aids have remained prominent in low-vision care even as “high-tech” assistive devices in the marketplace continue to advance.
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