Background: To quantify development of gaze stability throughout life during short and long fixational tasks using eye tracking technology. Methods: Two hundred and fifty-nine participants aged between 5 months and 77 years were recruited along the study. All participants underwent a complete ophthalmological assessment. Fixational behavior during long and short fixational tasks was analyzed using a DIVE (Device for an Integral Visual Examination), a digital test assisted with eye tracking technology. The participants were divided into ten groups according to their age. Group 1, 0–2 years; group 2, 2–5 years; group 3, 5–10 years; group 4, 10–20 years; group 5, 20–30 years; group 6, 30–40 years; group 7, 40–50 years; group 8, 50–60 years; group 9, 60–70 years; and group 10, over 70 years. Results: Gaze stability, assessed by logBCEA (log-transformed bivariate contour ellipse area), improved with age from 5 months to 30 years (1.27 vs. 0.57 deg2 for long fixational task, 0.73 vs. −0.04 deg2 for short fixational task), while fixations tend to be longer (1.95 vs. 2.80 msec for long fixational tasks and 0.80 vs. 1.71 msec for short fixational tasks). All fixational outcomes worsened progressively from the fifth decade of life. Log-transformed bivariate contour ellipse area (0.79, 0.83, 0.91, 1.42 deg2 for long fixational task and 0.01, 0.18, 0.28, 0.44 deg2 for short fixational task, for group 7, 8, 9, and 10 respectively). Stimuli features may influence oculomotor performance, with smaller stimuli providing prolonged fixations. Conclusions: Fixational behavior can be accurately assessed from 5 months of age using a DIVE. We report normative data of gaze stability and duration of fixations for every age group. Currently available technology may increase the accuracy of our visual assessments at any age.
Conclusions DIVE is an automatic, objective and reliable tool to assess several visual function parameters in children, and it has good agreement with classical VA tests, especially for the first stage of life.
Aim:We aim to assess oculomotor behaviour in children adopted from Eastern Europe, who are at high risk of maternal alcohol consumption. Methods: This cross-sectional study included 29 adoptees and age-matched controls. All of them underwent a complete ophthalmological examination. Oculomotor control, including fixation and saccadic performance, was assessed using a DIVE device, with eye tracking technology. Anthropometric and facial measurements were obtained from all the adopted children, to identify features of fetal alcohol spectrum disorders (FASD). Fixational and saccadic outcomes were compared between groups and the effect of adoption and FASD features quantified. Results: Oculomotor performance was poorer in adopted children. They presented shorter (0.53 versus 1.43 milliseconds in the long task and 0.43 versus 0.82 in the short task) and more unstable fixations (with a bivariate contour ellipse area of 27.9 versus 11.6 degree 2 during the long task and 6.9 versus 1.3 degree 2 during the short task) and slower saccadic reactions (278 versus 197 milliseconds). Children with sentinel finding for FASD showed the worst oculomotor outcomes. Conclusion: Children adopted from Eastern Europe present oculomotor deficits, affecting both fixation and saccadic skills. We highlight prenatal exposure to alcohol as the main cause for these deficits. KEY NOTES Children adopted from Eastern Europe present poorer oculomotor control than agematched peers, with larger saccadic reaction times. Adoptees show shorter and less stable fixations both in short and long fixational tasks. The presence of FASD features is related to less stable fixations in adopted children.
Visual assessment in preverbal children mostly relies on the preferential looking paradigm. It requires an experienced observer to interpret the child’s responses to a stimulus. DIVE (Device for an Integral Visual Examination) is a digital tool with an integrated eye tracker (ET) that lifts this requirement and automatizes this process. The aim of our study was to assess the development of two visual functions, visual acuity (VA) and contrast sensitivity (CS), with DIVE, in a large sample of children from 6 months to 14 years (y) of age, and to compare the results of preterm and full-term children. Participants were recruited in clinical settings from five countries. There were 2208 children tested, 609 of them were born preterm. Both VA and CS improved throughout childhood, with the maximum increase during the first 5 years of age. Gestational age, refractive error and age had an impact on VA results, while CS values were only influenced by age. With this study we report normative reference outcomes for VA and CS throughout childhood and validate the DIVE tests as a useful tool to measure basic visual functions in children.
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