No abstract
Abstract-The prevalence of oculomotor dysfunctions associated with blast-induced mild traumatic brain injury (mTBI) in warfighters has increased as a consequence of recent conflicts. This study evaluated the effectiveness of computerized oculomotor vision screening (COVS) in a military population. Oculomotor functions were assessed with COVS and by conventional methods in 20 U.S. military personnel with and 20 without mTBI. The validity of COVS was determined by Pearson correlation and Bland-Altman method or the kappa coefficient. The repeatability of the COVS was assessed with the coefficient of repeatability or the kappa coefficient. The results showed that COVS had high sensitivity and specificity for screening near oculomotor functions. Overall, the COVS showed excellent validity and repeatability for assessing near lateral and vertical phorias, Worth 4 Dot, and fixation, as well as pursuit and saccadic eye movements. Despite the strong Pearson correlation, the Bland-Altman analysis identified minor to moderate discrepancies for both positive and negative fusional vergence and their associated recovery as well as for the monocular accommodative facility measurements. This study demonstrated that non-eye-care professionals may be able to use the COVS as a tool to efficiently screen oculomotor functions in a military population with or without mTBI.
The Warfighter in the modern battlespace has a predetermined, but ever-changing, set of tasks that must be performed. Performance on these tasks is affected strongly by the amount and quality of the visual input, as well as by the resultant visual perception and cognitive performance. Visual perception is defined as the mental organization and interpretation of the visual sensory information with the intent of attaining awareness and understanding of the local environment, e.g., objects and events. Cognition refers to the faculty for the human-like processing of this information and application of previously acquired knowledge (i.e., memory) to build understanding and initiate responses. Cognition involves attention, expectation, learning, memory, language, and problem solving. The direct physical stimuli for visual perception are the emitted or reflected quanta of light energy from objects in the visual environment that enters the eyes. It is important to understand that the resulting perception of the stimuli is not only a result of their physical properties (e.g., wavelength, intensity, and hue) but also of the changes induced by the transduction, filtering, and transformation of the physical input by the entire human visual system. This chapter explores some of the more important visual processes that contribute to visual perception and cognitive performance. These include brightness perception, size constancy, visual acuity (VA), contrast sensitivity, color discrimination, motion perception, depth perception and stereopsis. An analogous discussion of input via the auditory sense is discussed in Chapter 11, Auditory Perception and Cognitive Performance. Brightness Perception In physics, the luminance of an object is exactingly defined as the luminous flux per unit of projected area per unit solid angle leaving a surface at a given point and in a given direction. A more useable definition is the amount of visible light that that reaches the eye from an object. But, when an observer describes how "bright" an object appears, he/she is describing his/her brightness perception of the object. This brightness is the perceptual correlate to luminance and depends on both the light from the object and from the object's background region. Human visual perception of brightness and lightness involves both low-level and higher levels of processing that interact to determine the brightness and lightness of parts of a scene (Adelson, 1999). 1 If a scene was scanned by a photodetector, it would measure the amount of luminance energy at each point in the scene; the more light coming from a particular part of the scene the greater the measured value. The human eye's retinal receptors (cones) respond in a similar manner when a scene is imaged unto it. However the appearance (perception) of a region of the scene can be drastically altered without affecting the response of retinal receptors. The well-known simultaneous contrast effect demonstrates this phenomenon (Figure 10-1). In reality, the two center regions have
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