Coordination of Gaze Behavior and Foot Placement During Walking in Persons With Glaucoma

Abstract

Glaucoma significantly disrupts gaze-foot coordination and results in less accurate foot placement when precision is required during walking. This may increase the risk of trips and falls in this population.

Glaucoma-Related Differences in Gaze Behavior When Negotiating Obstacles

“…When precise foot placement is required, people with glaucoma make saccades away from a target sooner in relation to stepping on it. 27 This is accompanied by reduced foot-placement accuracy, similar to normally sighted older adults at a high risk of falling. 36 In this precision-walking situation, glaucoma subjects prioritize planning future accurate steps at the expense of the current step.…”

“…The time at which the local angular gaze velocity crossed above or below a threshold of 100°/s for a minimum of 16 ms defined the onset and offset of gaze shifts. 27 , 34 We defined gaze fixations as instances with stable gaze on a location for a minimum of 66 ms. 27 , 35 To determine which aspects of the visual scene subjects fixated, we used the 30-Hz video of the path with crosshairs of gaze position superimposed. Fixation locations included route-planning features (gap between obstacles, ground regions, and end goal region), obstacles (or end gates) and, in the case of the visual search dual-task condition, shapes.…”

“… 26 Recently, we also found the timing of gaze shifts to and from stepping targets with respect to foot placement is significantly altered in this population, particularly when performing a concurrent secondary task. 27 These differences in gaze timing are accompanied by reduced foot-placement accuracy.…”

“…Because people often engage in conversation or attempt to identify landmarks when walking, subjects performed the obstacle negotiation task in isolation and while performing a concurrent task that simulated these everyday situations. Preliminary research in glaucoma suggests that multitasking affects gaze behavior in other walking tasks 27 and general walking function. 28 Here, we tested the hypothesis that gaze strategies and the number of collisions differ between people with glaucoma and normally sighted controls when navigating around obstacles, particularly under multitasking situations.…”

24-Month Phase I/II Clinical Trial of Bimatoprost Sustained-Release Implant (Bimatoprost SR) in Glaucoma Patients

“…Glaucoma poses a substantial patient burden that increases with disease progression [5][6][7]. Individuals may experience decreased quality of life because of reduced mobility and ability to perform routine tasks as well as an increased risk of falls and associated injury and death [8][9][10]. The most common form of glaucoma is open-angle glaucoma (OAG), accounting for 74% of people diagnosed globally [3].…”