The feasibility and effects of eye movement training for visual field loss after stroke: a mixed methods study

Abstract

Introduction Visual field loss affects around 20% of stroke survivors, reducing quality of life. Eye movement training is a promising rehabilitation method, and several different interventions are used by occupational therapists. This study aimed to explore the feasibility and effects of four eye movement training interventions for stroke survivors with visual field loss. Method A mixed methods study – quantitative n-of-1 with qualitative interviews. The participants were 11 home-dwelling stroke survivors with visual field loss. The interventions used were MyHappyNeuron, NVT, Rainbow Readers and VISIOcoach, delivered in a randomised order. Visual search, reading speed, activities of daily living and quality of life were assessed three times before intervention use, then immediately after each intervention; these were analysed visually. A final semi-structured interview was then analysed using framework methods. Results Evidence of effect was divergent. Quantitatively there was no measured effect, but qualitatively participants reported benefits in visual skills, daily life skills and emotions, which varied by intervention. Median training time was 3–4 hours (range 0.5–6.5) for NVT, Rainbow Readers and MyHappyNeuron, and 9.5 hours (range 2.3–16.8) for VISIOcoach. Conclusion Eye movement training interventions were feasible for stroke survivors at home. Qualitative evidence suggests that variations in the eye movements trained and delivery modality underlie variations in perceived effect.

Influence of open-source virtual-reality based gaze training on navigation performance in Retinitis pigmentosa patients in a crossover randomized controlled trial

“… 3 The patient displays some spots of remaining vision in the peripheral field. 4 A commercially available screen-based gaze training software for RP patients [ 35 ], applied in the previously mentioned studies by Ivanov et al [ 14 ] and Roth et al [ 16 ] and evaluated by Hazelton et al [ 18 ]. 5 It should be noted that participant 4 does not meet the participation criterion of a visual acuity >0.1.…”

“… 4 A commercially available screen-based gaze training software for RP patients [ 35 ], applied in the previously mentioned studies by Ivanov et al [ 14 ] and Roth et al [ 16 ] and evaluated by Hazelton et al [ 18 ]. …”

“…In the study by Kuyk et al, no significant effects in walking speed were found, but collision avoidance improved in one of the two tested lighting conditions. A different study by Hazelton et al [ 18 ] compared the effectiveness of four different eye movement training tools on patients with stroke-induced visual field loss. Quantitatively, no significant improvements were found for any of the four tools, with only individual patients displaying improvements in certain testing paradigms such as visual search or reading speed.…”

Influence of open-source virtual-reality based gaze training on navigation performance in Retinitis pigmentosa patients in a crossover randomized controlled trial

“…The concept of gaze training for low-vision compensation has been investigated and applied before [11][12][13][14][15]. However, the constant advancements in technology and accessibility of Virtual Reality (VR) headsets raises a question about their potential to be applied for gaze training purposes.…”