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Kurukuti NM, Manda S, Peli E. Risk of pedestrian collision for persons with peripheral field loss: A computational analysis. Optom Vis Sci 2024; 101:514-522. [PMID: 39163120 DOI: 10.1097/opx.0000000000002175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024] Open
Abstract
SIGNIFICANCE People with peripheral field loss report colliding with other pedestrians on their blind side(s). We show that, in dyadic collision scenarios between persons, one with field loss, such as homonymous hemianopia, and the other normally sighted pedestrian, collisions occur only if the persons with homonymous hemianopia are overtaking the pedestrians, and the collision risk is concentrated at farther bearing angles than previously suggested. PURPOSE Prior work computed the risk of collision while simulating both pedestrians as points and did not consider the ability of the other pedestrian's normal vision to avoid the collision. We extended the model to better characterize the open space collision risk posed for persons with homonymous hemianopia by normally sighted pedestrians where both have volume. METHODS We computed the risk of collision with approaching pedestrians using a model that simulates approaching pedestrians as volumetric entities without vision, volumetric entities with vision, and as points for comparison with the prior work. Collision risk of approaching pedestrians is characterized for all three conditions through spatial collision risk maps and collision risk densities as a function of bearing and radial distances. RESULTS The collision risk for volumetric pedestrians is slightly different from that of point pedestrians. For volumetric pedestrians simulated with normal vision, the risk of collision was reduced substantially, as the other pedestrians could detect and avoid most impending collisions. The remaining collision risk is from pedestrians approaching at higher bearing angles (>50°) and from shorter radial distances (<2 m). Thus, collisions occurred when the pedestrians started in front of the person with homonymous hemianopia that was overtaking the pedestrian. CONCLUSIONS The probability of collisions between pedestrians and the person with peripheral field loss is low and occurs only when the person with peripheral field loss is walking from behind the pedestrian at faster speed, thereby overtaking them. Such collisions occur with pedestrians at higher bearing angles, which should be monitored by assistive aids to avoid collisions. The same collision risk applies not only in homonymous hemianopia but also in other peripheral field loss such as monocular vision loss or concentric field loss, as common in retinitis pigmentosa and glaucoma.
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Affiliation(s)
| | - Sailaja Manda
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
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2
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Chin BM, Wang M, Mikkelsen LT, Friedman CT, Ng CJ, Chu MA, Cooper EA. A paradigm for characterizing motion misperception in people with typical vision and low vision. Optom Vis Sci 2024; 101:252-262. [PMID: 38857038 DOI: 10.1097/opx.0000000000002139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
PURPOSE We aimed to develop a paradigm that can efficiently characterize motion percepts in people with low vision and compare their responses with well-known misperceptions made by people with typical vision when targets are hard to see. METHODS We recruited a small cohort of individuals with reduced acuity and contrast sensitivity (n = 5) as well as a comparison cohort with typical vision (n = 5) to complete a psychophysical study. Study participants were asked to judge the motion direction of a tilted rhombus that was either high or low contrast. In a series of trials, the rhombus oscillated vertically, horizontally, or diagonally. Participants indicated the perceived motion direction using a number wheel with 12 possible directions, and statistical tests were used to examine response biases. RESULTS All participants with typical vision showed systematic misperceptions well predicted by a Bayesian inference model. Specifically, their perception of vertical or horizontal motion was biased toward directions orthogonal to the long axis of the rhombus. They had larger biases for hard-to-see (low contrast) stimuli. Two participants with low vision had a similar bias, but with no difference between high- and low-contrast stimuli. The other participants with low vision were unbiased in their percepts or biased in the opposite direction. CONCLUSIONS Our results suggest that some people with low vision may misperceive motion in a systematic way similar to people with typical vision. However, we observed large individual differences. Future work will aim to uncover reasons for such differences and identify aspects of vision that predict susceptibility.
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Affiliation(s)
- Benjamin M Chin
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
| | - Minqi Wang
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
| | - Loganne T Mikkelsen
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
| | - Clara T Friedman
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
| | - Cherlyn J Ng
- Department of Cognitive Sciences, The University of California, Irvine, Irvine, California
| | - Marlena A Chu
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
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Doyon JK, Hwang AD, Jung JH. Understanding viewpoint changes in peripheral prisms for field expansion by virtual reality simulation. BIOMEDICAL OPTICS EXPRESS 2024; 15:1393-1407. [PMID: 38495729 PMCID: PMC10942672 DOI: 10.1364/boe.513758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/19/2024]
Abstract
Prism field expansion is a common treatment for patients with peripheral field loss, shifting images from the blind field into the seeing field. The shifted image originates from a new viewpoint translated and rotated from the original viewpoint by the prism. To understand such viewpoint changes, we simulated two field expansion methods in virtual reality: 1) angular (i.e., rotational) field expansion and 2) linear field expansion via image crop-and-shift. Changes to object locations, sizes, and optic flow patterns by those methods were demonstrated and analyzed in both static and dynamic conditions, which may affect navigation with such field expansion devices.
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Affiliation(s)
- Jonathan K. Doyon
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
| | - Alex D. Hwang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
| | - Jae-Hyun Jung
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
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Han S, Kim S, Jung JH. The effect of visual rivalry in peripheral head-mounted displays on mobility. Sci Rep 2023; 13:20199. [PMID: 37980436 PMCID: PMC10657352 DOI: 10.1038/s41598-023-47427-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/14/2023] [Indexed: 11/20/2023] Open
Abstract
Recent head-mounted displays and smart glasses use vision multiplexing, an optical approach where two or more views are superimposed on each other. In vision multiplexing, augmented information is presented over an observer's natural field of view, providing field expansion and critical information during mobility situations like walking and driving. Yet despite its utility, vision multiplexing may produce visual rivalry, a phenomenon where perception alternates between the augmented information and the background scene for seconds at a time. To investigate, we compared the effect of different peripheral vision multiplexing configurations (unilateral opaque, unilateral see-through and bilateral see-through) on the detection of augmented information, incorporating at the same time real-world characteristics (target eccentricity, depth condition, and gaze movement) for a more realistic assessment. Results showed a persistently lower target detection rate in unilateral configurations than the bilateral configuration, suggesting a larger effect of binocular rivalry on target visibility. Nevertheless, this effect does become attenuated when more naturalistic elements are incorporated, and we discuss recommendations for vision multiplexing design and possible avenues for further research.
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Affiliation(s)
- Shui'er Han
- Institute for Infocomm Research, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Sujin Kim
- Department of Ophthalmology, Harvard Medical School, Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, MA, USA
| | - Jae-Hyun Jung
- Department of Ophthalmology, Harvard Medical School, Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, MA, USA.
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Falahati M, Kurukuti NM, Vargas-martin F, Peli E, Jung JH. Oblique multi-periscopic prism for field expansion of homonymous hemianopia. BIOMEDICAL OPTICS EXPRESS 2023; 14:2352-2364. [PMID: 37206143 PMCID: PMC10191663 DOI: 10.1364/boe.485373] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/05/2023] [Accepted: 04/14/2023] [Indexed: 05/21/2023]
Abstract
Oblique Fresnel peripheral prisms have been used for field expansion in homonymous hemianopia mobility such as walking and driving. However, limited field expansion, low image quality, and small eye scanning range limit their effectiveness. We developed a new oblique multi-periscopic prism using a cascade of rotated half-penta prisms, which provides 42° horizontal field expansion along with 18° vertical shift, high image quality, and wider eye scanning range. Feasibility and performance of a prototype using 3D-printed module are demonstrated by raytracing, photographic depiction, and Goldmann perimetry with patients with homonymous hemianopia.
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Affiliation(s)
- Mojtaba Falahati
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology,Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
| | - Nish Mohith Kurukuti
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology,Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
| | | | - Eli Peli
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology,Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
| | - Jae-Hyun Jung
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology,Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
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Hwang AD, Peli E, Jung JH. Development of Virtual Reality Walking Collision Detection Test on Head-mounted display. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2023; 12449:124491J. [PMID: 36970501 PMCID: PMC10037228 DOI: 10.1117/12.2647141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Detecting and avoiding collisions during walking is critical for safe mobility. To determine the effectiveness of clinical interventions, a realistic objective outcome measure is needed. A real-world obstacle course with moving hazards has numerous limitations (e.g., safety concerns of physical collision, inability to control events, maintaining event consistency, and event randomization). Virtual reality (VR) platforms may overcome such limitations. We developed a VR walking collision detection test using a standalone head-mounted display (HMD, Meta Quest 2) with the Unity 3D engine to enable subjects' physical walking within a VR environment (i.e., a busy shopping mall). The performance measures focus on the detection and avoidance of potential collisions, where a pedestrian may (or may not) walks toward a collision with the subject, while various non-colliding pedestrians are presented simultaneously. The physical space required for the system was minimized. During the development, we addressed expected and unexpected hurdles, such as mismatch of visual perception of VR space, limited field of view (FOV) afforded by the HMD, design of pedestrian paths, design of the subject task, handling of subject's response (detection or avoidance behavior), use of mixed reality (MR) for walking path calibration. We report the initial implementation of the HMD VR walking collision detection and avoidance scenarios that showed promising potential as clinical outcome measures.
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Affiliation(s)
- Alex D Hwang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA 02114
| | - Eli Peli
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA 02114
| | - Jae-Hyun Jung
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA 02114
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Kim S, Han S, Jung JH. Binocular see-through configuration and eye movement attenuate visual rivalry in peripheral wearable displays. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2023; 12449:124490T. [PMID: 36970500 PMCID: PMC10037227 DOI: 10.1117/12.2648481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Visual confusion occurs when two dissimilar images are superimposed onto the same retinal location. In the context of wearable displays, it can be used to provide multiple sources of information to users on top of the real-world scene. While useful, visual confusion may cause visual rivalry that can suppress one of the sources. If two different images are projected to each eye (i.e., monocular displays), it provokes binocular rivalry wherein visual perception intermittently switches between the two images. When a semi-transparent image is superimposed (i.e., see-through displays), monocular rivalry results, causing perceptual alternations between the foreground and the background images. Here, we investigated how these rivalries influence the visibility of the peripheral target using three configurations of wearable displays (i.e., monocular opaque, monocular see-through, and binocular see-through) with three eye movement conditions (i.e., saccades, smooth pursuit, and central fixation). Using the HTC VIVE Eye Pro headset, subjects viewed a forward vection of a 3D corridor with a horizontally moving vertical grating at 10° above the center fixation. During each trial (~1 min), subjects followed a fixation cross that varied in location to induce eye movements and simultaneously reported whether the peripheral target was visible. Results showed that the binocular display had significantly higher target visibility than both monocular displays, and the monocular see-through display had the lowest target visibility. Target visibility was also higher when eye movements were executed, suggesting that the effects of rivalry are attenuated by eye movements and binocular see-through displays.
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Affiliation(s)
- Sujin Kim
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | - Shui’Er Han
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA
- Agency for Science, Technology and Research (A*STAR), Singapore
| | - Jae-Hyun Jung
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA
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Nguyen JD, Tan SM, Azenkot S, Chu MA, Cooper EA. Longitudinal Trends in Case Histories and Rehabilitative Device Assessments at Low Vision Examinations. Optom Vis Sci 2022; 99:817-829. [PMID: 36301592 PMCID: PMC9704812 DOI: 10.1097/opx.0000000000001953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/26/2022] [Indexed: 01/06/2023] Open
Abstract
SIGNIFICANCE Understanding 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. PURPOSE This study aimed to understand changes in patient priorities and patient care in low vision over the past decade. METHODS We 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. RESULTS Collapsing 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. CONCLUSIONS Reading 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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Affiliation(s)
- Jacqueline D. Nguyen
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Steven M. Tan
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
| | - Shiri Azenkot
- Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, Cornell University, New York, New York
| | - Marlena A. Chu
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
| | - Emily A. Cooper
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, California
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California
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Jung JH, Kurukuti NM, Peli E. Photographic Depiction of the Field of View with Spectacles-mounted Low Vision Aids. Optom Vis Sci 2021; 98:1210-1226. [PMID: 34629434 PMCID: PMC8560063 DOI: 10.1097/opx.0000000000001790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/24/2021] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Photographic depiction helps to illustrate the primary and secondary field of view effects of low vision devices along with their utility to clinicians, patients, and caretakers. This technique may also be helpful for designers and researchers in improving the design and fitting of low vision devices. PURPOSE The field of view through spectacles-mounted low vision devices has typically been evaluated using perimetry. However, the perimetric field diagram is different from the retinal image and often fails to represent the important aspects of the field of view and visual parameters. We developed a photographic depiction method to record and veridically show the field of view effects of these devices. METHODS We used a 3D-printed holder to place spectacles-mounted devices at the same distance from the empirically determined reference point of the field of view in a camera lens (f = 16 mm) as they would be from an eye, when in use. The field of view effects of a bioptic telescope, a minifier (reverse telescope), and peripheral prisms were captured using a conventional camera, representing retinal images. The human eye pupil size (adjusting the F number: f/2.8 to f/8 and f/22 in the camera lens) and fitting parameters (pantoscopic tilt and back vertex distance) varied. RESULTS Real-world indoor and outdoor walking and driving scenarios were depicted as retinal images illustrating the field of view through low vision devices, distinguishing optical and obscuration scotomas, and demonstrating secondary effects (spatial distortions, viewpoint changes, diplopia, spurious reflection, and multiplexing effects) not illustrated by perimetric field diagrams. CONCLUSIONS Photographic depiction illustrates the primary and secondary field of view effects of the low vision devices. These images highlight the benefit and possible trade-offs of the low vision devices and may be beneficial in education and training.
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Affiliation(s)
- Jae-Hyun Jung
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Nish Mohith Kurukuti
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Eli Peli
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
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Iskander M, Ogunsola T, Ramachandran R, McGowan R, Al-Aswad LA. Virtual Reality and Augmented Reality in Ophthalmology: A Contemporary Prospective. Asia Pac J Ophthalmol (Phila) 2021; 10:244-252. [PMID: 34383716 PMCID: PMC9167643 DOI: 10.1097/apo.0000000000000409] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Most published systematic reviews have focused on the use of virtual reality (VR)/augmented reality (AR) technology in ophthalmology as it relates to surgical training. To date, this is the first review that investigates the current state of VR/AR technology applied more broadly to the entire field of ophthalmology. METHODS PubMed, Embase, and CINAHL databases were searched systematically from January 2014 through December 1, 2020. Studies that discussed VR and/or AR as it relates to the field of ophthalmology and provided information on the technology used were considered. Abstracts, non-peer-reviewed literature, review articles, studies that reported only qualitative data, and studies without English translations were excluded. RESULTS A total of 77 studies were included in this review. Of these, 28 evaluated the use of VR/AR in ophthalmic surgical training/assessment and guidance, 7 in clinical training, 23 in diagnosis/screening, and 19 in treatment/therapy. 15 studies used AR, 61 used VR, and 1 used both. Most studies focused on the validity and usability of novel technologies. CONCLUSIONS Ophthalmology is a field of medicine that is well suited for the use of VR/AR. However, further longitudinal studies examining the practical feasibility, efficacy, and safety of such novel technologies, the cost-effectiveness, and medical/legal considerations are still needed. We believe that time will indeed foster further technological advances and lead to widespread use of VR/AR in routine ophthalmic practice.
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Affiliation(s)
- Mina Iskander
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Titilola Ogunsola
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Rithambara Ramachandran
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
| | - Richard McGowan
- Department of Epidemiology and Health Promotion, NYU College of Dentistry, New York, New York, US
| | - Lama A. Al-Aswad
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
- Department of Population Health, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, US
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Neugebauer A, Stingl K, Ivanov I, Wahl S. Influence of Systematic Gaze Patterns in Navigation and Search Tasks with Simulated Retinitis Pigmentosa. Brain Sci 2021; 11:brainsci11020223. [PMID: 33673036 PMCID: PMC7917782 DOI: 10.3390/brainsci11020223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/29/2022] Open
Abstract
People living with a degenerative retinal disease such as retinitis pigmentosa are oftentimes faced with difficulties navigating in crowded places and avoiding obstacles due to their severely limited field of view. The study aimed to assess the potential of different patterns of eye movement (scanning patterns) to (i) increase the effective area of perception of participants with simulated retinitis pigmentosa scotoma and (ii) maintain or improve performance in visual tasks. Using a virtual reality headset with eye tracking, we simulated tunnel vision of 20° in diameter in visually healthy participants (n = 9). Employing this setup, we investigated how different scanning patterns influence the dynamic field of view—the average area over time covered by the field of view—of the participants in an obstacle avoidance task and in a search task. One of the two tested scanning patterns showed a significant improvement in both dynamic field of view (navigation 11%, search 7%) and collision avoidance (33%) when compared to trials without the suggested scanning pattern. However, participants took significantly longer (31%) to finish the navigation task when applying this scanning pattern. No significant improvements in search task performance were found when applying scanning patterns.
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Affiliation(s)
- Alexander Neugebauer
- ZEISS Vision Science Lab., Institute for Ophthalmic Research, Eberhard-Karls-University Tuebingen, 72076 Tuebingen, Germany;
- Correspondence:
| | - Katarina Stingl
- Center for Ophthalmology, University Eye Hospital, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany;
- Center for Rare Eye Diseases, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
| | - Iliya Ivanov
- Carl Zeiss Vision International GmbH, 73430 Aalen, Germany;
| | - Siegfried Wahl
- ZEISS Vision Science Lab., Institute for Ophthalmic Research, Eberhard-Karls-University Tuebingen, 72076 Tuebingen, Germany;
- Carl Zeiss Vision International GmbH, 73430 Aalen, Germany;
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A Saccadic Choice Task for Target Face Detection at Large Visual Eccentricities in Patients with Glaucoma. Optom Vis Sci 2020; 97:871-878. [PMID: 33055511 DOI: 10.1097/opx.0000000000001586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Little is known about the perception of glaucomatous patients at large visual eccentricities. We show that the patients' performance drops beyond 40° eccentricity even for large images of scenes, suggesting that clinical tests should assess the patients' vision at larger eccentricities than 24 or 30°. PURPOSE Daily activities such as visual search, spatial navigation, and hazard detection require rapid scene recognition on a wide field of view. We examined whether participants with visual field loss at standard automated perimetry 30-2 were able to detect target faces at large visual eccentricities. METHODS Twelve patients with glaucoma and 14 control subjects were asked to detect a face in a two-alternative saccadic forced choice task. Pairs of scenes, one containing a face, were randomly displayed at 10, 20, 40, 60, or 80° eccentricity on a panoramic screen covering 180° horizontally. Participants were asked to detect and to saccade toward the scene containing a face. RESULTS Saccade latencies were significantly slower in patients (264 milliseconds; confidence interval [CI], 222 to 306 milliseconds) than in control subjects (207 milliseconds; CI, 190 to 226 milliseconds), and accuracy was significantly lower in patients (70% CI, 65 to 85%) than in control subjects (75.7% CI, 71.5 to 79.5%). Although still significantly above chance at 60°, the patients' performance dropped beyond 40° eccentricity. The control subjects' performance was still above chance at 80° eccentricity. CONCLUSIONS In patients with various degrees of peripheral visual field defect, performance dropped beyond 40° eccentricity for large images at a high contrast. This result could reflect reduced spread of exploration in glaucoma.
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Peli E. 2017 Charles F. Prentice Award Lecture: Peripheral Prisms for Visual Field Expansion: A Translational Journey. Optom Vis Sci 2020; 97:833-846. [PMID: 33055514 PMCID: PMC7606588 DOI: 10.1097/opx.0000000000001590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
On the occasion of being awarded the Prentice Medal, I was asked to summarize my translational journey. Here I describe the process of becoming a low-vision rehabilitation clinician and researcher, frustrated by the unavailability of effective treatments for some conditions. This led to decades of working to understand patients' needs and the complexities and subtleties of their visual systems and conditions. It was followed by many iterations of developing vision aids and the techniques needed to objectively evaluate their benefit. I specifically address one path: the invention and development of peripheral prisms to expand the visual fields of patients with homonymous hemianopia, leading to our latest multiperiscopic prism (mirror-based design) with its clear 45° field-of-view image shift.
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Affiliation(s)
- Eli Peli
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
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Peli E, Vargas-Martin F, Kurukuti NM, Jung JH. Multi-periscopic prism device for field expansion. BIOMEDICAL OPTICS EXPRESS 2020; 11:4872-4889. [PMID: 33014587 PMCID: PMC7510881 DOI: 10.1364/boe.399028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 05/30/2023]
Abstract
Patients with visual field loss frequently collide with other pedestrians, with the highest risk being from pedestrians at a bearing angle of 45°. Current prismatic field expansion devices (≈30°) cannot cover pedestrians posing the highest risk and are limited by poor image quality and restricted eye scanning range (<5°). A new field expansion device: multi-periscopic prism (MPP); comprising a cascade of half-penta prisms provides wider shifting power (45°) with dramatically better image quality and wider eye scanning range (15°) is presented. Spectacles-mounted MPPs were implemented using 3D printing. The efficacy of the MPP is demonstrated using perimetry, photographic depiction, and analyses of the collision risk covered by the devices.
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Affiliation(s)
- Eli Peli
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
| | | | - Nish Mohith Kurukuti
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
| | - Jae-Hyun Jung
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
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15
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Jung JH, Castle R, Kurukuti NM, Manda S, Peli E. Field Expansion with Multiplexing Prism Glasses Improves Pedestrian Detection for Acquired Monocular Vision. Transl Vis Sci Technol 2020; 9:35. [PMID: 32855881 PMCID: PMC7422757 DOI: 10.1167/tvst.9.8.35] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/23/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Patients with acquired monocular vision (AMV) lose vision in the temporal crescent on the side of the blind eye. This visual field loss affects patients’ ability to detect potential hazards in the blind field. Mounting a base-in multiplexing prism (MxP) on the nasal side of the seeing eye can provide true field expansion and enable detection of potential collision hazards. We evaluated the efficacy of the MxP glasses in a virtual reality walking environment. Methods A three-dimensional printed clip-on MxP holder that can be adjusted for an individual user's facial parameters was developed. Virtual reality walking scenarios were designed to evaluate the effect of MxP field expansion on the detection of a pedestrian approaching from different initial bearing angles and courses. The pedestrian detection rates and response times of 10 participants with simulated AMV (normally sighted participants with one eye patched) and three patients with AMV were measured. Results The MxP provided true field expansion of about 25°. Participants performed significantly better with the MxP than without the MxP in the pedestrian detection task on their blind field, while their seeing field performance was not significantly different. Conclusions The MxP glasses for patients with AMV improved the detection of potential collision hazards in the blind field. Translational Relevance The MxP with an adjustable clip-on holder may help patients with AMV to decrease the risk of collision with other pedestrians.
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Affiliation(s)
- Jae-Hyun Jung
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Rachel Castle
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Nish Mohith Kurukuti
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Sailaja Manda
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Eli Peli
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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16
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Sayed AM, Abdel-Mottaleb M, Kashem R, Roongpoovapatr V, Elsawy A, Abdel-Mottaleb M, Parrish RK, Abou Shousha M. Expansion of Peripheral Visual Field with Novel Virtual Reality Digital Spectacles. Am J Ophthalmol 2020; 210:125-135. [PMID: 31626763 DOI: 10.1016/j.ajo.2019.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine an image remapping method for peripheral visual field (VF) expansion with novel virtual reality digital spectacles (DSpecs) to improve visual awareness in glaucoma patients. DESIGN Prospective case series. METHODS Monocular peripheral VF defects were measured and defined with a head-mounted display diagnostic algorithm. The monocular VF was used to calculate remapping parameters with a customized algorithm to relocate and resize unseen peripheral targets within the remaining VF. The sequence of monocular VF was tested and customized image remapping was carried out in 23 patients with typical glaucomatous defects. Test images demonstrating roads and cars were used to determine increased awareness of peripheral hazards while wearing the DSpecs. Patients' scores in identifying and counting peripheral objects with the remapped images were the main outcome measurements. RESULTS The diagnostic monocular VF testing algorithm was comparable to standard automated perimetric determination of threshold sensitivity based on point-by-point assessment. Eighteen of 23 patients (78%) could identify safety hazards with the DSpecs that they could not previously. The ability to identify peripheral objects improved with the use of the DSpecs (P = 0.024, chi-square test). Quantification of the number of peripheral objects improved with the DSpecs (P = 0.0026, Wilcoxon rank sum test). CONCLUSIONS These novel spectacles may enhance peripheral objects awareness by enlarging the functional field of view in glaucoma patients.
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Affiliation(s)
- Ahmed M Sayed
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Biomedical Engineering Department, Helwan University, Helwan, Egypt
| | - Mostafa Abdel-Mottaleb
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | - Rashed Kashem
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | | | - Amr Elsawy
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | - Mohamed Abdel-Mottaleb
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | - Richard K Parrish
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | - Mohamed Abou Shousha
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA; Biomedical Engineering Department, University of Miami, Miami, Florida, USA.
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17
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Sayed AM, Kashem R, Abdel-Mottaleb M, Roongpoovapatr V, Eleiwa TK, Abdel-Mottaleb M, Parrish RK, Abou Shousha M. Toward Improving the Mobility of Patients with Peripheral Visual Field Defects with Novel Digital Spectacles. Am J Ophthalmol 2020; 210:136-145. [PMID: 31606442 DOI: 10.1016/j.ajo.2019.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the efficacy of novel Digital spectacles (DSpecs) to improve mobility of patients with peripheral visual field (VF) loss. DESIGN Prospective case series. METHODS Binocular VF defects were quantified with the DSpecs testing strategy. An algorithm was implemented that generated personalized visual augmentation profiles based on the measured VF. These profiles were achieved by relocating and resizing video signals to fit within the remaining VF in real time. Twenty patients with known binocular VF defects were tested using static test images, followed by dynamic walking simulations to determine if they could identify objects and avoid obstacles in an environment mimicking a real-life situation. The effect of the DSpecs were assessed for visual/hand coordination with object-grasping tests. Patients performed these tests with and without the DSpecs correction profile. RESULTS The diagnostic binocular VF testing with the DSpecs was comparable to the integrated monocular standard automated perimetry based on point-by-point assessment with a mismatch error of 7.0%. Eighteen of 20 patients (90%) could identify peripheral objects in test images with the DSpecs that they could not previously. Visual/hand coordination was successful for 17 patients (85%) from the first trial. The object-grasping performance improved to 100% by the third trial. Patient performance, judged by finding and identifying objects in the periphery in a simulated walking environment, was significantly better with the DSpecs (P = 0.02, Wilcoxon rank sum test). CONCLUSIONS DSpecs may improve mobility by facilitating the ability of patients to better identify moving peripheral hazardous objects.
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Affiliation(s)
- Ahmed M Sayed
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Biomedical Engineering Department, Helwan University, Helwan, Egypt
| | - Rashed Kashem
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | - Mostafa Abdel-Mottaleb
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | | | - Taher K Eleiwa
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Department of Ophthalmology, Faculty of Medicine, Benha University, Egypt
| | - Mohamed Abdel-Mottaleb
- Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA
| | - Richard K Parrish
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | - Mohamed Abou Shousha
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA; Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA; Biomedical Engineering Department, University of Miami, Miami, Florida, USA.
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18
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Choi HJ, Peli E, Park M, Jung JH. Design of 45° periscopic visual field expansion device for peripheral field loss. OPTICS COMMUNICATIONS 2020; 454:10.1016/j.optcom.2019.124364. [PMID: 32082001 PMCID: PMC7032564 DOI: 10.1016/j.optcom.2019.124364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Patients with visual field loss have difficulty in mobility due to collision with pedestrians/obstacles from the blind side. In order to retrieve the lost visual field, prisms which deflect the field from the blind to the seeing side, have been widely used. However, the deflection power of current clinical Fresnel prisms is limited to ~30° and only provides a 5° eye scanning range to the blind side. This is not sufficient to avoid collision and results in increasing demands for a device with a higher power. In this paper, we propose a novel design and optimization of a higher power prism-like device (cascaded structure of mirror pairs filled with high refractive index) and verify enhanced expansion of up to 45° in optical ray tracing and photorealistic simulations.
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Affiliation(s)
- Hee-Jin Choi
- Department of Physics and Astronomy, Sejong University, Seoul 05006, Korea
| | - Eli Peli
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Minyoung Park
- Department of Physics and Astronomy, Sejong University, Seoul 05006, Korea
| | - Jae-Hyun Jung
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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