Helping Blind People Grasp: Evaluating a Tactile Bracelet for Remotely Guiding Grasping Movements

The problem of supporting visually impaired and blind people in meaningful interactions with objects is often neglected. To address this issue, we adapted a tactile belt for enhanced spatial navigation into a bracelet worn on the wrist that allows visually impaired people to grasp target objects. Participants' performance in locating and grasping target items when guided using the bracelet, which provides direction commands via vibrotactile signals, was compared to their performance when receiving auditory instructions. While participants were faster with the auditory commands, they also performed well with the bracelet, encouraging future development of this system and similar systems.

SwingBoard: introducing swipe based virtual keyboard for visually impaired and blind users

PURPOSE

Nowadays, typing is considered as one of the highly important aspects of accessibility that the visually impaired and blinds struggle with the most as existing virtual keyboards are complex and slow.

MATERIALS AND METHODS

This paper proposes a new text entry method named SwingBoard for visually impaired and blind smartphone users to solve their accessibility problem. It supports a-z, 0-9, 7 punctuations, 12 symbols, and eight keyboard functionalities that are arranged in 8 zones (specific range of angles), four segments, two modes, and different gestures. The proposed keyboard is suitable for the either single-handed or both-handed operation that tracks swipe angle and length to trigger any of the 66 key events. The key triggering process is based on only swiping the finger at different angles with different lengths. Typing speed of SwingBoard is increased by including some effective features such as the quick alphabet and number mode shifting, haptic feedback feature, talkback on swipe to learn the map quickly, and customizable swipe length feature.

RESULTS

At the end of 150 one-minute tests, seven blind participants reached an average of 19.89 words per minute (WPM) with an 88% accuracy rate which is one of the fastest-ever recorded average typing speeds for the blind.

CONCLUSION

Almost all users found SwingBoard effective, easy to learn and want to keep using it. SwingBoard is a handy virtual keyboard for visually impaired people with amazing typing speed and accuracy.

Preliminary investigation of SEZUAL device for basic material identification and simple spatial navigation for blind and visually impaired people

PURPOSE

we present a preliminary set of experimental studies that demonstrates device-aided echolocation enabling in blind and visually impaired individuals. The proposed device emits a click-like sound into the surrounding space and returning sound is perceived by participants to infer the surrounding environment.

MATERIALS AND METHODS

two sets of experiments were set up to evaluate the echolocation abilities of nine blind participants. The first setup was designed to identify four material types based on the sound reflection properties of materials, such as glass, metal, wood, and ceramics. The second setup was navigation through a basic maze with the device.

RESULTS

experimental data demonstrate that the use of the proposed device enables active echolocation abilities in blind participants, particularly for material identification and spatial mobility.

CONCLUSION

the proposed device can potentially be used to rehabilitate disabled blind and visually impaired individuals in terms of spatial mobility and orientation.

The BLV App Arcade: a new curated repository and evaluation rubric for mobile applications supporting blindness and low vision

PURPOSE

Visual impairment-related disabilities have become increasingly pervasive. Current reports estimate a total of 36 million persons with blindness and 217 million persons with moderate to severe visual impairment worldwide. Assistive technologies (AT), including text-to-speech software, navigational/spatial guides, and object recognition tools have the capacity to improve the lives of people with blindness and low vision. However, access to such AT is constrained by high costs and implementation barriers. More recently, expansive growth in mobile computing has enabled many technologies to be translated into mobile applications. As a result, a marketplace of accessibility apps has become available, yet no framework exists to facilitate navigation of this voluminous space.

MATERIALS AND METHODS

We developed the BLV (Blind and Low Vision) App Arcade: a fun, engaging, and searchable curated repository of app AT broken down into 11 categories spanning a wide variety of themes from entertainment to navigation. Additionally, a standardized evaluation metric was formalized to assess each app in five key dimensions: reputability, privacy, data sharing, effectiveness, and ease of use/accessibility. In this paper, we describe the methodological approaches, considerations, and metrics used to find, store and score mobile applications.

CONCLUSION

The development of a comprehensive and standardized database of apps with a scoring rubric has the potential to increase access to reputable tools for the visually impaired community, especially for those in low- and middle-income demographics, who may have access to mobile devices but otherwise have limited access to more expensive technologies or services.

Survey and analysis of the current status of research in the field of outdoor navigation for the blind

PURPOSE

In this article, we comprehensively review the current situation and research on technology related to outdoor travel for blind and visually impaired people (BVIP), given the diverse types and incomplete functionality of navigation aids for the blind. This aims to provide a reference for related research in the fields of outdoor travel for BVIP and blind navigation.

MATERIALS AND METHODS

We compiled articles related to blind navigation, of which a total of 227 of them are included in the search criteria. One hundred and seventy-nine articles are selected from the initial set, from a technical point of view, to elaborate on five aspects of blind navigation: system equipment, data sources, guidance algorithms, optimization of related methods, and navigation maps.

RESULTS

The wearable form of assistive devices for the blind has the most research, followed by the handheld type of aids. The RGB data class based on vision sensor is the most common source of navigation environment information data. Object detection based on picture data is also particularly rich among navigation algorithms and associated methods, indicating that computer vision technology has become an important study content in the field of blind navigation. However, research on navigation maps is relatively less.

CONCLUSIONS

In the study and development of assistive equipment for BVIP, there will be an emphasis on prioritizing attributes, such as lightness, portability, and efficiency. In light of the upcoming driverless era, the research focus will be on the development of visual sensors and computer vision technologies that can aid in navigation for the blind.

Telerehabilitation for people with low vision

BACKGROUND

Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits to rehabilitation clinics to be trained to learn to use VAE. These people may be able to overcome barriers to care through access to remote, internet-based consultation (telerehabilitation).

OBJECTIVES

To compare the effects of telerehabilitation with face-to-face (e.g. in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and near reading ability in people with visual function loss due to any ocular condition. Secondary objectives were to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for VAE devices, and patient satisfaction ratings.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register) (2021, Issue 9); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the internet was not introduced to the public until 1982. We last searched CENTRAL, MEDLINE Ovid, Embase, and PubMed on 14 September 2021, and the trial registries on 16 March 2022.

SELECTION CRITERIA

We included randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants diagnosed with low vision had received vision rehabilitation services remotely from a human provider using internet, web-based technology compared with an approach involving in-person consultations.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles and abstracts retrieved by the searches of the electronic databases and then full-text articles for eligible studies. Two review authors independently abstracted data from the included studies. Any discrepancies were resolved by discussion.

MAIN RESULTS

We identified one RCT/CCT that indirectly met our inclusion criteria, and two ongoing trials that met our inclusion criteria. The included trial had an overall high risk of bias. We did not conduct a quantitative analysis since multiple controlled trials were not identified.  The single included trial of 57 participants utilized a parallel-group design. It compared 30 hours of either personalized low vision training through telerehabilitation with a low vision therapist (the experimental group) with the self-training standard provided by eSight using the eSkills User Guide that was self-administered by the participants at home for one hour per day for 30 days (the comparison group). The trial investigators found a similar direction of effects for both groups for vision-related quality of life and satisfaction at two weeks, three months, and six months. A greater proportion of participants in the comparison group had abandoned or discontinued use of the eSight Eyewear at two weeks than those in the telerehabilitation group, but discontinuance rates were similar between groups at one month and three months. We rated the certainty of the evidence for all outcomes as very low due to high risk of bias in randomization processes and missing outcome data and imprecision.   AUTHORS' CONCLUSIONS: The included trial found similar efficacy between telerehabilitation with a therapist and an active control intervention of self-guided training in mostly younger to middle-aged adults with low vision who received a new wearable electronic aid. Given the disease burden and the growing interest in telemedicine, the two ongoing studies, when completed, may provide further evidence of the potential for telerehabilitation as a platform for providing services to people with low vision.

SILICONE OIL-FILLED FOLDABLE CAPSULAR VITREOUS BODY VERSUS SILICONE OIL ENDOTAMPONADE FOR TREATMENT OF NO LIGHT PERCEPTION AFTER SEVERE OCULAR TRAUMA

PURPOSE

To compare the anatomical and functional outcomes of silicone oil (SO)-filled foldable capsular vitreous body (FCVB) and SO endotamponade in vitrectomy for patients with no light perception after ocular trauma.

METHODS

A total of 64 patients (64 eyes) with no light perception caused by severe ocular trauma were divided into FCVB and SO groups based on the surgical treatment. The main outcome measurements were retinal reattachment rate, intraocular pressure, best-corrected visual acuity, and number of operations.

RESULTS

Both the FCVB group (29 eyes) and the SO group (35 eyes) showed significant improvement in postoperative best-corrected visual acuity and intraocular pressure. The two groups showed no significant differences in final intraocular pressure and the retinal reattachment rate. The postoperative vision (≥LP) in the FCVB group was significantly worse than in the SO group (FCVB [4/29] vs. SO [18/35], P = 0.003). However, the number of surgeries in the FCVB group was significantly lower than in the SO group (FCVB [1.10] vs. SO [2.23], P < 0.001).

CONCLUSION

Vitrectomy combined with SO endotamponade shows better short-term improvement in the treatment of no light perception caused by severe ocular trauma. However, SO-filled FCVB can effectively prevent many complications caused by direct SO endotamponade, such as secondary surgeries or SO dependence.

Maximizing Telerehabilitation for Patients With Visual Loss After Stroke: Interview and Focus Group Study With Stroke Survivors, Carers, and Occupational Therapists

BACKGROUND

Visual field defects are a common consequence of stroke, and compensatory eye movement strategies have been identified as the most promising rehabilitation option. There has been a move toward compensatory telerehabilitation options, such as the Durham Reading and Exploration (DREX) training app, which significantly improves visual exploration, reading, and self-reported quality of life.

OBJECTIVE

This study details an iterative process of liaising with stroke survivors, carers, and health care professionals to identify barriers and facilitators to using rehabilitation tools, as well as elements of good practice in telerehabilitation, with a focus on how the DREX package can be maximized.

METHODS

Survey data from 75 stroke survivors informed 12 semistructured engagement activities (7 focus groups and 5 interviews) with 32 stroke survivors, 10 carers, and 24 occupational therapists.

RESULTS

Thematic analysis identified key themes within the data. Themes identified problems associated with poststroke health care from both patients' and occupational therapists' perspectives that need to be addressed to improve uptake of this rehabilitation tool and telerehabilitation options generally. This included identifying additional materials or assistance that were required to boost the impact of training packages. The acute rehabilitation setting was an identified barrier, and perceptions of technology were considered a barrier by some but a facilitator by others. In addition, 4 key features of telerehabilitation were identified: additional materials, the importance of goal setting, repetition, and feedback.

CONCLUSIONS

The data were used to try to overcome some barriers to the DREX training and are further discussed as considerations for telerehabilitation in general moving forward.

Helping the Blind to Get through COVID-19: Social Distancing Assistant Using Real-Time Semantic Segmentation on RGB-D Video

The current COVID-19 pandemic is having a major impact on our daily lives. Social distancing is one of the measures that has been implemented with the aim of slowing the spread of the disease, but it is difficult for blind people to comply with this. In this paper, we present a system that helps blind people to maintain physical distance to other persons using a combination of RGB and depth cameras. We use a real-time semantic segmentation algorithm on the RGB camera to detect where persons are and use the depth camera to assess the distance to them; then, we provide audio feedback through bone-conducting headphones if a person is closer than 1.5 m. Our system warns the user only if persons are nearby but does not react to non-person objects such as walls, trees or doors; thus, it is not intrusive, and it is possible to use it in combination with other assistive devices. We have tested our prototype system on one blind and four blindfolded persons, and found that the system is precise, easy to use, and amounts to low cognitive load.

Navigation aid for blind persons by visual-to-auditory sensory substitution: A pilot study

PURPOSE

In this study, we investigate to what degree augmented reality technology can be used to create and evaluate a visual-to-auditory sensory substitution device to improve the performance of blind persons in navigation and recognition tasks.

METHODS

A sensory substitution algorithm that translates 3D visual information into audio feedback was designed. This algorithm was integrated in an augmented reality based mobile phone application. Using the mobile device as sensory substitution device, a study with blind participants (n = 7) was performed. The participants navigated through pseudo-randomized obstacle courses using either the sensory substitution device, a white cane or a combination of both. In a second task, virtual 3D objects and structures had to be identified by the participants using the same sensory substitution device.

RESULTS

The realized application for mobile devices enabled participants to complete the navigation and object recognition tasks in an experimental environment already within the first trials without previous training. This demonstrates the general feasibility and low entry barrier of the designed sensory substitution algorithm. In direct comparison to the white cane, within the study duration of ten hours the sensory substitution device did not offer a statistically significant improvement in navigation.

Lingual electrotactile discrimination ability is associated with the presence of specific connective tissue structures (papillae) on the tongue surface

Electrical stimulation of nerve endings in the tongue can be used to communicate information to users and has been shown to be highly effective in sensory substitution applications. The anterior tip of the tongue has very small somatosensory receptive fields, comparable to those of the finger tips, allowing for precise two-point discrimination and high tactile sensitivity. However, perception of electrotactile stimuli varies significantly between users, and across the tongue surface. Despite this, previous studies all used uniform electrode grids to stimulate a region of the dorsal-medial tongue surface. In an effort to customize electrode layouts for individual users, and thus improve efficacy for sensory substitution applications, we investigated whether specific neuroanatomical and physiological features of the tongue are associated with enhanced ability to perceive active electrodes. Specifically, the study described here was designed to test whether fungiform papillae density and/or propylthiouracil sensitivity are positively or negatively associated with perceived intensity and/or discrimination ability for lingual electrotactile stimuli. Fungiform papillae number and distribution were determined for 15 participants and they were exposed to patterns of electrotactile stimulation (ETS) and asked to report perceived intensity and perceived number of stimuli. Fungiform papillae number and distribution were then compared to ETS characteristics using comprehensive and rigorous statistical analyses. Our results indicate that fungiform papillae density is correlated with enhanced discrimination ability for electrical stimuli. In contrast, papillae density, on average, is not correlated with perceived intensity of active electrodes. However, results for at least one participant suggest that further research is warranted. Our data indicate that propylthiouracil taster status is not related to ETS perceived intensity or discrimination ability. These data indicate that individuals with higher fungiform papillae number and density in the anterior medial tongue region may be better able to use lingual ETS for sensory substitution.

Older adults with dual sensory loss in rehabilitation show high functioning and may fare better than those with single sensory loss

The population of older adults that have Dual Sensory Loss (DSL) is increasing, yet most research to date has focused on single sensory impairment and is inconclusive as to whether DSL is associated with worse impact on health and well-being over single sensory loss. The primary aim of this study was to characterize the health and functioning of community-dwelling older adults with DSL who were receiving sensory rehabilitation, using an understudied assessment: the interRAI Community Health Assessment (CHA). The secondary aim was to investigate whether older adults with DSL had worse health-related outcomes than their peers with only vision loss (VL) or only hearing loss (HL). We report and compare the interRAI CHA results in a sample of 200 older adults (61+ years of age) who had DSL, VL or HL. Overall, all sensory impairment groups showed high functioning in the areas of cognition, communication, activities of daily living, depression, and psycho-social well-being. DSL was not always associated with worse outcomes compared to a single sensory loss. Rather, the results varied depending on the tasks assessed, as well as which groups were compared. Our findings highlight that despite the negative impact of sensory losses, community-dwelling older adults receiving sensory rehabilitation services tend to have overall good health and a high level of independence. These results also show that DSL is not always associated with worse outcomes compared to a single sensory loss. Further research is needed to better characterize older adults with DSL who have more severe sensory and cognitive difficulties than those in our sample, and among those who are not receiving rehabilitation services.

FingerSight: A Vibrotactile Wearable Ring for Assistance With Locating and Reaching Objects in Peripersonal Space

This paper describes a prototype guidance system, "FingerSight," to help people without vision locate and reach to objects in peripersonal space. It consists of four evenly spaced tactors embedded into a ring worn on the index finger, with a small camera mounted on top. Computer-vision analysis of the camera image controls vibrotactile feedback, leading users to move their hand to near targets. Two experiments tested the functionality of the prototype system. The first found that participants could discriminate between five different vibrotactile sites (four individual tactors and all simultaneously) with a mean accuracy of 88.8% after initial training. In the second experiment, participants were blindfolded and instructed to move their hand wearing the device to one of four locations within arm's reach, while hand trajectories were tracked. The tactors were controlled using two different strategies: (1) repeatedly signal axis with largest error, and (2) signal both axes in alternation. Participants demonstrated essentially straight-line trajectories toward the target under both instructions, but the temporal parameters (rate of approach, duration) showed an advantage for correction on both axes in sequence.

Double-Diamond Model-Based Orientation Guidance in Wearable Human-Machine Navigation Systems for Blind and Visually Impaired People

This paper presents the analysis and design of a new, wearable orientation guidance device in modern travel aid systems for blind and visually impaired people. The four-stage double-diamond design model was applied in the design process to achieve human-centric innovation and to ensure technical feasibility and economic viability. Consequently, a sliding tactile feedback wristband was designed and prototyped. Furthermore, a Bezier curve-based adaptive path planner is proposed to guarantee collision-free planned motion. Proof-of-concept experiments on both virtual and real-world scenarios are conducted. The evaluation results confirmed the efficiency and feasibility of the design and imply the design’s remarkable potential in spatial perception rehabilitation.

Eye Conditions in Infants and Children: Accommodations for Children With Vision Impairment

The effects of vision impairment and blindness on children can last a lifetime. Most children with vision impairments need a multidisciplinary team of teachers, child development specialists, and social workers. Blindness often is associated with other risk factors, disease processes, and/or disabilities. In the United States, the Social Security Administration defines children as legally blind when best corrected visual acuity is less than 20/200. The US law concerning accommodations for children with impairments is part of the Americans with Disabilities Act of 1990 (ADA), and specifically the Individuals with Disabilities Education Act (IDEA), which covers preschool-age and school-age children. Accommodations for children with vision impairment include low vision aids allowing them to stay in mainstream classes and schools.

Enhancing general spatial skills of young visually impaired people with a programmable distance discrimination training: a case control study

BACKGROUND

The estimation of relative distance is a perceptual task used extensively in everyday life. This important skill suffers from biases that may be more pronounced when estimation is based on haptics. This is especially true for the blind and visually impaired, for which haptic estimation of distances is paramount but not systematically trained. We investigated whether a programmable tactile display, used autonomously, can improve distance discrimination ability in blind and severely visually impaired youngsters between 7 and 22 years-old.

METHODS

Training consisted of four weekly sessions in which participants were asked to haptically find, on the programmable tactile display, the pairs of squares which were separated by the shortest and longest distance in tactile images with multiple squares. A battery of haptic tests with raised-line drawings was administered before and after training, and scores were compared to those of a control group that did only the haptic battery, without doing the distance discrimination training on the tactile display.

RESULTS

Both blind and severely impaired youngsters became more accurate and faster at the task during training. In haptic battery results, blind and severely impaired youngsters who used the programmable display improved in three and two tests, respectively. In contrast, in the control groups, the blind control group improved in only one test, and the severely visually impaired in no tests.

CONCLUSIONS

Distance discrimination skills can be trained equally well in both blind and severely impaired participants. More importantly, autonomous training with the programmable tactile display had generalized effects beyond the trained task. Participants improved not only in the size discrimination test but also in memory span tests. Our study shows that tactile stimulation training that requires minimal human assistance can effectively improve generic spatial skills.

Adaptations to support occupational engagement with age-related vision loss: A metasynthesis study

BACKGROUND.

Age-related vision loss (ARVL) is a progressive process that adversely affects older adults' occupational engagement. As such, older adults often employ a variety of psychological adaptation strategies.

PURPOSE.

The purpose of this study was to identify those psychological adaptation strategies employed by older adults aging with ARVL.

METHOD.

This metasynthesis searched and identified 21 qualitative articles that described a link between psychological adaptation strategies and occupational engagement.

FINDINGS.

The psychological strategies identified were categorized into five themes. The strategies of persisting with hope, positivity, and acceptance and portraying a self-image consistent with independence, competence, and self-reliance were well established in the literature, while other themes were more emerging, such as using humour, relying on religious/spiritual beliefs, and comparing the self to others.

IMPLICATIONS.

By understanding the psychological adaptation strategies employed by older adults with ARVL, occupational therapists will be better positioned to guide their clients toward positive adaptive patterns.

Effect of modulating braille dot height on reading regressions

It is well known that people who read print or braille sometimes make eye or finger movements against the reading direction. The way these regressions are elicited has been studied in detail by manipulating linguistic aspects of the reading material. Actually, it has been shown that reducing the physical intensity or clarity of the visual input signal can also lead to increased regressions during reading. We asked whether the same might be true in the haptic realm while reading braille. We set the height of braille dots at three different levels (high, medium, and low) and asked adult blind, practiced braille readers to read standardized texts without any repetition of content. The results show that setting the braille dot height near the tactile threshold significantly increased the frequency of regressive finger movements. Additionally, at the lowest braille dot height, braille reading speed significantly diminished. These effects did not occur at braille dot heights that were closer to the height of standard braille (medium and high). We tentatively conclude that this effect may be due to a heightened sense of uncertainty elicited by perception near the threshold that seems to be common to the reading process, independent of the sensory input modality. Furthermore, the described effect may be a feature of a brain area that contributes to the reading process mediated by vision as well as touch.

Safe Local Navigation for Visually Impaired Users With a Time-of-Flight and Haptic Feedback Device

This paper presents ALVU (Array of Lidars and Vibrotactile Units), a contactless, intuitive, hands-free, and discreet wearable device that allows visually impaired users to detect low- and high-hanging obstacles, as well as physical boundaries in their immediate environment. The solution allows for safe local navigation in both confined and open spaces by enabling the user to distinguish free space from obstacles. The device presented is composed of two parts: a sensor belt and a haptic strap. The sensor belt is an array of time-of-flight distance sensors worn around the front of a user's waist, and the pulses of infrared light provide reliable and accurate measurements of the distances between the user and surrounding obstacles or surfaces. The haptic strap communicates the measured distances through an array of vibratory motors worn around the user's upper abdomen, providing haptic feedback. The linear vibration motors are combined with a point-loaded pretensioned applicator to transmit isolated vibrations to the user. We validated the device's capability in an extensive user study entailing 162 trials with 12 blind users. Users wearing the device successfully walked through hallways, avoided obstacles, and detected staircases.

LIDAR Assist Spatial Sensing for the Visually Impaired and Performance Analysis

Echolocation enables people with impaired or no vision to comprehend the surrounding spatial information through the reflected sound. However, this technique often requires substantial training, and the accuracy of echolocation is subject to various conditions. Furthermore, the individuals who practice this sensing method must simultaneously generate the sound and process the received audio information. This paper proposes and evaluates a proof-of-concept light detection and ranging (LIDAR) assist spatial sensing (LASS) system, which intends to overcome these restrictions by obtaining the spatial information of the user's surroundings through a LIDAR sensor and translating the spatial information into the stereo sound of various pitches. The stereo sound of relative pitch represents the information regarding objects' angular orientation and horizontal distance, respectively, thus granting visually impaired users an enhanced spatial perception of his or her surrounding areas and potential obstacles. This paper is divided into two phases: Phase I is to engineer the hardware and software of the LASS system and Phase II focuses on the system efficacy study. The study, approved by the Penn State Institutional Review Board, included 18 student volunteers, who were recruited through the Penn State Department of Psychology Subject Pool. This paper demonstrates that the blindfolded individuals equipped with the LASS system are able to quantitatively identify the surrounding obstacles, differentiate their relative distance, and distinguish the angular location of multiple objects with minimal training.

Optimising technology to measure functional vision, mobility and service outcomes for people with low vision or blindness: protocol for a prospective cohort study in Australia and Malaysia

INTRODUCTION

Orientation and mobility (O&M) specialists assess the functional vision and O&M skills of people with mobility problems, usually relating to low vision or blindness. There are numerous O&M assessment checklists but no measures that reduce qualitative assessment data to a single comparable score suitable for assessing any O&M client, of any age or ability, in any location. Functional measures are needed internationally to align O&M assessment practices, guide referrals, profile O&M clients, plan appropriate services and evaluate outcomes from O&M programmes (eg, long cane training), assistive technology (eg, hazard sensors) and medical interventions (eg, retinal implants). This study aims to validate two new measures of functional performance vision-related outcomes in orientation and mobility (VROOM) and orientation and mobility outcomes (OMO) in the context of ordinary O&M assessments in Australia, with cultural comparisons in Malaysia, also developing phone apps and online training to streamline professional assessment practices.

METHODS AND ANALYSIS

This multiphase observational study will employ embedded mixed methods with a qualitative/quantitative priority: corating functional vision and O&M during social inquiry. Australian O&M agencies (n=15) provide the sampling frame. O&M specialists will use quota sampling to generate cross-sectional assessment data (n=400) before investigating selected cohorts in outcome studies. Cultural relevance of the VROOM and OMO tools will be investigated in Malaysia, where the tools will inform the design of assistive devices and evaluate prototypes. Exploratory and confirmatory factor analysis, Rasch modelling, cluster analysis and analysis of variance will be undertaken along with descriptive analysis of measurement data. Qualitative findings will be used to interpret VROOM and OMO scores, filter statistically significant results, warrant their generalisability and identify additional relevant constructs that could also be measured.

ETHICS AND DISSEMINATION

Ethical approval has been granted by the Human Research Ethics Committee at Swinburne University (SHR Project 2016/316). Dissemination of results will be via agency reports, journal articles and conference presentations.

Electrical Stimulation of Visual Cortex: Relevance for the Development of Visual Cortical Prosthetics

Electrical stimulation of the cerebral cortex is a powerful tool for exploring cortical function. Stimulation of early visual cortical areas is easily detected by subjects and produces simple visual percepts known as phosphenes. A device implanted in visual cortex that generates patterns of phosphenes could be used as a substitute for natural vision in blind patients. We review the possibilities and limitations of such a device, termed a visual cortical prosthetic. Currently, we can predict the location and size of phosphenes produced by stimulation of single electrodes. A functional prosthetic, however, must produce spatial temporal patterns of activity that will result in the perception of complex visual objects. Although stimulation of later visual cortical areas alone usually does not lead to a visual percept, it can alter visual perception and the performance of visual behaviors, and training subjects to use signals injected into these areas may be possible.

Performance of real-world functional vision tasks by blind subjects improves after implantation with the Argus® II retinal prosthesis system

BACKGROUND

The main objective of this study was to test Argus II subjects on three real-world functional vision tasks.

DESIGN

The study was designed to be randomized and prospective. Testing was conducted in a hospital/research laboratory setting at the various participating centres.

PARTICIPANTS

Twenty eight Argus II subjects, all profoundly blind, participated in this study.

METHODS

Subjects were tested on the three real-world functional vision tasks: Sock Sorting, Sidewalk Tracking and Walking Direction Discrimination task MAIN OUTCOME MEASURES: For the Sock Sorting task, percentage correct was computed based on how accurately subjects sorted the piles on a cloth-covered table and on a bare table. In the Sidewalk Tracking task, an 'out of bounds' count was recorded, signifying how often the subject veered away from the test course. During the Walking Direction Discrimination task, subjects were tested on the number of times they correctly identified the direction of testers walking across their field of view.

RESULTS

The mean percentage correct OFF versus ON for the Sock Sorting task was found to be significantly different for both testing conditions (t-test, P < 0.01). On the Sidewalk Tracking task, subjects performed significantly better with the system ON than they did with the system OFF (t-test, P < 0.05). Eighteen (18) of 27 subjects (67%) performed above chance with the system ON, and 6 (22%) did so with system OFF on the Walking Direction Discrimination task.

CONCLUSIONS

Argus II subjects performed better on all three tasks with their systems ON than they did with their systems OFF.