Practice-related changes in eye movement strategy in healthy adults with simulated hemianopia

Simulation of visual impairment in persons with normal vision for scientific research

Simulation of visual impairment in healthy eyes has multiple applications in students' training, research and product development. However, due to the absence of an existing standard protocol, the method of simulation was left to the discretion of the researcher. This review aimed to outline the various methods of simulating visual impairment and categorising them. A scoping review of the relevant publications was conducted. Of the 1593 articles originally retrieved from the databases, 103 were included in the review. The characteristics of the participants, the method for simulation of the visual impairment in persons with normal vision and the level or type of visual impairment that was simulated were extracted from the papers. None of the methods of simulation can be judged as being superior to the others. However, electronic displays produced the most consistent form of visual impairment simulation.

Adapting attentional control settings in a shape-changing environment

In rich visual environments, humans have to adjust their attentional control settings in various ways, depending on the task. Especially if the environment changes dynamically, it remains unclear how observers adapt to these changes. In two experiments (online and lab-based versions of the same task), we investigated how observers adapt their target choices while searching for color singletons among shape distractor contexts that changed over trials. The two equally colored targets had shapes that differed from each other and matched a varying number of distractors. Participants were free to select either target. The results show that participants adjusted target choices to the shape ratio of distractors: even though the task could be finished by focusing on color only, participants showed a tendency to choose targets matching with fewer distractors in shape. The time course of this adaptation showed that the regularities in the changing environment were taken into account. A Bayesian modeling approach was used to provide a fine-grained picture of how observers adapted their behavior to the changing shape ratio with three parameters: the strength of adaptation, its delay relative to the objective distractor shape ratio, and a general bias toward specific shapes. Overall, our findings highlight that systematic changes in shape, even when it is not a target-defining feature, influence how searchers adjust their attentional control settings. Furthermore, our comparison between lab-based and online assessments with this paradigm suggests that shape is a good choice as a feature dimension in adaptive choice online experiments.

The effects of simulated hemianopia on eye movements during text reading

Vision loss is a common, devastating complication of cerebral strokes. In some cases the complete contra-lesional visual field is affected, leading to problems with routine tasks and, notably, the ability to read. Although visual information crucial for reading is imaged on the foveal region, readers often extract useful parafoveal information from the next word or two in the text. In hemianopic field loss, parafoveal processing is compromised, shrinking the visual span and resulting in slower reading speeds. Recent approaches to rehabilitation using perceptual training have been able to demonstrate some recovery of useful visual capacity. As gains in visual sensitivity were most pronounced at the border of the scotoma, it may be possible to use training to restore some of the lost visual span for reading. As restitutive approaches often involve prolonged training sessions, it would be beneficial to know how much recovery is required to restore reading ability. To address this issue, we employed a gaze-contingent paradigm using a low-pass filter to blur one side of the text, functionally simulating a visual field defect. The degree of blurring acts as a proxy for visual function recovery that could arise from restitutive strategies, and allows us to evaluate and quantify the degree of visual recovery required to support normal reading fluency in patients. Because reading ability changes with age, we recruited a group of younger participants, and another with older participants who are closer in age to risk groups for ischaemic strokes. Our results show that changes in patterns of eye movement observed in hemianopic loss can be captured using this simulated reading environment. This opens up the possibility of using participants with normal visual function to help identify the most promising strategies for ameliorating hemianopic loss, before translation to patient groups.

Visual search habits and the spatial structure of scenes

Some spatial layouts may suit our visual search habits better than others. We compared eye movements during search across three spatial configurations. Participants searched for a line segment oriented 45^∘ to the right. Variation in the orientation of distractor line segments determines the extent to which this target would be visible in peripheral vision: a target among homogeneous distractors is highly visible, while a target among heterogeneous distractors requires central vision. When the search array is split into homogeneous and heterogeneous left and right halves, a large proportion of fixations are “wasted” on the homogeneous half, leading to slower search times. We compared this pattern to two new configurations. In the first, the array was split into upper and lower halves. During a passive viewing baseline condition, we observed biases to look both at the top half and also at the hetergeneous region first. Both of these biases were weaker during active search, despite the fact that the heterogeneous bias would have led to improvements in efficiency if it had been retained. In the second experiment, patches of more or less heterogeneous line segments were scattered across the search space. This configuration allows for more natural, spatially distributed scanpaths. Participants were more efficient and less variable relative to the left/right configuration. The results are consistent with the idea that visual search is associated with a distributed sequence of fixations, guided only loosely by the potential visibility of the target in different regions of the scene.

Opportunities and Limitations of a Gaze-Contingent Display to Simulate Visual Field Loss in Driving Simulator Studies

Background

Research on task performance under visual field loss is often limited due to small and heterogenous samples. Simulations of visual impairments hold the potential to account for many of those challenges. Digitally altered pictures, glasses, and contact lenses with partial occlusions have been used in the past. One of the most promising methods is the use of a gaze-contingent display that occludes parts of the visual field according to the current gaze position. In this study, the gaze-contingent paradigm was implemented in a static driving simulator to simulate visual field loss and to evaluate parallels in the resulting driving and gaze behavior in comparison to patients.

Methods

The sample comprised 15 participants without visual impairment. All the subjects performed three drives: with full vision, simulated left-sided homonymous hemianopia, and simulated right-sided homonymous hemianopia, respectively. During each drive, the participants drove through an urban environment where they had to maneuver through intersections by crossing straight ahead, turning left, and turning right.

Results

The subjects reported reduced safety and increased workload levels during simulated visual field loss, which was reflected in reduced lane position stability and greater absence of large gaze movements. Initial compensatory strategies could be found concerning a dislocated gaze position and a distorted fixation ratio toward the blind side, which was more pronounced for right-sided visual field loss. During left-sided visual field loss, the participants showed a smaller horizontal range of gaze positions, longer fixation durations, and smaller saccadic amplitudes compared to right-sided homonymous hemianopia and, more distinctively, compared to normal vision.

Conclusion

The results largely mirror reports from driving and visual search tasks under simulated and pathological homonymous hemianopia concerning driving and scanning challenges, initially adopted compensatory strategies, and driving safety. This supports the notion that gaze-contingent displays can be a useful addendum to driving simulator research with visual impairments if the results are interpreted considering methodological limitations and inherent differences to the pathological impairment.

Search strategies improve with practice, but not with time pressure or financial incentives

When searching for an object, do we minimize the number of eye movements we need to make? Under most circumstances, the cost of saccadic parsimony likely outweighs the benefit, given the cost is extensive computation and the benefit is a few hundred milliseconds of time saved. Previous research has measured the proportion of eye movements directed to locations where the target would have been visible in the periphery as a way of quantifying the proportion of superfluous fixations. A surprisingly large range of individual differences has emerged from these studies, suggesting some people are highly efficient and others much less so. Our question in the current study is whether these individual differences can be explained by differences in motivation. In two experiments, we demonstrate that neither time pressure nor financial incentive led to improvements of visual search strategies; the majority of participants continued to make many superfluous fixations in both experiments. The wide range of individual differences in efficiency observed previously was replicated here. We observed small but consistent improvements in strategy over the course of the experiment (regardless of reward or time pressure) suggesting practice, not motivation, makes participants more efficient. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Biomechanical adaptation to post-stroke visual field loss: a systematic review

BACKGROUND

Homonymous visual field defects represent the most frequent type of visual field loss after stroke, affecting nearly 30% of individuals with unilateral post-chiasmal brain damage. This review aimed to gather the available evidence on the biomechanical changes to visual field loss following stroke.

METHODS

A systematic review was conducted inclusive of randomised controlled trials, cohort studies, before-after studies and case-controlled studies. Studies including adult and paediatric participants that investigated eye, head, or body movements in post-stroke visual field loss during visual exploration tasks were included. Search terms included a range of MESH terms as well as alternative terms relating to stroke, visual field loss, hemianopia, visual functions and scanning behaviour. Articles were selected by two authors independently. Data were extracted by one author and verified by a second. All included articles were assessed for risk of bias using checklists appropriate to the study design.

RESULTS

Thirty-six articles (1123 participants) were included in the overall review (Kappa 0.863) and categorised into simulated or true visual field loss (typically hemianopia). Seven studies identified the biomechanical alterations to simulated hemianopia compared to normal performance. Twenty-nine studies detailed eye, head and body movement parameters in true hemianopia. Hemianopic participants and healthy adults with simulated hemianopia differed significantly from controls in various fixation and saccade parameters as indicated by increased number and duration of fixations, number and duration of saccades and scan path length with shorter mean saccadic amplitude. Under simulated hemianopia, participants were consistently biased towards the sighted visual field while gaze behaviour in true hemianopia was biased in the direction of the blind hemifield.

CONCLUSIONS

There is considerable evidence on the altered eye movements that occur in true hemianopia and in healthy adults with simulated hemianopia. Successful performance in naturalistic tasks of visual exploration appears to be related to compensatory mechanisms of visual exploratory behaviour, namely, an increase in the amplitude and peak velocity of saccades, widening horizontally the distribution of eye movements, and a shift of the overall distribution of saccades into the blind field. This review highlights the lack of studies reporting head and other body movement parameters in hemianopia. Further studies with robust methodology and large sample sizes involving participants with post-stroke visual field loss are needed.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020194403.

Stable individual differences in strategies within, but not between, visual search tasks

A striking range of individual differences has recently been reported in three different visual search tasks. These differences in performance can be attributed to strategy, that is, the efficiency with which participants control their search to complete the task quickly and accurately. Here, we ask whether an individual’s strategy and performance in one search task is correlated with how they perform in the other two. We tested 64 observers and found that even though the test–retest reliability of the tasks was high, an observer’s performance and strategy in one task was not predictive of their behaviour in the other two. These results suggest search strategies are stable over time, but context-specific. To understand visual search, we therefore need to account not only for differences between individuals but also how individuals interact with the search task and context.

Inefficient Eye Movements: Gamification Improves Task Execution, But Not Fixation Strategy

Decisions about where to fixate are highly variable and often inefficient. In the current study, we investigated whether such decisions would improve with increased motivation. Participants had to detect a discrimination target, which would appear in one of two boxes, but only after they chose a location to fixate. The distance between boxes determines which location to fixate to maximise the probability of being able to see the target: participants should fixate between the two boxes when they are close together, and on one of the two boxes when they are far apart. We "gamified" this task, giving participants easy-to-track rewards that were contingent on discrimination accuracy. Their decisions and performance were compared to previous results that were gathered in the absence of this additional motivation. We used a Bayesian beta regression model to estimate the size of the effect and associated variance. The results demonstrate that discrimination accuracy does indeed improve in the presence of performance-related rewards. However, there was no difference in eye movement strategy between the two groups, suggesting this improvement in accuracy was not due to the participants making more optimal eye movement decisions. Instead, the motivation encouraged participants to expend more effort on other aspects of the task, such as paying more attention to the boxes and making fewer response errors.

Seeing Beyond Salience and Guidance: The Role of Bias and Decision in Visual Search

Visual search is a popular tool for studying a range of questions about perception and attention, thanks to the ease with which the basic paradigm can be controlled and manipulated. While often thought of as a sub-field of vision science, search tasks are significantly more complex than most other perceptual tasks, with strategy and decision playing an essential, but neglected, role. In this review, we briefly describe some of the important theoretical advances about perception and attention that have been gained from studying visual search within the signal detection and guided search frameworks. Under most circumstances, search also involves executing a series of eye movements. We argue that understanding the contribution of biases, routines and strategies to visual search performance over multiple fixations will lead to new insights about these decision-related processes and how they interact with perception and attention. We also highlight the neglected potential for variability, both within and between searchers, to contribute to our understanding of visual search. The exciting challenge will be to account for variations in search performance caused by these numerous factors and their interactions. We conclude the review with some recommendations for ways future research can tackle these challenges to move the field forward.