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Biebl B, Arcidiacono E, Kacianka S, Rieger JW, Bengler K. Opportunities and Limitations of a Gaze-Contingent Display to Simulate Visual Field Loss in Driving Simulator Studies. FRONTIERS IN NEUROERGONOMICS 2022; 3:916169. [PMID: 38235462 PMCID: PMC10790882 DOI: 10.3389/fnrgo.2022.916169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/11/2022] [Indexed: 01/19/2024]
Abstract
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.
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Affiliation(s)
- Bianca Biebl
- Chair of Ergonomics, School of Engineering and Design, Technical University of Munich, Garching, Germany
| | - Elena Arcidiacono
- Chair of Ergonomics, School of Engineering and Design, Technical University of Munich, Garching, Germany
| | - Severin Kacianka
- Chair of Software and Systems Engineering, Department of Informatics, Technical University of Munich, Garching, Germany
| | - Jochem W. Rieger
- Department of Psychology, University of Oldenburg, Oldenburg, Germany
| | - Klaus Bengler
- Chair of Ergonomics, School of Engineering and Design, Technical University of Munich, Garching, Germany
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Massof RW. Patient-Reported Measures of the Effects of Vision Impairments and Low Vision Rehabilitation on Functioning in Daily Life. Annu Rev Vis Sci 2022; 8:217-238. [PMID: 35417256 DOI: 10.1146/annurev-vision-100620-022121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The quantification of vision impairments dates to the mid-nineteenth century with standardization of visual acuity and visual field measures in the eye clinic. Attempts to quantify the impact of vision impairments on patients' lives did not receive clinical attention until the close of the twentieth century. Although formal psychometric theories and measurement instruments were well developed and commonplace in educational testing, as well as in various areas in psychology and rehabilitation medicine, the late start applying them to clinical vision research created a vacuum that invited poorly developed and poorly functioning instruments and analytic methods. Although this research is still burdened with legacy instruments, mandates by regulatory agencies to include the patients' perspectives and preferences in the evaluation of clinical outcomes have stimulated the development and validation of self-report instruments grounded in modern psychometric theory and methods. Here I review the progress and accomplishments of applying modern psychometrics to clinical vision research. Expected final online publication date for the Annual Review of Vision Science, Volume 8 is September 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Robert W Massof
- Lions Vision Research and Rehabilitation Center, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;
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Vreeken HL, van Nispen RMA, Kramer SE, van Rens GHMB. 'Dual Sensory Loss Protocol' for Communication and Wellbeing of Older Adults With Vision and Hearing Impairment - A Randomized Controlled Trial. Front Psychol 2020; 11:570339. [PMID: 33324283 PMCID: PMC7725686 DOI: 10.3389/fpsyg.2020.570339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/29/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives Many older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss (DSL) protocol on communication and wellbeing of older persons with DSL and their communication partners (e.g., spouse or child) in the Netherlands and Belgium. Methods Participants (N = 131) and their communication partners (n = 113) were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired (CPHI). Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory (HHDI) - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models (LMM) were used to analyze effects between groups over time for every outcome measure. Results Intention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies (effect size SMD = 0.60, 95% CI: 0.25 to 0.95) in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects. Conclusion The DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals. Clinical Trial Registration www.ClinicalTrials.gov, identifier NTR2843.
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Affiliation(s)
- Hilde L Vreeken
- Department of Ophthalmology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ruth M A van Nispen
- Department of Ophthalmology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Sophia E Kramer
- Department of Otolaryngology, Head and Neck Surgery, Section Ear and Hearing, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ger H M B van Rens
- Department of Ophthalmology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Department of Ophthalmology, Elkerliek Hospital, Helmond, Netherlands
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Jones PR, Somoskeöy T, Chow-Wing-Bom H, Crabb DP. Seeing other perspectives: evaluating the use of virtual and augmented reality to simulate visual impairments (OpenVisSim). NPJ Digit Med 2020; 3:32. [PMID: 32195367 PMCID: PMC7064490 DOI: 10.1038/s41746-020-0242-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/11/2020] [Indexed: 12/26/2022] Open
Abstract
Simulations of visual impairment are used to educate and inform the public. However, evidence regarding their accuracy remains lacking. Here we evaluated the effectiveness of modern digital technologies to simulate the everyday difficulties caused by glaucoma. 23 normally sighted adults performed two everyday tasks that glaucoma patients often report difficulties with: a visual search task in which participants attempted to locate a mobile phone in virtual domestic environments (virtual reality (VR)), and a visual mobility task in which participants navigated a physical, room-scale environment, while impairments were overlaid using augmented reality (AR). On some trials, a gaze-contingent simulated scotoma-generated using perimetric data from a real patient with advanced glaucoma-was presented in either the superior or inferior hemifield. The main outcome measure was task completion time. Eye and head movements were also tracked and used to assess individual differences in looking behaviors. The results showed that the simulated impairments substantially impaired performance in both the VR (visual search) and AR (visual mobility) tasks (both P < 0.001). Furthermore, and in line with previous patient data: impairments were greatest when the simulated Visual Field Loss (VFL) was inferior versus superior (P < 0.001), participants made more eye and head movements in the inferior VFL condition (P < 0.001), and participants rated the inferior VFL condition as more difficult (P < 0.001). Notably, the difference in performance between the inferior and superior conditions was almost as great as the difference between a superior VFL and no impairment at all (VR: 71%; AR: 70%). We conclude that modern digital simulators are able to replicate and objectively quantify some of the key everyday difficulties associated with visual impairments. Advantages, limitations, and possible applications of current technologies are discussed. Instructions are also given for how to freely obtain the software described (OpenVisSim).
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Affiliation(s)
- Pete R. Jones
- Division of Optometry and Visual Science, School of Health Science, Northampton Square, City, University of London, London, EC1V 0HB UK
- Institute of Ophthalmology, University College London (UCL), 11-43 Bath Street, London, EC1V 9EL UK
- NIHR Moorfields Biomedical Research Centre, London, EC1V 2PD UK
| | - Tamás Somoskeöy
- Division of Optometry and Visual Science, School of Health Science, Northampton Square, City, University of London, London, EC1V 0HB UK
| | - Hugo Chow-Wing-Bom
- Institute of Ophthalmology, University College London (UCL), 11-43 Bath Street, London, EC1V 9EL UK
- NIHR Moorfields Biomedical Research Centre, London, EC1V 2PD UK
| | - David P. Crabb
- Division of Optometry and Visual Science, School of Health Science, Northampton Square, City, University of London, London, EC1V 0HB UK
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Wilson AH, Alsius A, Paré M, Munhall KG. Spatial Frequency Requirements and Gaze Strategy in Visual-Only and Audiovisual Speech Perception. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:601-15. [PMID: 27537379 PMCID: PMC5280058 DOI: 10.1044/2016_jslhr-s-15-0092] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/16/2015] [Accepted: 10/07/2015] [Indexed: 06/06/2023]
Abstract
PURPOSE The aim of this article is to examine the effects of visual image degradation on performance and gaze behavior in audiovisual and visual-only speech perception tasks. METHOD We presented vowel-consonant-vowel utterances visually filtered at a range of frequencies in visual-only, audiovisual congruent, and audiovisual incongruent conditions (Experiment 1; N = 66). In Experiment 2 (N = 20), participants performed a visual-only speech perception task and in Experiment 3 (N = 20) an audiovisual task while having their gaze behavior monitored using eye-tracking equipment. RESULTS In the visual-only condition, increasing image resolution led to monotonic increases in performance, and proficient speechreaders were more affected by the removal of high spatial information than were poor speechreaders. The McGurk effect also increased with increasing visual resolution, although it was less affected by the removal of high-frequency information. Observers tended to fixate on the mouth more in visual-only perception, but gaze toward the mouth did not correlate with accuracy of silent speechreading or the magnitude of the McGurk effect. CONCLUSIONS The results suggest that individual differences in silent speechreading and the McGurk effect are not related. This conclusion is supported by differential influences of high-resolution visual information on the 2 tasks and differences in the pattern of gaze.
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Affiliation(s)
- Amanda H. Wilson
- Psychology Department, Queen's University, Kingston, Ontario, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Agnès Alsius
- Psychology Department, Queen's University, Kingston, Ontario, Canada
| | - Martin Paré
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Kevin G. Munhall
- Psychology Department, Queen's University, Kingston, Ontario, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
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High visual resolution matters in audiovisual speech perception, but only for some. Atten Percept Psychophys 2016; 78:1472-87. [DOI: 10.3758/s13414-016-1109-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Roberts KL, Allen HA. Perception and Cognition in the Ageing Brain: A Brief Review of the Short- and Long-Term Links between Perceptual and Cognitive Decline. Front Aging Neurosci 2016; 8:39. [PMID: 26973514 PMCID: PMC4772631 DOI: 10.3389/fnagi.2016.00039] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/15/2016] [Indexed: 11/13/2022] Open
Abstract
Ageing is associated with declines in both perception and cognition. We review evidence for an interaction between perceptual and cognitive decline in old age. Impoverished perceptual input can increase the cognitive difficulty of tasks, while changes to cognitive strategies can compensate, to some extent, for impaired perception. While there is strong evidence from cross-sectional studies for a link between sensory acuity and cognitive performance in old age, there is not yet compelling evidence from longitudinal studies to suggest that poor perception causes cognitive decline, nor to demonstrate that correcting sensory impairment can improve cognition in the longer term. Most studies have focused on relatively simple measures of sensory (visual and auditory) acuity, but more complex measures of suprathreshold perceptual processes, such as temporal processing, can show a stronger link with cognition. The reviewed evidence underlines the importance of fully accounting for perceptual deficits when investigating cognitive decline in old age.
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Affiliation(s)
| | - Harriet A Allen
- School of Psychology, University of Nottingham Nottingham, UK
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Dawes P, Dickinson C, Emsley R, Bishop P, Cruickshanks K, Edmondson-Jones M, McCormack A, Fortnum H, Moore DR, Norman P, Munro K. Vision impairment and dual sensory problems in middle age. Ophthalmic Physiol Opt 2014; 34:479-88. [PMID: 24888710 PMCID: PMC4273649 DOI: 10.1111/opo.12138] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 05/06/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE Vision and hearing impairments are known to increase in middle age. In this study we describe the prevalence of vision impairment and dual sensory impairment in UK adults aged 40-69 years in a very large and recently ascertained data set. The associations between vision impairment, age, sex, socioeconomic status, and ethnicity are reported. METHODS This research was conducted using the UK Biobank Resource, with subsets of UK Biobank data analysed with respect to self-report of eye problems and glasses use. Better-eye visual acuity with habitually worn refractive correction was assessed with a logMAR chart (n = 116,682). Better-ear speech reception threshold was measured with an adaptive speech in noise test, the Digit Triplet Test (n = 164,770). Prevalence estimates were weighted with respect to UK 2001 Census data. RESULTS Prevalence of mild visual impairment (VA >0.1 logMAR (6/7.5, 20/25) and ≥0.48 (6/18, 20/60)) and low vision (VA >0.48 (6/18, 20/60) and ≥1.3 (6/120, 20/400)) was estimated at 13.1% (95% CI 12.9-13.4) and 0.8% (95% CI 0.7-0.9), respectively. Use of glasses was 88.0% (95% CI 87.9-88.1). The prevalence of dual sensory impairment was 3.1% (95% CI 3.0-3.2) and there was a nine-fold increase in the prevalence of dual sensory problems between the youngest and oldest age groups. Older adults, those from low socioeconomic and ethnic minority backgrounds were most at risk for vision problems. CONCLUSIONS Mild vision impairment is common in middle aged UK adults, despite widespread use of spectacles. Increased likelihood of vision impairment with older age and with ethnic minorities is of concern given ageing and more ethnically diverse populations. Possible barriers to optometric care for those from low socioeconomic and ethnic minority backgrounds may require attention. A higher than expected prevalence of dual impairment suggests that hearing and vision problems share common causes. Optometrists should consider screening for hearing problems, particularly among older adults.
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Affiliation(s)
- Piers Dawes
- School of Psychological Sciences, University of Manchester
| | | | - Richard Emsley
- Centre for Biostatistics, Institute of Population Health, University of Manchester
| | - Paul Bishop
- Institute of Human Development, University of Manchester
| | - Karen Cruickshanks
- Population Health Sciences and Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin
| | - Mark Edmondson-Jones
- NIHR Nottingham Hearing Biomedical Research Unit, University of Nottingham
- School of Medicine, University of Nottingham
| | - Abby McCormack
- NIHR Nottingham Hearing Biomedical Research Unit, University of Nottingham
- School of Medicine, University of Nottingham
| | - Heather Fortnum
- NIHR Nottingham Hearing Biomedical Research Unit, University of Nottingham
- School of Medicine, University of Nottingham
| | | | | | - Kevin Munro
- School of Psychological Sciences, University of Manchester
- Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre
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Vreeken HL, van Rens GHMB, Kramer SE, Knol DL, Festen JM, van Nispen RMA. Dual sensory loss: development of a dual sensory loss protocol and design of a randomized controlled trial. BMC Geriatr 2013; 13:84. [PMID: 23941667 PMCID: PMC3751532 DOI: 10.1186/1471-2318-13-84] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 08/05/2013] [Indexed: 12/04/2022] Open
Abstract
Background Dual sensory loss (DSL) has a negative impact on health and wellbeing and its prevalence is expected to increase due to demographic aging. However, specialized care or rehabilitation programs for DSL are scarce. Until now, low vision rehabilitation does not sufficiently target concurrent impairments in vision and hearing. This study aims to 1) develop a DSL protocol (for occupational therapists working in low vision rehabilitation) which focuses on optimal use of the senses and teaches DSL patients and their communication partners to use effective communication strategies, and 2) describe the multicenter parallel randomized controlled trial (RCT) designed to test the effectiveness and cost-effectiveness of the DSL protocol. Methods/design To develop a DSL protocol, literature was reviewed and content was discussed with professionals in eye/ear care (interviews/focus groups) and DSL patients (interviews). A pilot study was conducted to test and confirm the DSL protocol. In addition, a two-armed international multi-center RCT will evaluate the effectiveness and cost-effectiveness of the DSL protocol compared to waiting list controls, in 124 patients in low vision rehabilitation centers in the Netherlands and Belgium. Discussion This study provides a treatment protocol for rehabilitation of DSL within low vision rehabilitation, which aims to be a valuable addition to the general low vision rehabilitation care. Trial registration Netherlands Trial Register (NTR) identifier: NTR2843
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Affiliation(s)
- Hilde L Vreeken
- Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands.
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Abstract
PURPOSE Contrast sensitivity is reduced in people with eye disease, and also in older adults without eye disease. In this article, we compare contrast of text presented in print and digital formats with contrast sensitivity values for a large cohort of subjects in a population-based study of older adults (the Salisbury Eye Evaluation). METHODS Contrast sensitivity values were recorded for 2520 adults aged 65 to 84 years living in Salisbury, Maryland. The proportion of the sample likely to be unable to read text of different formats (electronic books, newsprint, paperback books, laser print, and LED computer monitors) was calculated using published contrast reserve levels required to perform spot reading, to read with fluency, high fluency, and under optimal conditions. RESULTS One percent of this sample had contrast sensitivity less than that required to read newsprint fluently. Text presented on an LED computer monitor had the highest contrast. Ninety-eight percent of the sample had contrast sensitivity sufficient for high fluent reading of text (at least 160 words/min) on a monitor. However, 29.6% were still unlikely to be able to read this text with optimal fluency. CONCLUSIONS Reduced contrast of print limits text accessibility for many people in the developed world. Presenting text in a high-contrast format, such as black laser print on a white page, would increase the number of people able to access such information. Additionally, making text available in a format that can be presented on an LED computer monitor will increase access to written documents.
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Morris NL, Chaparro A, Downs D, Wood JM. Effects of simulated cataracts on speech intelligibility. Vision Res 2012; 66:49-54. [DOI: 10.1016/j.visres.2012.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 05/30/2012] [Accepted: 06/09/2012] [Indexed: 10/28/2022]
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Di Berardino F, Cesarani A. The importance of hearing evaluation in the study of simulated visual impairment in speech reading abilities. Ophthalmic Physiol Opt 2011; 32:165; author reply 165. [PMID: 22039895 DOI: 10.1111/j.1475-1313.2011.00877.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dickinson CM, Taylor JJ. Authors’ response. Ophthalmic Physiol Opt 2011. [DOI: 10.1111/j.1475-1313.2011.00881.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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