The Assessment of Visual Fields in Infants Using Saccadic Vector Optokinetic Perimetry (SVOP): A Feasibility Study

A review of experimental task design in psychophysical eye tracking research

While eye tracking is a technique commonly used in the experimental study of higher-level perceptual processes such as visual search, working memory, reading, and scene exploration, its use for the quantification of basic visual functions (visual acuity, contrast sensitivity, color vision, motion detection) is less explored. The use of eye movement features as dependent variables in a psychophysical investigation can serve multiple roles. They can be central in studies with neurological patients or infants that cannot comply with verbal instructions, understand task demands, and/or emit manual responses. The technique may also serve a complementary role, determining the conditions under which a manual or verbal response is given, such as stimulus position in the visual field, or it can afford the analysis of new dependent variables, such as the time interval between oculomotor and manual responses. Our objective is to review the literature that applied the eye tracking technique to psychophysical problems. The two questions our review raises are: can eye movements (reflex or voluntary) be an objective index of stimulus detection in psychophysical tasks? If so, under what conditions, and how does it compare with traditional paradigms requiring manual responses? Our (non-systematic) methodological review selected studies that used video-oculography as the technique of choice and had a basic visual function as their primary object of investigation. Studies satisfying those criteria were then categorized into four broad classes reflecting their main research interest: (1) stimulus detection and threshold estimation, (2) the effects of stimulus properties on fixational eye movements, (3) the effects of eye movements on perception, and (4) visual field assessment. The reviewed studies support the idea that eye tracking is a valuable technique for the study of basic perceptual processes. We discuss methodological characteristics within each of the proposed classification area, with the objective of informing future task design.

Eye Tracking in Optometry: A Systematic Review

This systematic review examines the use of eye-tracking devices in optometry, describing their main characteristics, areas of application and metrics used. Using the PRISMA method, a systematic search was performed of three databases. The search strategy identified 141 reports relevant to this topic, indicating the exponential growth over the past ten years of the use of eye trackers in optometry. Eye-tracking technology was applied in at least 12 areas of the field of optometry and rehabilitation, the main ones being optometric device technology, and the assessment, treatment, and analysis of ocular disorders. The main devices reported on were infrared light-based and had an image capture frequency of 60 Hz to 2000 Hz. The main metrics mentioned were fixations, saccadic movements, smooth pursuit, microsaccades, and pupil variables. Study quality was sometimes limited in that incomplete information was provided regarding the devices used, the study design, the methods used, participants' visual function and statistical treatment of data. While there is still a need for more research in this area, eye-tracking devices should be more actively incorporated as a useful tool with both clinical and research applications. This review highlights the robustness this technology offers to obtain objective information about a person's vision in terms of optometry and visual function, with implications for improving visual health services and our understanding of the vision process.

Evaluation of Virtual Reality Perimetry and Standard Automated Perimetry in Normal Children

Purpose

The Olleyes VisuALL-K is a pediatric videogame-based static threshold perimeter using a virtual reality headset. We determined normal threshold sensitivities for the 24-2 test locations using the virtual reality perimetry (VRP) and also tested patients on the Humphrey Field Analyzer (HFA). Patient satisfaction for the two instruments was compared.

Methods

This exploratory study tested 50 normal pediatric participants aged 8 to 17 years on the HFA and VRP. The main outcome measure was threshold sensitivity at the 24-2 test locations for the two instruments.

Results

The mean participant age was 13.0 ± 2.6 years; 50% were female. The threshold values for VRP are reported as measured on the device and after conversion to an HFA-equivalent scale. Age-adjusted thresholds showed a mean sensitivity of 31.8 ± 1.1 dB (46.1 ± dB HFA equivalent) diminution from the maximum light intensity in the VRP and 31.0 ± 1.5 dB diminution from the maximum light intensity in the HFA; interparticipant variability in mean threshold sensitivity was 2.7 ± 0.4 dB for the VRP and 2.7 ± 0.6 dB for the HFA. The HFA demonstrated decreased threshold sensitivity with increasing eccentricity, whereas the VRP threshold did not seem to vary with eccentricity. Mild age effects on threshold sensitivity were seen in the VRP and the HFA (R2 = 0.11, P < 0.001 and R2 = 0.05, P < 0.05, respectively). The mean time to completion for VRP and HFA was 7.6 ± 1.5 and 5.3 ± 0.9 min/eye, respectively (P < 0.0001). Patient satisfaction scores favored VRP (P < 0.01) despite the longer test duration.

Conclusions

The Olleyes game-based VRP and HFA can be used to map out the peripheral vision in normal children. The VRP has a higher patient satisfaction when used in children than the HFA. The portability of the test allows it to be performed in a myriad of environments, lending a flexibility that can benefit this population.

Translational Relevance

This virtual reality perimetry device provides an alternative to the Humphrey Field Analyzer for children.

Reflexive Saccades Used for Objective and Automated Measurements of Contrast Sensitivity in Selected Areas of Visual Field

Purpose

This study proposes a novel approach for objective and automated peripheral contrast sensitivity (CS) testing using reflexive saccades. Here the CS was examined in various areas the of visual field (VF) using a live analysis of gaze data. For validation of the new test, we examined CS with an established procedure of identifying the orientation of a contrast stimulus.

Methods

To perform and validate the saccade-based testing, two separate measurement events were performed. In the first, participants were asked to execute a saccade toward a newly-appeared stimulus in their VF. After the saccade execution or stimulus expiry, reporting the target orientation was required in a four-alternatives forced choice (4AFC). Therefore the first measurement yields two outcomes (objective and subjective). In the second measurement, only the identification of the stimulus orientation was requested, while fixating a central mark. Stimulus contrast was controlled by an adaptive psychometric procedure in both measurements.

Results

The study found strong correlations (all r ≥ 0.79) of CS values for all three possible testing methods (saccade-based responding in saccadic measurements, keyboard-based responding in saccadic measurements, keyboard-based responding in non-saccadic measurements), showing the feasibility of employment of reflexive saccades in such testing. Second, this study shows a significant influence of eccentricity and direction of the stimulus on the CS function.

Conclusions

CS measured with reflexive saccades is comparable to other testing methods over several areas of the participant's VF. Hence, we propose it as a novel and objective testing procedure for CS measurements.

Translational Relevance

Assessment of CS using reflexive saccades extends the portfolio of suggested eye movement-based tests, allowing objective examination across the VF, which might be helpful especially in the early detection of various eye diseases.