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Assessment of performance in patients with homonymous visual field defects by analysis of their visual exploration, using standardized, virtual reality environments

Research Topic

My work, under the supervision of Professor Ulrich Schiefer has been to investigate the viewing strategies of patients with homonymous visual field defects (HVFDs) in a virtual-reality (VR) driving scenario. HVFDs are among the most frequent disorders after brain damage and create a marked amount of subjective inconvenience in everyday life. Conventional kinetic and static perimetric methods, which are usually used for the assessment of visual field, are however rather artificial, since they are conducted under strict gaze fixation. On the other hand, visual exploration – i.e. the “scanning of visible objects” by gaze movements – is a typical characteristic of vision in everyday life and allows shifting of binocular visual field defects, from relevant to less important areas of the visual environment.

Together with our collaborators, led by Professor Hanspeter Mallot, we have found that some patients with HVFDs demonstrated sufficient compensatory driving behavior during the simulated test ride. Furthermore, the extent of the visual field loss was weakly related to driving performance. This finding suggests that visual field indices per se are inadequate to describe the driving performance of patients with HVFDs in this VR-scenario. Intact exploration ability thus could compensate for the visual field defects through activation of the efferent oculomotor system.

We are now analyzing the viewing behavior of patients with HVFDs, in order to assess if there are characteristic gaze patterns predictive of the successful or unsuccessful obstacle avoidance in the VR scenario. It is also suggested that efficient oculomotor scanning behavior depends on the site and extent of brain lesion. Using brain lesion analysis and software-based imaging tools, we are investigating if the underlying brain damage influences performance and the ability to compensate.

Future “dreams or visions” in vision researc

My personal dream in vision research is to continue discovering compensatory gaze strategies of patients with reduced vision. Insight into these compensatory mechanisms will further enhance the determination of the best examination procedure to predict and quantify their visual performance. Overall in the vision field, I would like to witness the development of rehabilitation tools for clinical use in low vision patients.

Eleni Papageorgiou

General Hospital of Larissa
Department of Ophthalmology

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