Beyond visual acuity: development of a simple test of the slow-to-see phenomenon in children with infantile nystagmus syndrome
Beyond visual acuity: development of a simple test of the slow-to-see phenomenon in children with infantile nystagmus syndrome
Purpose: conventional static visual acuity testing profoundly underestimates the impact of infantile nystagmus on functional vision. The slow-to-see phenomenon explains why many patients with nystagmus perform well in non-time restricted acuity tests but experience difficulty in certain situations. This is often observed by parents when their child struggles to recognise familiar faces in crowded scenes. A test measuring more than visual acuity could permit a more real-world assessment of visual impact and provide a robust outcome measure for clinical trials.
Methods: children with nystagmus and, age and acuity matched controls attending Southampton General Hospital were recruited for two tasks. In the first, eye-tracking measured the time participants spent looking at an image of their mother when alongside a stranger, this was then repeated with a sine grating and a homogenous grey box. Next, a tablet-based app was developed where participants had to find and press either their mother or a target face from up to 16 faces. Here, response time was measured. The tablet task was refined over multiple iterations.
Results: in the eye-tracking task, controls spent significantly longer looking at their mother and the grating (P<0.05). Interestingly, children with nystagmus looked significantly longer at the grating (P<0.05) but not their mother (P>0.05). This confirmed a facial target was key to further development. The tablet-based task demonstrated that children with nystagmus take significantly longer to identify the target; this was most pronounced using a 3-minute test with 12-face displays.
Conclusion: this study has shown a facial target is key to identifying the time-to-see deficit in infantile nystagmus and provides the basis for an outcome measure for use in clinical treatment trials.
Infantile nystagmus, child vision test, faces, slow-to-see
Self, James
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Lee, Helena
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Osborne, Daniel
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Evans, Megan J.E.
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Dunn, Matt
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Theodorou, M.
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February 2021
Self, James
0f6efc58-ae24-4667-b8d6-6fafa849e389
Lee, Helena
5d36fd1e-9334-4db5-b201-034d147133fb
Osborne, Daniel
921c0d16-57f6-4608-836d-df11e41d4bc5
Evans, Megan J.E.
7048ea56-e957-4f37-98c5-51ecbea25229
Dunn, Matt
fab9d2ea-2428-4c2d-8c72-7c07515b7dfc
Theodorou, M.
dbc0a10f-e5fb-4057-b416-7048023b5d67
Self, James, Lee, Helena, Osborne, Daniel, Evans, Megan J.E., Dunn, Matt and Theodorou, M.
(2021)
Beyond visual acuity: development of a simple test of the slow-to-see phenomenon in children with infantile nystagmus syndrome.
Current Eye Research.
(doi:10.1080/02713683.2020.1784438).
Abstract
Purpose: conventional static visual acuity testing profoundly underestimates the impact of infantile nystagmus on functional vision. The slow-to-see phenomenon explains why many patients with nystagmus perform well in non-time restricted acuity tests but experience difficulty in certain situations. This is often observed by parents when their child struggles to recognise familiar faces in crowded scenes. A test measuring more than visual acuity could permit a more real-world assessment of visual impact and provide a robust outcome measure for clinical trials.
Methods: children with nystagmus and, age and acuity matched controls attending Southampton General Hospital were recruited for two tasks. In the first, eye-tracking measured the time participants spent looking at an image of their mother when alongside a stranger, this was then repeated with a sine grating and a homogenous grey box. Next, a tablet-based app was developed where participants had to find and press either their mother or a target face from up to 16 faces. Here, response time was measured. The tablet task was refined over multiple iterations.
Results: in the eye-tracking task, controls spent significantly longer looking at their mother and the grating (P<0.05). Interestingly, children with nystagmus looked significantly longer at the grating (P<0.05) but not their mother (P>0.05). This confirmed a facial target was key to further development. The tablet-based task demonstrated that children with nystagmus take significantly longer to identify the target; this was most pronounced using a 3-minute test with 12-face displays.
Conclusion: this study has shown a facial target is key to identifying the time-to-see deficit in infantile nystagmus and provides the basis for an outcome measure for use in clinical treatment trials.
Text
Nystagmus App Paper- Current Eye Research- RevisionsHighligtedChanges
- Accepted Manuscript
More information
Accepted/In Press date: 13 June 2020
e-pub ahead of print date: 2 July 2020
Published date: February 2021
Additional Information:
Funding Information:
This work was supported by the Nystagmus Network under grant number 24NN183
Publisher Copyright:
© 2020, © 2020 Taylor & Francis Group, LLC.
Keywords:
Infantile nystagmus, child vision test, faces, slow-to-see
Identifiers
Local EPrints ID: 442381
URI: http://eprints.soton.ac.uk/id/eprint/442381
ISSN: 0271-3683
PURE UUID: 935abdf7-67c6-4154-b53b-4e634566bc32
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Date deposited: 14 Jul 2020 16:31
Last modified: 17 Mar 2024 05:44
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Contributors
Author:
Daniel Osborne
Author:
Megan J.E. Evans
Author:
Matt Dunn
Author:
M. Theodorou
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