Purpose
To assess the use of new software, “OKN-Dot Test"* as a tool for visual rehabilitation in ophthalmology patients. Visual rehabilitation is of interest among patients with diabetic retinopathy, glaucoma, age related macular degeneration, low vision patients and stroke patients.
Methods
“OKN-Dot Test,"* is software that combines saccadic movement with an impulse driven gaze software. The test uses optokinetic nystagmus in alternating black and white 2 cm stripes and a series of disappearing dots that measure 2 cm in diameter. Patients (PT) and controls (C) were enrolled in an ophthalmology office. Inclusion criteria: age ≥18 years, Snellen visual acuity between 20/15 - 20/40. OKN Dot Test involves 30 sec of OKN, followed by 15 sec of the impulse driven gaze game "Dots." Each eye was tested separately, repeated 5x and the game score was averaged. Test time was 4.5 minutes to 7 minutes. Normal volunteers served as controls. Patient inclusion criteria: those diagnosed with age related macular degeneration, glaucoma, or diabetic retinopathy. Exclusion criteria was inability of the patient to understand instructions. Visual acuity: 1 line of vision designated as 5 letters. Each single letter was assigned 0.2 score, 1 line = 1.0.
Results
A total of 49 patients and controls were enrolled. Using Fisher’s Exact test, C vs PT based on improvement of visual acuity, pre and post test: p ≤0.001.
Conclusions
This small study suggests that patients with mild visual impairment had greater positive change in visual acuity after "OKN-Dot Test" than our Control Group. OKN therapy has been used to improve saccadic movement in stroke patients. Eccentric viewing has been used for AMD patients with macular scotomas. The impulse driven gaze of the software may facilitate improved scanning, thereby improving vision. We are hopeful that the "OKN-Dot Test" software may be useful in patients for beginning stages of visual rehabilitation. *provisional patent-61/848,958 (2013)
Keywords: 525 eye movements: saccades and pursuits •
611 neuro-ophthalmology: cortical function/rehabilitation •
641 perception