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H.K. Falkenberg, P.J. Bex; The Impact of Central and Peripheral Visual Field Loss on Eye Movements and Mobility While Walking . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4608.
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Purpose: To investigate the impact of visual field loss on eye movements, mobility and quality of life in patients with impaired central (age–related macular degeneration) or peripheral (glaucoma) visual field while walking towards a goal in an unfamiliar real environment. The results reported here are from a preliminary study investigating two normal observers and five patients. Methods:Mobility performance, fixation behaviour and travel time were measured in patients and age–matched, visually normal observers while walking a 132m indoor and outdoor route. Eye movements and direction of gaze were measured with a video–based mobile head–mounted eye–tracker (ASL 501). The route was divided into six sections, including corridors, stairs and road–crossing. Instructions were given at the start of each section. Direction of gaze was classified into scene categories that were analysed manually, and computationally by cross–correlation of the image at fixation over time. Questionnaires were used to assess the observers’ own perception of their mobility and quality of life. Results: Self–assessed and experimentally–assessed mobility was impaired in patients with visual field loss compared to age–matched normals. Visually healthy observers primarily fixated the pre–determined goal points. Patients with central and peripheral field loss had more variable fixations and saccades, and viewed more scene categories before reaching the goal. This was confirmed with the objective cross–correlation analysis. In addition, patients spent more time fixating the ground plane and took longer to complete the route. Conclusions: Patients with central and peripheral visual field loss show impaired mobility when walking an unfamiliar real environment. Visually healthy observers tended mostly to fixate the target region, indicating a goal–directed strategy. No differences in eye movement or gaze behaviour were found between patients with central and peripheral field loss. All patients fixated many other objects in the scene in addition to the target, suggesting that greater effort was required to identify the goal or potential obstacles and that this occurs regardless of the location of the scotoma.
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