Reduced visual acuity is mirrored in low vision imagery.

Research has examined the nature of visual imagery in normally sighted and blind subjects, but not in those with low vision. Findings with normally sighted subjects suggest that imagery involves primary visual areas of the brain. Since the plasticity of visual cortex appears to be limited in adulthood, we might expect imagery of those with adult-onset low vision to be relatively unaffected by these losses. But if visual imagery is based on recent and current experience, we would expect images of those with low vision to share some properties of impaired visual perception. We examined key parameters of mental images reported by normally sighted subjects, compared to those with early- and late-onset low vision, and with a group of subjects with restricted visual fields using an imagery questionnaire. We found evidence that those with reduced visual acuity report the imagery distances of objects to be closer than those with normal acuity and also depict objects in imagery with lower resolution than those with normal visual acuity. We also found that all low vision groups, like the normally sighted, image objects at a substantially greater distance than when asked to place them at a distance that 'just fits' their imagery field (overflow distance). All low vision groups, like the normally sighted, showed evidence of a limited visual field for imagery, but our group with restricted visual fields did not differ from the other groups in this respect. We conclude that imagery of those with low vision is similar to that of those with normal vision in being dependent on the size of objects or features being imaged, but that it also reflects their reduced visual acuity. We found no evidence for a dependence on imagery of age of onset or number of years of vision impairment.

Online Survey of Digital Reading by Adults with Low Vision.

SIGNIFICANCE: Access to digital text is increasingly widespread, but its impact on low-vision reading is not well understood. PURPOSE: We conducted an online survey of people with low vision to determine what assistive technologies they use for visual reading, their preferred text characteristics, and the time they devote to reading digital and hard-copy text. METHODS: One hundred thirty-three low-vision participants completed an online survey. Participants reported the nature and history of their low vision, their usage of different assistive technologies, and time devoted to five visual reading activities. RESULTS: The three largest diagnostic categories were albinism (n = 36), retinitis pigmentosa (n = 20), and glaucoma (n = 15). Mean self-reported acuity was 0.93 logMAR (range, 0.1 to 1.6 logMAR). Mean age was 46 years (range, 18 to 98 years). Participants reported on percentage time spent reading using vision, audio, or touch (braille). Seventy-five percent of our participants did more than 50% of their reading visually. Across five categories of reading activities-work or education, news, pleasure, spot reading, and social networking-participants reported more time spent on digital reading than hard-copy reading. Eighty-nine percent of our participants used at least one technology from each of our two major categories of assistive technologies (digital content magnifiers and hard-copy content magnifiers) for visual reading. CONCLUSIONS: Despite the growing availability of digital text in audio or braille formats, our findings from an online sample of people with low vision indicate the continuing importance of visual reading. Our participants continue to use technology to access both hard-copy and digital text, but more time is devoted to digital reading. Our findings highlight the need for continued research and development of technology to enhance visual reading accessibility.

Preserved tactile acuity in older pianists.

A previous study from our lab demonstrated retention of high tactile acuity throughout the lifespan in blind subjects in contrast to the typical decline found for sighted subjects (Legge, Madison, Vaughn, Cheong & Miller, Percept Psychophys, 70 (8), 1471-1488, 2008). We hypothesize that preserved tactile acuity in old age is due to lifelong experience with focused attention to touch and not to blindness per se. Proficient pianists devote attention to touch - fingerings and dynamics - over years of practice. To test our hypothesis, we measured tactile acuity in groups of ten young (mean age 24.5 years) and 11 old (mean age 64.7 years) normally sighted pianists and compared their results to the blind and sighted subjects in our 2008 study. The pianists, like the subjects in 2008, were tested on two tactile-acuity charts requiring active touch, one composed of embossed Landolt rings and the other composed of dot patterns similar to braille. For both tests, the pianists performed more like the blind subjects than the sighted subjects from our 2008 study. For the ring chart, there was no significant difference in tactile acuity between the young and old pianists and no significant difference between the pianists and the blind subjects. For the dot chart, the pianists showed an age-related decline in tactile acuity, but not as severe as the sighted subjects from 2008. Our results are consistent with the hypothesis that lifelong experience with focused attention to touch acts to preserve tactile acuity into old age for both blind and sighted subjects.

How People with Low Vision Achieve Magnification in Digital Reading.

SIGNIFICANCE: Digital reading displays provide opportunities for enhancing accessibility of text for low vision. How are these displays used by people in their daily lives? PURPOSE: Subjects responded to an online survey concerning their vision history, reading technology, display preferences, and reading habits. Here, we report on findings concerning acuity and magnification. METHODS: The survey asked subjects to arrange a text passage for typical reading and to report viewing distance, screen dimensions, and the number of characters per line. Seventy-five adult subjects (most with early-onset low vision, few with central field loss) completed all survey questions relevant to the analysis of acuity and magnification. Mean acuity was .92 logMAR (range, 0.1 to 1.6), and mean age was 44.8 years (range, 18 to 71 years). Twelve normally sighted controls reported the same information while viewing the passage on cell phones, tablets, and computers. RESULTS: The controls had a mean viewing distance of 38.7 cm and a mean x-height of 1.38 mm. For all three types of devices, angular x-height was 0.21° (close to laboratory estimates of the critical print size for reading). Low vision subjects showed decreasing viewing distance and increasing print size with larger values of logMAR acuity. Most of the low vision subjects achieved their desirable magnification by a combination of reduced viewing distance and increased physical letter size. The majority (54 of 75) relied more on letter-size magnification. Relative to the controls, regression analysis revealed that a typical low vision subject with logMAR acuity of 1.0 reduced viewing distance by a factor of 2.8 and enlarged physical print size by a factor of 6. CONCLUSIONS: Our survey shows that people with a wide range of acuities are engaged in digital reading. Our subjects achieved desirable magnification primarily by enlarging physical character size and to a lesser extent by reducing viewing distance.

Indoor Spatial Updating With Impaired Vision.

Purpose: Spatial updating is the ability to keep track of position and orientation while moving through an environment. We asked how normally sighted and visually impaired subjects compare in spatial updating and in estimating room dimensions. Methods: Groups of 32 normally sighted, 16 low-vision, and 16 blind subjects estimated the dimensions of six rectangular rooms. Updating was assessed by guiding the subjects along three-segment paths in the rooms. At the end of each path, they estimated the distance and direction to the starting location, and to a designated target. Spatial updating was tested in five conditions ranging from free viewing to full auditory and visual deprivation. Results: The normally sighted and low-vision groups did not differ in their accuracy for judging room dimensions. Correlations between estimated size and physical size were high. Accuracy of low-vision performance was not correlated with acuity, contrast sensitivity, or field status. Accuracy was lower for the blind subjects. The three groups were very similar in spatial-updating performance, and exhibited only weak dependence on the nature of the viewing conditions. Conclusions: People with a wide range of low-vision conditions are able to judge room dimensions as accurately as people with normal vision. Blind subjects have difficulty in judging the dimensions of quiet rooms, but some information is available from echolocation. Vision status has little impact on performance in simple spatial updating; proprioceptive and vestibular cues are sufficient.

Indoor Spatial Updating with Reduced Visual Information.

PURPOSE: Spatial updating refers to the ability to keep track of position and orientation while moving through an environment. People with impaired vision may be less accurate in spatial updating with adverse consequences for indoor navigation. In this study, we asked how artificial restrictions on visual acuity and field size affect spatial updating, and also judgments of the size of rooms. METHODS: Normally sighted young adults were tested with artificial restriction of acuity in Mild Blur (Snellen 20/135) and Severe Blur (Snellen 20/900) conditions, and a Narrow Field (8°) condition. The subjects estimated the dimensions of seven rectangular rooms with and without these visual restrictions. They were also guided along three-segment paths in the rooms. At the end of each path, they were asked to estimate the distance and direction to the starting location. In Experiment 1, the subjects walked along the path. In Experiment 2, they were pushed in a wheelchair to determine if reduced proprioceptive input would result in poorer spatial updating. RESULTS: With unrestricted vision, mean Weber fractions for room-size estimates were near 20%. Severe Blur but not Mild Blur yielded larger errors in room-size judgments. The Narrow Field was associated with increased error, but less than with Severe Blur. There was no effect of visual restriction on estimates of distance back to the starting location, and only Severe Blur yielded larger errors in the direction estimates. Contrary to expectation, the wheelchair subjects did not exhibit poorer updating performance than the walking subjects, nor did they show greater dependence on visual condition. DISCUSSION: If our results generalize to people with low vision, severe deficits in acuity or field will adversely affect the ability to judge the size of indoor spaces, but updating of position and orientation may be less affected by visual impairment.

Comparing the visual spans for faces and letters.

The visual span-the number of adjacent text letters that can be reliably recognized on one fixation-has been proposed as a sensory bottleneck that limits reading speed (Legge, Mansfield, & Chung, 2001). Like reading, searching for a face is an important daily task that involves pattern recognition. Is there a similar limitation on the number of faces that can be recognized in a single fixation? Here we report on a study in which we measured and compared the visual-span profiles for letter and face recognition. A serial two-stage model for pattern recognition was developed to interpret the data. The first stage is characterized by factors limiting recognition of isolated letters or faces, and the second stage represents the interfering effect of nearby stimuli on recognition. Our findings show that the visual span for faces is smaller than that for letters. Surprisingly, however, when differences in first-stage processing for letters and faces are accounted for, the two visual spans become nearly identical. These results suggest that the concept of visual span may describe a common sensory bottleneck that underlies different types of pattern recognition.

Indoor navigation by people with visual impairment using a digital sign system.

There is a need for adaptive technology to enhance indoor wayfinding by visually-impaired people. To address this need, we have developed and tested a Digital Sign System. The hardware and software consist of digitally-encoded signs widely distributed throughout a building, a handheld sign-reader based on an infrared camera, image-processing software, and a talking digital map running on a mobile device. Four groups of subjects-blind, low vision, blindfolded sighted, and normally sighted controls-were evaluated on three navigation tasks. The results demonstrate that the technology can be used reliably in retrieving information from the signs during active mobility, in finding nearby points of interest, and following routes in a building from a starting location to a destination. The visually impaired subjects accurately and independently completed the navigation tasks, but took substantially longer than normally sighted controls. This fully functional prototype system demonstrates the feasibility of technology enabling independent indoor navigation by people with visual impairment.

Recognition of ramps and steps by people with low vision.

PURPOSE: Detection and recognition of ramps and steps are important for the safe mobility of people with low vision. Our primary goal was to assess the impact of viewing conditions and environmental factors on the recognition of these targets by people with low vision. A secondary goal was to determine if results from our previous studies of normally sighted subjects, wearing acuity-reducing goggles, would generalize to low vision. METHODS: Sixteen subjects with heterogeneous forms of low vision participated-acuities from approximately 20/200 to 20/2000. they viewed a sidewalk interrupted by one of five targets: a single step up or down, a ramp up or down, or a flat continuation of the sidewalk. Subjects reported which of the five targets was shown, and percent correct was computed. The effects of viewing distance, target-background contrast, lighting arrangement, and subject locomotion were investigated. Performance was compared with a group of normally sighted subjects who viewed the targets through acuity-reducing goggles. RESULTS: Recognition performance was significantly better at shorter distances and after locomotion (compared with purely stationary viewing). The effects of lighting arrangement and target-background contrast were weaker than hypothesized. Visibility of the targets varied, with the step up being more visible than the step down. CONCLUSIONS: The empirical results provide insight into factors affecting the visibility of ramps and steps for people with low vision. The effects of distance, target type, and locomotion were qualitatively similar for low vision and normal vision with artificial acuity reduction. However, the effects of lighting arrangement and background contrast were only significant for subjects with normal vision.

Seeing steps and ramps with simulated low acuity: impact of texture and locomotion.

PURPOSE: Detecting and recognizing steps and ramps is an important component of the visual accessibility of public spaces for people with impaired vision. The present study, which is part of a larger program of research on visual accessibility, investigated the impact of two factors that may facilitate the recognition of steps and ramps during low-acuity viewing. Visual texture on the ground plane is an environmental factor that improves judgments of surface distance and slant. Locomotion (walking) is common during observations of a layout, and may generate visual motion cues that enhance the recognition of steps and ramps. METHODS: In two experiments, normally sighted subjects viewed the targets monocularly through blur goggles that reduced acuity to either approximately 20/150 (mild blur) or 20/880 Snellen (severe blur). The subjects judged whether a step, ramp, or neither was present ahead on a sidewalk. In the texture experiment, subjects viewed steps and ramps on a surface with a coarse black-and-white checkerboard pattern. In the locomotion experiment, subjects walked along the sidewalk toward the target before making judgments. RESULTS: Surprisingly, performance was lower with the textured surface than with a uniform surface, perhaps because the texture masked visual cues necessary for target recognition. Subjects performed better in walking trials than in stationary trials, possibly because they were able to take advantage of visual cues that were only present during motion. CONCLUSIONS: We conclude that under conditions of simulated low acuity, large high-contrast texture elements can hinder the recognition of steps and ramps, whereas locomotion enhances recognition.

Visual accessibility of ramps and steps.

The visual accessibility of a space refers to the effectiveness with which vision can be used to travel safely through the space. For people with low vision, the detection of steps and ramps is an important component of visual accessibility. We used ramps and steps as visual targets to examine the interacting effects of lighting, object geometry, contrast, viewing distance, and spatial resolution. Wooden staging was used to construct a sidewalk with transitions to ramps or steps. Forty-eight normally sighted subjects viewed the sidewalk monocularly through acuity-reducing goggles and made recognition judgments about the presence of the ramps or steps. The effects of variation in lighting were milder than expected. Performance declined for the largest viewing distance but exhibited a surprising reversal for nearer viewing. Of relevance to pedestrian safety, the step up was more visible than the step down. We developed a probabilistic cue model to explain the pattern of target confusions. Cues determined by discontinuities in the edge contours of the sidewalk at the transition to the targets were vulnerable to changes in viewing conditions. Cues associated with the height in the picture plane of the targets were more robust.