What do patients with glaucoma see: a novel iPad app to improve glaucoma patient awareness of visual field loss.

PURPOSE: Glaucoma patients with peripheral vision loss have in the past subjectively described their field loss as 'blurred' or 'no vision compromise'. We developed an iPad app for patients to self-characterise perception within areas of glaucomatous visual field loss. METHODS: Twelve glaucoma patients with visual acuity ≥20/40 in each eye, stable and reliable Humphrey Visual Field (HVF) over 2 years were enrolled. An iPad app (held at 33 cm) allowed subjects to modify 'blur' or 'dimness' to match their perception of a 2×2 m wall-mounted poster at 1 m distance. Subjects fixated at the centre of the poster (spanning 45° of field from centre). The output was degree of blur/dim: normal, mild and severe noted on the iPad image at the 54 retinal loci tested by the HVF 24-2 and was compared to threshold sensitivity values at these loci. Monocular (Right eye (OD), left eye (OS)) HVF responses were used to calculate an integrated binocular (OU) visual field index (VFI). All three data sets were analysed separately. RESULTS: 36 HVF and iPad responses from 12 subjects (mean age 71±8.2y) were analysed. The mean VFI was 77% OD, 76% OS, 83% OU. The most common iPad response reported was normal followed by blur. No subject reported dim response. The mean HVF sensitivity threshold was significantly associated with the iPad response at the corresponding retinal loci (For OD, OS and OU, respectively (dB): normal: 23, 25, 27; mild blur: 18, 16, 22; severe blur: 9, 9, 11). On receiver operative characteristic (ROC) curve analysis, the HVF retinal sensitivity cut-off at which subjects reported blur was 23.4 OD, 23 OS and 23.3 OU (dB). CONCLUSIONS: Glaucoma subjects self-pictorialised their field defects as blur; never dim or black. Our innovation allows translation of HVF data to quantitatively characterise visual perception in patients with glaucomatous field defects.

Convergence and divergence to radial optic flow in infancy.

Research finds a relationship between the development of depth perception and ocular motion functions including smooth pursuit and ocular following response. Infants' reactions to looming stimuli also suggest sensitivity to optic flow information that specifies relative distance. With radial optic flow, an expanding flow field elicits involuntary convergent eye movements while a contracting one elicits involuntary divergent eye movements. This response suggests the visual system is interpreting the radial flow as a change in relative depth. We measured the oculomotor response to radial optic flow in infants aged two to five months. The stimulus comprised a radial optic flow pattern that expanded or contracted across eight 400 ms trials while eye position was monitored with a Tobii X120 eye tracker. A subset of infants also viewed trials of a static version of the stimulus. On average, most infants in each age group demonstrated convergence to the expanding pattern and divergence to the contracting one. Moreover, the difference in gain between the convergence and divergence eye movements was significant. The presence of correct-direction vergence eye movements in response to expansion and contraction provides further evidence that infants are sensitive to information that specifies relative motion in depth.

Aging does not affect integration times for the perception of depth from motion parallax.

To successfully navigate throughout the world, observers must rapidly recover depth information. One depth cue that is especially important for a moving observer is motion parallax. To perceive unambiguous depth from motion parallax, the visual system must integrate information from two different proximal signals, retinal image motion and a pursuit eye movement. Previous research has shown that aging affects both of these necessary components for motion parallax depth perception, but no research has yet investigated how aging affects the mechanism for integrating motion and pursuit information to recover depth from motion parallax. The goal of the current experiment was to assess the integration time required by older adults to process depth information. In four psychophysical conditions, younger and older observers made motion and depth judgments about stationary or translating random-dot stimuli. Stimulus presentations in all four psychophysical conditions were followed by a high-contrast pattern mask, and minimum stimulus presentation durations (stimulus-to-mask onset asynchrony, or SOA) were measured. These SOAs reflect the minimum neural processing time required to make motion and motion parallax depth judgments. Pursuit latency was also measured. The results revealed that, after accounting for age-related delays in motion processing and pursuit onset, older and younger adults required similar temporal intervals to combine retinal image motion with an internal pursuit signal for the perception of depth. These results suggest that the mechanism for motion and pursuit integration is not affected by age.

The effects of aging on the perception of depth from motion parallax.

Successful navigation in the world requires effective visuospatial processing. Unfortunately, older adults have many visuospatial deficits, which can have severe real-world consequences. Although some of these age effects are well documented, some others, such as the perception of depth from motion parallax, are poorly understood. Depth perception from motion parallax requires intact retinal image motion and pursuit eye movement processing. Decades of research have shown that both motion processing and pursuit eye movements are affected by age; it follows that older adults may also be less sensitive to depth from motion parallax. The goals of the present study were to characterize motion parallax depth thresholds in older adults, and to explain older adults' sensitivity to depth from motion parallax in terms of motion and pursuit deficits. Younger and older adults' motion thresholds and pursuit accuracy were measured. Observers' depth thresholds across several different stimulus conditions were measured, as well. Older adults had higher motion thresholds and less accurate pursuit than younger adults. They were also less sensitive to depth from motion parallax at slow and moderate pursuit speeds. Although older adults had higher motion thresholds than younger adults, they used the available motion signals optimally, and age differences in motion processing could not account for the older adults' increased depth thresholds. Rather, these age effects can be explained by changes in older adults' pursuit signals.

A Pursuit Theory Account for the Perception of Common Motion in Motion Parallax.

The visual system uses an extraretinal pursuit eye movement signal to disambiguate the perception of depth from motion parallax. Visual motion in the same direction as the pursuit is perceived nearer in depth while visual motion in the opposite direction as pursuit is perceived farther in depth. This explanation of depth sign applies to either an allocentric frame of reference centered on the fixation point or an egocentric frame of reference centered on the observer. A related problem is that of depth order when two stimuli have a common direction of motion. The first psychophysical study determined whether perception of egocentric depth order is adequately explained by a model employing an allocentric framework, especially when the motion parallax stimuli have common rather than divergent motion. A second study determined whether a reversal in perceived depth order, produced by a reduction in pursuit velocity, is also explained by this model employing this allocentric framework. The results show than an allocentric model can explain both the egocentric perception of depth order with common motion and the perceptual depth order reversal created by a reduction in pursuit velocity. We conclude that an egocentric model is not the only explanation for perceived depth order in these common motion conditions.

Motion parallax thresholds for unambiguous depth perception.

The perception of unambiguous depth from motion parallax arises from the neural integration of retinal image motion and extra-retinal eye movement signals. It is only recently that these parameters have been articulated in the form of the motion/pursuit ratio. In the current study, we explored the lower limits of the parameter space in which observers could accurately perform near/far relative depth-sign discriminations for a translating random-dot stimulus. Stationary observers pursued a translating random dot stimulus containing relative image motion. Their task was to indicate the location of the peak in an approximate square-wave stimulus. We measured thresholds for depth from motion parallax, quantified as motion/pursuit ratios, as well as lower motion thresholds and pursuit accuracy. Depth thresholds were relatively stable at pursuit velocities 5-20 deg/s, and increased at lower and higher velocities. The pattern of results indicates that minimum motion/pursuit ratios are limited by motion and pursuit signals, both independently and in combination with each other. At low and high pursuit velocities, depth thresholds were limited by inaccurate pursuit signals. At moderate pursuit velocities, depth thresholds were limited by motion signals.

Modeling depth from motion parallax with the motion/pursuit ratio.

The perception of unambiguous scaled depth from motion parallax relies on both retinal image motion and an extra-retinal pursuit eye movement signal. The motion/pursuit ratio represents a dynamic geometric model linking these two proximal cues to the ratio of depth to viewing distance. An important step in understanding the visual mechanisms serving the perception of depth from motion parallax is to determine the relationship between these stimulus parameters and empirically determined perceived depth magnitude. Observers compared perceived depth magnitude of dynamic motion parallax stimuli to static binocular disparity comparison stimuli at three different viewing distances, in both head-moving and head-stationary conditions. A stereo-viewing system provided ocular separation for stereo stimuli and monocular viewing of parallax stimuli. For each motion parallax stimulus, a point of subjective equality (PSE) was estimated for the amount of binocular disparity that generates the equivalent magnitude of perceived depth from motion parallax. Similar to previous results, perceived depth from motion parallax had significant foreshortening. Head-moving conditions produced even greater foreshortening due to the differences in the compensatory eye movement signal. An empirical version of the motion/pursuit law, termed the empirical motion/pursuit ratio, which models perceived depth magnitude from these stimulus parameters, is proposed.

The role of eye movements in depth from motion parallax during infancy.

Motion parallax is a motion-based, monocular depth cue that uses an object's relative motion and velocity as a cue to relative depth. In adults, and in monkeys, a smooth pursuit eye movement signal is used to disambiguate the depth-sign provided by these relative motion cues. The current study investigates infants' perception of depth from motion parallax and the development of two oculomotor functions, smooth pursuit and the ocular following response (OFR) eye movements. Infants 8 to 20 weeks of age were presented with three tasks in a single session: depth from motion parallax, smooth pursuit tracking, and OFR to translation. The development of smooth pursuit was significantly related to age, as was sensitivity to motion parallax. OFR eye movements also corresponded to both age and smooth pursuit gain, with groups of infants demonstrating asymmetric function in both types of eye movements. These results suggest that the development of the eye movement system may play a crucial role in the sensitivity to depth from motion parallax in infancy. Moreover, describing the development of these oculomotor functions in relation to depth perception may aid in the understanding of certain visual dysfunctions.

In pursuit of perspective: does vertical perspective disambiguate depth from motion parallax?

Motion parallax provides a dynamic, unambiguous, monocular visual depth cue. However, the lateral image motion in computer-generated motion parallax displays is depth-sign ambiguous. While mounting evidence indicates that the visual system uses an extra-retinal signal from the pursuit system to disambiguate depth, vertical perspective is a potential confound because it co-varies with the stimulus translation that produces the pursuit signal. Here the role of an extra-retinal pursuit signal and the role of vertical perspective in disambiguating depth from motion parallax were investigated. Through the careful isolation of each cue, the results indicate that observers have excellent depth discrimination with an extra-retinal pursuit cue alone, but have poor discrimination with vertical perspective alone. The conclusion is that vertical perspective does not play a role in the disambiguation of depth in small computer-generated motion parallax displays.

Integration time for the perception of depth from motion parallax.

The perception of depth from relative motion is believed to be a slow process that "builds-up" over a period of observation. However, in the case of motion parallax, the potential accuracy of the depth estimate suffers as the observer translates during the viewing period. Our recent quantitative model for the perception of depth from motion parallax proposes that relative object depth (d) can be determined from retinal image motion (dθ/dt), pursuit eye movement (dα/dt), and fixation distance (f) by the formula: d/f≈dθ/dα. Given the model's dynamics, it is important to know the integration time required by the visual system to recover dα and dθ, and then estimate d. Knowing the minimum integration time reveals the incumbent error in this process. A depth-phase discrimination task was used to determine the time necessary to perceive depth-sign from motion parallax. Observers remained stationary and viewed a briefly translating random-dot motion parallax stimulus. Stimulus duration varied between trials. Fixation on the translating stimulus was monitored and enforced with an eye-tracker. The study found that relative depth discrimination can be performed with presentations as brief as 16.6 ms, with only two stimulus frames providing both retinal image motion and the stimulus window motion for pursuit (mean range=16.6-33.2 ms). This was found for conditions in which, prior to stimulus presentation, the eye was engaged in ongoing pursuit or the eye was stationary. A large high-contrast masking stimulus disrupted depth-discrimination for stimulus presentations less than 70-75 ms in both pursuit and stationary conditions. This interval might be linked to ocular-following response eye-movement latencies. We conclude that neural mechanisms serving depth from motion parallax generate a depth estimate much more quickly than previously believed. We propose that additional sluggishness might be due to the visual system's attempt to determine the maximum dθ/dα ratio for a selection of points on a complicated stimulus.

Visual depth from motion parallax and eye pursuit.

A translating observer viewing a rigid environment experiences "motion parallax", the relative movement upon the observer's retina of variously positioned objects in the scene. This retinal movement of images provides a cue to the relative depth of objects in the environment, however retinal motion alone cannot mathematically determine relative depth of the objects. Visual perception of depth from lateral observer translation uses both retinal image motion and eye movement. In Nawrot and Stroyan (Vision Res 49:1969-1978, 2009) we showed mathematically that the ratio of the rate of retinal motion over the rate of smooth eye pursuit mathematically determines depth relative to the fixation point in central vision. We also reported on psychophysical experiments indicating that this ratio is the important quantity for perception. Here we analyze the motion/pursuit cue for the more general, and more complicated, case when objects are distributed across the horizontal viewing plane beyond central vision. We show how the mathematical motion/pursuit cue varies with different points across the plane and with time as an observer translates. If the time varying retinal motion and smooth eye pursuit are the only signals used for this visual process, it is important to know what is mathematically possible to derive about depth and structure. Our analysis shows that the motion/pursuit ratio determines an excellent description of depth and structure in these broader stimulus conditions, provides a detailed quantitative hypothesis of these visual processes for the perception of depth and structure from motion parallax, and provides a computational foundation to analyze the dynamic geometry of future experiments.

MT neurons combine visual motion with a smooth eye movement signal to code depth-sign from motion parallax.

The capacity to perceive depth is critical for an observer to interact with his or her surroundings. During observer movement, information about depth can be extracted from the resulting patterns of image motion on the retina (motion parallax). Without extraretinal signals related to observer movement, however, depth-sign (near versus far) from motion parallax can be ambiguous. We previously demonstrated that MT neurons combine visual motion with extraretinal signals to code depth-sign from motion parallax in the absence of other depth cues. In that study, head translations were always accompanied by compensatory tracking eye movements, allowing at least two potential sources of extraretinal input. We now show that smooth eye movement signals provide the critical extraretinal input to MT neurons for computing depth-sign from motion parallax. Our findings demonstrate a powerful modulation of MT activity by eye movements, as predicted by human studies of depth perception from motion parallax.

The motion/pursuit law for visual depth perception from motion parallax.

One of vision's most important functions is specification of the layout of objects in the 3D world. While the static optical geometry of retinal disparity explains the perception of depth from binocular stereopsis, we propose a new formula to link the pertinent dynamic geometry to the computation of depth from motion parallax. Mathematically, the ratio of retinal image motion (motion) and smooth pursuit of the eye (pursuit) provides the necessary information for the computation of relative depth from motion parallax. We show that this could have been obtained with the approaches of Nakayama and Loomis [Nakayama, K., & Loomis, J. M. (1974). Optical velocity patterns, velocity-sensitive neurons, and space perception: A hypothesis. Perception, 3, 63-80] or Longuet-Higgens and Prazdny [Longuet-Higgens, H. C., & Prazdny, K. (1980). The interpretation of a moving retinal image. Proceedings of the Royal Society of London Series B, 208, 385-397] by adding pursuit to their treatments. Results of a psychophysical experiment show that changes in the motion/pursuit ratio have a much better relationship to changes in the perception of depth from motion parallax than do changes in motion or pursuit alone. The theoretical framework provided by the motion/pursuit law provides the quantitative foundation necessary to study this fundamental visual depth perception ability.

The development of depth perception from motion parallax in infancy.

Little is known about infants' perception of depth from motion parallax, even though it is known that infants are sensitive both to motion and to depth-from-motion cues at an early age. The present experiment assesses whether infants are sensitive to the unambiguous depth specified by motion parallax and, if so, when this sensitivity first develops. Eleven infants were followed longitudinally from 8 to 29 weeks. Infants monocularly viewed a translating Rogers and Graham (1979) random-dot stimulus, which appears as a corrugated surface to adult observers. Using the infant-control habituation paradigm, looking time was recorded for each 10-sec trial until habituation, followed by two test trials: one using a depth-reversed and one using a flat stimulus. Dishabituation results indicate that infants may be sensitive to unambiguous depth from motion parallax by 16 weeks of age. Implications for the developmental sequence of depth from motion, stereopsis, and eye movements are discussed.

First and second-order motion perception after focal human brain lesions.

Perception of visual motion includes a first-order mechanism sensitive to luminance changes and a second-order motion mechanism sensitive to contrast changes. We studied neural substrates for these motion types in 142 subjects with visual cortex lesions, 68 normal controls and 28 brain lesion controls. On first-order motion, the visual cortex lesion group performed significantly worse than normal controls overall and in each hemifield, but second-order motion did not differ. Only one individual showed a selective second-order motion deficit. Motion deficits were seen with lesions outside the small occipito-temporal region thought to contain a human homolog of motion processing area MT (V5), suggesting that many areas of human brain process visual motion.

Concordant eye movement and motion parallax asymmetries in esotropia.

The role of eye movements in the perception of depth from motion was investigated in esotropia. Elevated motion parallax thresholds have been shown in strabismus [Thompson, A. M., & Nawrot, M. (1999). Abnormal depth perception from motion parallax in amblyopic observers. Vision Research, 39, 1407-1413] suggesting a global deficit in depth perception involving both stereopsis and motion. However, this motion parallax deficit in strabismus might be better explained by the role that eye movements play in motion parallax [Nawrot, M., & Joyce, L. (2006). The pursuit theory of motion parallax. Vision Research, 46, 4709-4725]. Esotropia is associated with asymmetric pursuit and optokinetic response eye movements [Demer, J. L., & von Noorden, G. K. (1988). Optokinetic asymmetry in esotropia. Journal of Pediatric Ophthalmology and Strabismus, 25, 286-292; Schor, C. M., & Levi, D. M. (1980). Disturbances of small-field horizontal and vertical optokinetic nystagmus in amblyopia. Investigative Ophthalmology and Visual Science, 19, 851-864; Tychsen, L., & Lisberger, S. G. (1986). Maldevelopment of visual motion processing in humans who had strabismus with onset in infancy. The Journal of Neuroscience, 6, 2495-2508; [Westall, C. A., Eizenman, M., Kraft, S. P., Panton, C. M., Chatterjee, S., & Sigesmund, D. (1998). Cortical binocularity and monocular optokinetic asymmetry in early-onset esotropia. Investigative Ophthalmology and Visual Science, 39, 1352-1360.]. The first experiment demonstrates that the motion parallax deficit in esotropia mirrors the pursuit eye movement asymmetry: in the direction of normal pursuit, esotropic observers had normal depth from motion parallax. A second set of experiments, conducted in normal observers, demonstrates that this motion parallax deficit is not a secondary problem due to the retinal slip created by inadequate pursuit. These results underscore the role of pursuit eye movements in the perception of depth from motion parallax.

The pursuit theory of motion parallax.

Although motion parallax is closely associated with observer head movement, the underlying neural mechanism appears to rely on a pursuit-like eye movement signal to disambiguate perceived depth sign from the ambiguous retinal motion information [Naji, J. J., & Freeman, T. C. A. (2004). Perceiving depth order during pursuit eye movement. Vision Research, 44, 3025-3034; Nawrot, M. (2003). Eye movements provide the extra-retinal signal required for the perception of depth from motion parallax. Vision Research, 43, 1553-1562]. Here, we outline the evidence for a pursuit signal in motion parallax and propose a simple neural network model for how the pursuit theory of motion parallax might function within the visual system. The first experiment demonstrates the crucial role that an extra-retinal pursuit signal plays in the unambiguous perception of depth from motion parallax. The second experiment demonstrates that identical head movements can generate opposite depth percepts, and even ambiguous percepts, when the pursuit signal is altered. The pursuit theory of motion parallax provides a parsimonious explanation for all of these observations.

Disruption of eye movements by ethanol intoxication affects perception of depth from motion parallax.

Motion parallax, the ability to recover depth from retinal motion generated by observer translation, is important for visual depth perception. Recent work indicates that the perception of depth from motion parallax relies on the slow eye movement system. It is well known that ethanol intoxication reduces the gain of this system, and this produces the horizontal gaze nystagmus that law enforcement's field sobriety test is intended to reveal. The current study demonstrates that because of its influence on the slow eye movement system, ethanol intoxication impairs the perception of depth from motion parallax. Thresholds in a motion parallax task were significantly increased by acute ethanol intoxication, whereas thresholds for an identical test relying on binocular disparity were unaffected. Perhaps a failure of motion parallax plays a role in alcohol-related driving accidents; because of the effects of alcohol on eye movements, intoxicated drivers may have inaccurate or inadequate information for judging the relative depth of obstacles from motion parallax.

Disorders of motion and depth.

Damage to the human homologue of area MT produces a motion perception deficit similar to that found in the monkey with MT lesions. Even temporary disruption of MT processing with transcranial magnetic stimulation can produce a temporary akinetopsia [127]. Motion perception deficits, however, also are found with a variety of subcortical lesions and other neurologic disorders that can best be described as causing a disconnection within the motion processing stream. The precise role of these subcortical structures, such as the cerebellum, remains to be determined. Simple motion perception, moreover, is only a part of MT function. It undoubtedly has an important role in the perception of depth from motion and stereopsis [112]. Psychophysical studies using aftereffects in normal observers suggest a link between stereo mechanisms and the perception of depth from motion [9-11]. There is even a simple correlation between stereo acuity and the perception of depth from motion [128]. Future studies of patients with cortical lesions will take a closer look at depth perception in association with motion perception and should provide a better understanding of how motion and depth are processed together.

Eye movements provide the extra-retinal signal required for the perception of depth from motion parallax.

It has been unclear whether the perception of depth from motion parallax is an entirely visual process or whether it requires extra-retinal information such as head movements, vestibular activation, or eye movements. Using a motion aftereffect and static test stimulus technique to eliminate visual cues to depth, this psychophysical study demonstrates that the visual system employs a slow eye movement signal, optokinetic response (OKR) in particular, for the unambiguous perception of depth from motion parallax. A vestibular signal, or vestibularly driven eye movement signal is insufficient for unambiguous depth from motion parallax. Removal of the OKR eye movement signal gives rise to ambiguous perceived depth in motion parallax conditions. Neurophysiological studies suggest a possible neural mechanism in medial temporal and medial superior temporal cortical neurons that are selective to depth, motion, and direction of eye movement.