Abnormal spatial selection and tracking in children with amblyopia.

We assessed 18 children with unilateral amblyopia and 30 age-matched controls on one low-level and three high-level motion tasks. Children with amblyopia showed similar performance to controls in both amblyopic and fellow eyes on a low-level global motion task and on a high-level 2-dot apparent motion task. Performance on both single-object and multiple-object attentive tracking tasks was significantly depressed in both amblyopic and fellow eyes relative to controls. These findings suggest that binocular regions of posterior parietal cortex likely contribute to a deficit in voluntary, spatial attention that is a component of amblyopia.

The maturation of form and motion perception in school age children.

The purpose of the current study was to investigate the maturation of form and motion perception, specifically the component visual abilities involved in the identification of motion-defined form, in children ranging in age from 3 to 12 years. Experiment 1 compared the maturation of motion-defined and texture-defined shape identification. Minimum speed thresholds on the motion-defined shape task decreased until age 7 years. Orientation difference thresholds on the texture-defined shape task decreased until age 11 years. Experiment 2 compared the maturation of global motion and global texture direction discrimination. Coherence thresholds on both tasks were similar in children of all ages and adults. Experiment 3 compared the maturation of direction discrimination on motion coherence and motion displacement tasks. Maximum displacement thresholds (Dmax) increased until age 7 years. The results are discussed with respect to the maturation of M/dorsal and P/ventral visual pathways.

Dichotic pitch: a new stimulus distinguishes normal and dyslexic auditory function.

Two patterns of appropriately filtered acoustic white noise can be binaurally fused by the human auditory system to extract pitch and location information that is not available to either ear alone. This phenomenon is called dichotic pitch. Here we present a new method for generating more effective and useful dichotic pitch stimuli. These novel stimuli allow the psychophysical assessment of dichotic pitch detection thresholds. We show that dichotic pitch detection is significantly impaired in individuals with developmental dyslexia, as compared to average readers. These results suggest a low-level auditory deficit associated with dyslexia and also demonstrate the potential value of our new dichotic pitch stimuli for assessment of auditory processing.

Loss of sensitivity to motion-defined form in patients with primary open-angle glaucoma and ocular hypertension.

During the past few years many researchers have attempted to find a psychophysical test that will identify at an early stage patients at risk for developing glaucoma. We investigated the ability of a test of motion-defined (MD) form recognition to discriminate between patients with primary open-angle glaucoma (POAG) and control subjects and to identify patients with ocular hypertension (OHT) at risk for developing glaucoma. Performance on two MD tests and three tests of static, luminance-defined (LD) form recognition was compared. Speed thresholds for reading MD letters proved to be the most sensitive test of early glaucomatous damage. 80% of POAG and 38% of OHT patients were abnormal on this test. During a 3-year follow-up period, 50% of these OHT patients developed glaucoma. These psychophysical findings support the hypothesis of early motion deficits in glaucoma.

Measurement of glare susceptibility using low-contrast letter charts.

The Committee on Ophthalmic Procedures Assessment of the American Academy of Ophthalmology suggested either contrast sensitivity or low-contrast visual acuity (VA) measured before and after adding a glare source as a test for assessing overall visual disability from immature cataracts. We have developed a test that follows the Committee's three principles of design, and we report that the effect of glare on VA is considerably greater for recognizing low-contrast letters than for recognizing high-contrast letters. The effect of glare on VA increases progressively as letter contrast is reduced from 96% through 50%, 25%, 11%, and 4%. The 25% chart (and possibly the 11% chart) gives the most suitable sensitivity for eyes with immature cataracts. Neither age-related brunescence and aging itself nor even the presence of a distinct opacity necessarily produces high sensitivity to glare. The test is sensitive enough to detect an ageing effect even before the age of 45 to 55 years and to reveal large intersubject differences among normally sighted 19- to 25-year-old subjects.

Measurement of glare sensitivity in cataract patients using low-contrast letter charts.

The Committee on Ophthalmic Procedures Assessment of the American Academy of Ophthalmology suggested using low-contrast visual acuity measured before and after adding a glare source as a test for assessing overall visual disability from immature cataracts. We have developed a test that follows the Committee's three principles of design, and we report that the effect of glare on visual acuity is considerably greater for recognizing low-contrast letters than for recognizing high-contrast letters. The effect of glare on visual acuity increases progressively as letter contrast is reduced in the stages 96%, 50%, 25%, 11% and 4%. The 25% chart (and possibly the 11% chart) gives the most suitable sensitivity for eyes with immature cataracts. Age-related brunescence and aging itself do not necessarily produce high sensitivity to glare. Sensitivity to glare was markedly different in eyes with different kinds of cataract.

Crowding and contrast in amblyopia.

The crowding effect, defined as the ratio of visual acuities for letters presented in Snellen (i.e., line) format and isolated-letter format, was measured in the amblyopic eyes of 15 children and 15 adults with unilateral amblyopia. Normal limits were based on data from 20 children and 20 adults with no history of amblyopia. The crowding effect was compared for letters of high (96%) contrast and for letters of low (11%) contrast. We report that amblyopia can differentially affect line and isolated-letter acuity for both high- and low-contrast letters. For the patients that show an abnormal crowding effect, this effect can be: (1) significantly stronger, (2) significantly weaker, or (3) not significantly different for high- than for low-contrast letters. These findings are consistent with the hypothesis that the crowding effect is contrast-dependent in some amblyopic eyes of both child and adult unilateral amblyopes.

Method for identifying amblyopes whose reduced line acuity is caused by defective selection and/or control of gaze.

Three visual tests were administered to a group of 15 amblyopic children, 15 adult amblyopes and two age-matched control groups, each of 20 subjects. Test results comprised visual acuity for recognizing high contrast letters presented in line (i.e. Snellen) format, isolated-letter format and repeat-letter format. The classical Snellen format confounds the effects of gaze control defects with the effects of adjacent contours on a patient's ability to recognize a foveated letter. We designed a repeat-letter format intended to unconfound these effects. The repeat letter format is much less sensitive to gaze control defects, and somewhat more sensitive to adjacent contour interactions than is the Snellen format. We report that amblyopic eyes can be subdivided empirically into three repeat-letter categories: repeat-letter acuity significantly better than Snellen acuity; repeat letter acuity not significantly different from Snellen acuity; and repeat letter acuity significantly worse than Snellen acuity. We report that this subdivision cuts across the clinical subclassification of amblyopia and also across the crowding/no crowding subclassification. We suggest that, rather than abnormal lateral interactions, defective selection and/or control of gaze is an important factor in depressed visual acuity in amblyopic eyes of the first repeat-letter category but not for the third type, in which abnormal lateral interactions may be important. To test the hypothesis that the response to patching and refractive therapy may be less satisfactory in our first category of amblyopic eyes, we are carrying out a prospective study.(ABSTRACT TRUNCATED AT 250 WORDS)

Defective processing of motion-defined form in the fellow eye of patients with unilateral amblyopia.

The following three measurements were made on a group of 20 pediatric and 5 adult patients with unilateral amblyopia: (1) speed threshold for recognizing motion-defined dotted letters; (2) recognition acuity for isolated solid letters of 4% contrast; and (3) Snellen line acuity for high-contrast letters. Normal limits were established with a group of 30 pediatric and 10 adult control subjects. The main finding was that, in amblyopic children, a high percentage (83%, 15 of 18) of fellow eyes showed a degraded ability to recognize motion-defined letters, even though Snellen acuity and 4% letter acuity were normal for age. The fellow eyes of all nine patients with strabismic amblyopia showed this pattern of loss, as did four of six fellow eyes of patients with anisometropic amblyopia and two of three fellow eyes of patients with anisometropic plus strabismic amblyopia. Only two clinically unaffected eyes were normal for motion-defined letters. These eyes belonged to patients with anisometropic amblyopia. Eighteen of the 19 previously amblyopic eyes tested were abnormal for motion-defined letters even though Snellen acuity was within normal limits for 6 of these eyes. In adults, only one of five fellow eyes failed the motion-defined letter test. It was concluded that the degradation of form perception associated with amblyopia can be different for luminance-defined and motion-defined form and that defective processing of motion-defined form is common in the fellow eyes of children with unilateral amblyopia.