Alzheimer's disease pathophysiology in the Retina.

The retina is an emerging CNS target for potential noninvasive diagnosis and tracking of Alzheimer's disease (AD). Studies have identified the pathological hallmarks of AD, including amyloid ß-protein (Aß) deposits and abnormal tau protein isoforms, in the retinas of AD patients and animal models. Moreover, structural and functional vascular abnormalities such as reduced blood flow, vascular Aß deposition, and blood-retinal barrier damage, along with inflammation and neurodegeneration, have been described in retinas of patients with mild cognitive impairment and AD dementia. Histological, biochemical, and clinical studies have demonstrated that the nature and severity of AD pathologies in the retina and brain correspond. Proteomics analysis revealed a similar pattern of dysregulated proteins and biological pathways in the retina and brain of AD patients, with enhanced inflammatory and neurodegenerative processes, impaired oxidative-phosphorylation, and mitochondrial dysfunction. Notably, investigational imaging technologies can now detect AD-specific amyloid deposits, as well as vasculopathy and neurodegeneration in the retina of living AD patients, suggesting alterations at different disease stages and links to brain pathology. Current and exploratory ophthalmic imaging modalities, such as optical coherence tomography (OCT), OCT-angiography, confocal scanning laser ophthalmoscopy, and hyperspectral imaging, may offer promise in the clinical assessment of AD. However, further research is needed to deepen our understanding of AD's impact on the retina and its progression. To advance this field, future studies require replication in larger and diverse cohorts with confirmed AD biomarkers and standardized retinal imaging techniques. This will validate potential retinal biomarkers for AD, aiding in early screening and monitoring.

Assessing REALTER simulator: analysis of ocular movements in simulated low-vision conditions with extended reality technology.

Immersive technology, such as extended reality, holds promise as a tool for educating ophthalmologists about the effects of low vision and for enhancing visual rehabilitation protocols. However, immersive simulators have not been evaluated for their ability to induce changes in the oculomotor system, which is crucial for understanding the visual experiences of visually impaired individuals. This study aimed to assess the REALTER (Wearable Egocentric Altered Reality Simulator) system's capacity to induce specific alterations in healthy individuals' oculomotor systems under simulated low-vision conditions. We examined task performance, eye movements, and head movements in healthy participants across various simulated scenarios. Our findings suggest that REALTER can effectively elicit behaviors in healthy individuals resembling those observed in individuals with low vision. Participants with simulated binocular maculopathy demonstrated unstable fixations and a high frequency of wide saccades. Individuals with simulated homonymous hemianopsia showed a tendency to maintain a fixed head position while executing wide saccades to survey their surroundings. Simulation of tubular vision resulted in a significant reduction in saccade amplitudes. REALTER holds promise as both a training tool for ophthalmologists and a research instrument for studying low vision conditions. The simulator has the potential to enhance ophthalmologists' comprehension of the limitations imposed by visual disabilities, thereby facilitating the development of new rehabilitation protocols.

Prospective comparative study on enhancing geometrical mental representation and anatomical learning in medical students through modeling clay as an assessment tool.

While traditional anatomy education often emphasizes passive learning and rote memorization, it seldom employs constructivist theories that focus on active, hands-on experiences for effective learning. This study tests the hypothesis that tactile experiences with modeling clay enhance geometric mental representation more effectively than verbal descriptions. We examine the potential of clay modeling to reflect and evaluate students' mental representation of anatomical structures. Utilizing a prospective randomized, open, blind endpoint (PROBE) design, we engaged 36 participants divided into three groups: blind, visually impaired, and a control group. The primary outcome measure was the difference between post-touch score and pre-touch score, which gauged the efficacy of tactile intervention in enhancing the participants' capacity to mentally reconstruct a well-designed anatomical fiction structure. Scoring was executed using a double-blind double-evaluation methodology, positioning clay model reconstruction as both an objective reliable assessment and a pedagogical tool. The analysis demonstrated a pronounced improvement in mental representation of anatomical structures, particularly in spatial comprehension and detailed textural discernment, with the mean score soaring from 47.81 pre-touch to 85.09 post-touch. Distinct cognitive processing adaptations were evident across groups, with the blind group excelling in tactile acuity and the visually impaired group showing the most significant gains in spatial understanding post-intervention (Cohen's d = 2.74). The application of modeling clay as a tactile intervention tool can significantly improve the learning of anatomy among medical students. The study underscores the value of active, multisensory engagement and customized teaching strategies for effective anatomy education among this demographic.

The impact of early and late blindness on language and verbal working memory: A brain-constrained neural model.

Neural circuits related to language exhibit a remarkable ability to reorganize and adapt in response to visual deprivation. Particularly, early and late blindness induce distinct neuroplastic changes in the visual cortex, repurposing it for language and semantic processing. Interestingly, these functional changes provoke a unique cognitive advantage - enhanced verbal working memory, particularly in early blindness. Yet, the underlying neuromechanisms and the impact on language and memory-related circuits remain not fully understood. Here, we applied a brain-constrained neural network mimicking the structural and functional features of the frontotemporal-occipital cortices, to model conceptual acquisition in early and late blindness. The results revealed differential expansion of conceptual-related neural circuits into deprived visual areas depending on the timing of visual loss, which is most prominent in early blindness. This neural recruitment is fundamentally governed by the biological principles of neural circuit expansion and the absence of uncorrelated sensory input. Critically, the degree of these changes is constrained by the availability of neural matter previously allocated to visual experiences, as in the case of late blindness. Moreover, we shed light on the implication of visual deprivation on the neural underpinnings of verbal working memory, revealing longer reverberatory neural activity in 'blind models' as compared to the sighted ones. These findings provide a better understanding of the interplay between visual deprivations, neuroplasticity, language processing and verbal working memory.

Comparing autonomous vehicle acceptance of German residents with and without visual impairments.

Connected and autonomous vehicles (CAVs) will greatly impact the lives of individuals with visual impairments, but how they differ in expectations compared to sighted individuals is not clear. The present research reports results based on survey responses from 114 visually impaired participants and 117 panel recruited participants without visual impairments, from Germany. Their attitudes towards autonomous vehicles and their expectations for consequences of wide-spread adoption of CAVs are assessed. Results indicate significantly more positive CAV attitudes in participants with visual impairments compared to those without visual impairments. Mediation analyses indicate that visually impaired individuals' more positive CAV attitudes (compared to sighted individuals') are largely explained by higher hopes for independence, and more optimistic expectations regarding safety and sustainability. Policy makers should ensure accessibility without sacrificing goals for higher safety and lower ecological impact to make CAVs an acceptable inclusive mobility solution.

Autonomous vehicles can significantly enhance the independence of individuals with visual impairments by providing a reliable and convenient mode of transportation.Autonomous vehicles could offer advanced wayfinding capabilities, including indoor navigation in complex environments, which can be particularly beneficial for people with visual impairments.Comprehensive training programs should be available to help individuals with visual impairments become familiar with autonomous vehicle technology, ensuring they can use it effectively and confidently.Regular feedback from individuals with visual impairments should be sought during the design and development phases to ensure that their specific needs and preferences are taken into account.

"If You Don't Arrange Your Bets Well You Will Still Lose": Gambling Strategies of Visually Impaired Students.

Few studies have focused on people with hearing loss and intellectual disabilities engaging in gambling activities. However, people with visual impairments' energetic participation in sports betting activities is unexplored. This article highlights sports betting strategies of visually impaired students to understand how their motives affect their gambling behaviours as an alternative to their survival. Six male adults aged between 27 and 40 years participated using semi-structured interviews, which were conducted face-to-face, recorded, transcribed, and thematically analysed with the Braun and Clarke model. Findings show that sports betting prevails in communities fostering peer persuasion including family relations serving as an inducer for visually impaired students. Their strategies are varied including the fewer the better concept based on teams' selection dynamics. While they are inspired by potential economic gains, some recognise it as acquiring entrepreneurial skills because of risk-taking, thus asymmetry and disconnected. The article recommends stakeholders' education to provide better policies that can remind them to bet for leisure or desist from gambling.

Barriers and Challenges for Visually Impaired Students in PE-An Interview Study with Students in Austria, Germany, and the USA.

Physical education (PE) is an important part of school education worldwide, and at the same time, almost the only subject that explicitly deals with body and movement. PE is therefore of elementary importance in the upbringing of young people. This also applies to children with visual impairments. However, existing findings on participation and belonging in PE as well as on physical and motor development reveal that this group of children and adolescents is noticeably disadvantaged in this respect. Against this background, this paper aims to explore fundamental barriers and challenges across different types of schools, types of schooling, and countries from the perspective of visually impaired children. The qualitative interview study with 22 children with visual impairments at different types of schools in three countries (Austria, Germany, USA) reveals that none of the respondents could escape the power of social distinctions and related problematic and existing hierarchies. Hence, ideas of normality and associated values remain the main challenge for all of them. However, the type-forming analysis provides important insight across settings on how visually impaired children differ on this, allowing for greater sensitivity to the concerns of children with visual impairments.

Vision Impairments in Young Adults with Down Syndrome.

People with Down syndrome have more visual problems than the general population. They experience premature ageing, and they are expected to also have an acceleration in worsening visual function. A prospective observational study which includes visual acuity, refractive error, accommodation, binocular and colour vision was performed on young adults with (n = 69) and without (n = 65) Down syndrome and on a senior group (n = 55) without Down syndrome. Results showed significant differences in visual acuity between groups (p < 0.001), and it can be improved with a new prescription in 40% of the participants with Down syndrome. Regarding the accommodative state, no significant differences were found between groups of young people. Concerning binocular vision, 64.7% of strabismus was observed in the group with Down syndrome (p < 0.001). Visual abnormalities are significant in young adults with Down syndrome and are different from those of older people without Down syndrome, some of which can be improved by providing the optimal prescription as well as regular eye examinations.

Training a Child with Blindness on the Basic Use of Computer with the Aim of Internet Socialization; an Intervention Program.

In the present intervention program an eleven-year-old student with visual impairments was introduced in the basic use of a computer for the first time. The key tools for achieving this goal were the screen reading software "NVDA" as well as the development of a well-structured educational program. The purpose of the intervention was to enhance the student's technological skills, to make him familiar with the use of assistive technology and to enable him to exploit these new skills for his internet socialization. The evaluation of the intervention program's results was completed on three stages: a) after testing the student's knowledge and skills in the basic use of a computer (pre- and post-assessment ), b) after measuring his social network, his self-esteem and the perceived social support, and c) after analyzing the content of the student's written speech based on a series of criteria. (pre- and post-assessment). The results showed that the basic use of a computer was acquired and internet socialization increased his level of self-esteem, his social network and simultaneously created a sense of belonging. Finally, there was an improvement in his writing.

Eye Care Utilization among Older Subjects with Visual Impairment in Northwest Ethiopia.

Purpose: To find out the level of eye care service utilization and its determinants among the elderly visually impaired populations while visiting ophthalmic outreach locations in North-Western Ethiopia, 2021. Methods: An ophthalmic outreach-based cross-sectional study was conducted on 852 visually impaired older people. Participants were selected by using a systematic random sampling method from January to July 2021. Data were collected by using an interviewer-administered questionnaire and an ocular examination. The collected data were entered into the Epi Info 7, and analyzed using SPSS 20. A binary logistic regression was fitted. Results: A total of 821 participants, with a response rate of 96.5%, were included in the study. The utilization of eye care services within the past two years prior to the study was 21.1% (95 % CI: 18.2-23.9). Having systemic disease (AOR = 3.2, 95% CI: 1.5-7.0), being a spectacle wearer (AOR = 4.5, 95% CI: 2.0-9.4), having visual impairment at distance (AOR = 2.9; 95% CI: 1.5-5.6), being blind (AOR = 2.9; 95% CI: 1.5-5.6), duration of visual impairment ≤1 year (AOR = 2.5; 95% CI: 1.3-4.9) were all significantly associated. Conclusion: In this study, utilization of eye care services was low. Being visually impaired at distance, being blind, recent onset of visual impairment, being a spectacle wearer, and having systemic disease were all related to the use of eye care services. The commonest barriers to utilization of eye care services were financial scarcity and long distances between eye care facilities.

Assessing low vision care and the utilisation of optical low vision aids among patients with visual impairment in Taiwan.

PURPOSE: The aim of this study was to examine the quality of assessment and the utilisation of optical low vision aids (OLVAs) among people with visual impairment (VI) in Taiwan. METHODS: The study included 577 participants between 4 and 100 years of age (314 males and 263 females). All participants had been certified by the Ministry of the Interior of Taiwan, indicating that they had undergone a thorough and comprehensive low vision assessment, including evaluation of visual acuity (VA), contrast sensitivity, colour vision, visual fields and glare disability. Furthermore, all participants who consented to refraction had received prescriptions for OLVAs. RESULT: All participants were prescribed one or more OLVAs such as eyeglasses, tinted lenses, magnifiers, closed-circuit television magnifiers, telescopes, or screen magnifiers. Among the 577 individuals, 515 received correction for refractive errors, providing the best-corrected VA (BCVA). The improvement in VA was significant at both distance and near, improving from 1.29 ± 0.55 to 1.01 ± 0.52 logMAR (p < 0.001) and from 1.29 ± 0.56 to 1.01 ± 0.52 logMAR (p < 0.001), respectively. Eyeglasses were the primary OLVAs chosen by 333 participants (64.7%), while 53.3%-80.3% of participants combined eyeglasses with other OLVAs to enhance their visual performance. CONCLUSIONS: The most commonly used and effective OLVA was eyeglasses. Skilfully utilising appropriate refractive and VA measurements is crucial for determining the most suitable and beneficial OLVA for individuals with VI.

Predictors for work participation of people with visual impairments: A systematic review and meta-analysis.

INTRODUCTION: The aim of this systematic review and meta-analysis was to assess factors associated with work participation in people with visual impairments and to explore how these factors may have changed over time. METHOD: A comprehensive search of PubMed, Embase.com, EBSCO/APA PsycInfo, EBSCO/CINAHL and EBSCO/ERIC from database inception to 1 April 2022 was performed. We included studies with cross-sectional design, case-control, case-series or cohort design, involving visually impaired working-age adults with at least moderate visual impairment, and evaluated the association between visual impairment and work participation. Studies involving participants with deaf-blindness or multiple disabilities were excluded. We assessed study quality (Newcastle-Ottawa Scale [NOS]), examined between-study heterogeneity and performed subgroup analyses. The study protocol was registered in PROSPERO, CRD42021241076. RESULTS: Of 13,585 records, 57 articles described 55 studies including 1,326,091 participants from mostly high-income countries. Sociodemographic factors associated with employment included higher education (odds ratio [OR] 3.34, 95% confidence interval [CI] 2.47 to 4.51, I2 0%), being male (OR 1.59, 95% CI 1.37 to 1.84, I2 95%), having a partner (OR 1.73, 95% CI 1.12 to 2.67, I2 34%), white ethnicity (OR 1.36, 95% CI 1.07 to 1.74, I2 0%) and having financial assistance (OR 0.38, 95% CI 0.26 to 0.55, I2 85%). Disease-related factors included worse visual impairment (OR 0.61, 95% CI 0.46 to 0.80, I2 98%) or having additional disabilities (OR 0.55, 95% CI 0.49 to 0.62, I2 16%). Intervention-related factors included mobility aid utilisation (OR 0.35, 95% CI 0.10 to 1.18, I2 94%). A potential moderating effect of time period and geographical region was observed for some factors. Study quality (NOS) was rated moderate to high. CONCLUSION: Several sociodemographic and disease related factors were associated with employment status. However, the results should be interpreted with caution because of overall high heterogeneity. Future research should focus on the role of workplace factors, technological adjustments and vocational rehabilitation services on work participation.

A direct comparison of sound and vibration as sources of stimulation for a sensory substitution glove.

Sensory substitution devices (SSDs) facilitate the detection of environmental information through enhancement of touch and/or hearing capabilities. Research has demonstrated that several tasks can be successfully completed using acoustic, vibrotactile, and multimodal devices. The suitability of a substituting modality is also mediated by the type of information required to perform the specific task. The present study tested the adequacy of touch and hearing in a grasping task by utilizing a sensory substitution glove. The substituting modalities inform, through increases in stimulation intensity, about the distance between the fingers and the objects. A psychophysical experiment of magnitude estimation was conducted. Forty blindfolded sighted participants discriminated equivalently the intensity of both vibrotactile and acoustic stimulation, although they experienced some difficulty with the more intense stimuli. Additionally, a grasping task involving cylindrical objects of varying diameters, distances and orientations was performed. Thirty blindfolded sighted participants were divided into vibration, sound, or multimodal groups. High performance was achieved (84% correct grasps) with equivalent success rate between groups. Movement variables showed more precision and confidence in the multimodal condition. Through a questionnaire, the multimodal group indicated their preference for using a multimodal SSD in daily life and identified vibration as their primary source of stimulation. These results demonstrate that there is an improvement in performance with specific-purpose SSDs, when the necessary information for a task is identified and coupled with the delivered stimulation. Furthermore, the results suggest that it is possible to achieve functional equivalence between substituting modalities when these previous steps are met.

Hey Google! Intelligent personal assistants and well-being in the context of disability during COVID-19.

BACKGROUND: Amidst the greatest technological advancement that societies have seen, the (health)care and quality of life of all, and especially of vulnerable individuals, see unprecedented improvements. Intelligent personal assistants (IPAs), such as Google Home (GH), can easily be implemented in their daily lives to facilitate routines. Technology can offer significant benefits for individuals with impairments and/or limitations in achieving greater autonomy and well-being. However, this opportunity still needs to be fully exploited, especially in long-term care facilities. Furthermore, such potential may be particularly needed during social isolation due to health concerns, such as the COVID-19 lockdowns and restrictions. We investigated the validity of implementing GH in residential care for individuals with visual impairments (VIs) and intellectual disabilities (IDs) and assessed the effects of a 10-week intervention on self-reported well-being. METHODS: We used a mixed-methods multiple case studies approach (N = 7) and performed intensive assessments (20 weeks), including self-report well-being questionnaires and observations focusing on well-being, autonomy, social participation and GH experiences. Nonoverlap of all pairs analyses were performed for quantitative data indexing performance differences between intervention phases. Thematic analysis was performed for the qualitative data. RESULTS: We found meaningful improvements in well-being in five clients, while all rated the experience of using GH positively. CONCLUSIONS: Our findings from the quantitative and qualitative analyses document that individuals with VI and/or ID benefit from IPAs in fostering better autonomy by facilitating access to information and entertainment. Further implications and possible barriers to large-scale implementation of IPAs in residential care are discussed.

Supporting students with blindness and visual impairments in microbiology.

The number of students with blindness and visual impairments (BVI) completing an undergraduate degree or majoring in STEM programs is low compared to students without disabilities. Though there are several reasons, numbering among them are the instructor's inexperience teaching students with BVI and a lack of knowledge regarding accessibility requirements and accommodations that can be provided to support them. This article contains suggestions regarding safety considerations, accessibility, and accommodations useful in supporting students with BVI in microbiology. Most of the information is applicable to other fields and scenarios as well. When students with BVI are provided with the necessary support, they can be as successful in microbiology as their classmates without disabilities. As more students with BVI achieve success, they can serve as role models and contribute to overcoming remaining barriers to success for students with BVI in microbiology and other STEM courses.

A holistic understanding of challenges faced by people with low vision.

Prior research on visual impairments has documented specific challenges that people with low vision face such as reading and mobility. Yet, much less focus has been given to the relationships between seemingly separate challenges such as mobility and social interactions; limiting the potential of services and assistive technologies for people with low vision. To address this gap, we conducted semi-structured interviews with 30 low vision participants and examined the relationships between challenges and coping strategies overarching three facets of life - functional, psychological, and social. We found that challenges in a specific area of life commonly interacted and impacted other facets of life and provide a conceptual map of these relationship. For example, challenges in mobility reduced social interactions, which in turn affected the psychological well-being. Moreover, participants repeatedly described how a seemingly specific functional challenge (i.e., seeing under different lighting conditions) influenced a wide range of activities, from mobility (e.g., seeing obstacles) to social interactions (e.g., seeing faces and interpreting non-verbal cues). Our results highlight the importance of considering the interrelationships between different facets of life for assistive technology development and evaluation.

Reduced contrast sensitivity function correlated with superficial retinal capillary plexus impairment in early stage of dysthyroid optic neuropathy.

BACKGROUND: To assess the accuracy of contrast sensitivity function (CSF) in detecting dysthyroid optic neuropathy (DON) at an early stage in thyroid-associated ophthalmopathy (TAO) patients and to examine potential factors that may be linked to early visual impairments in these individuals. METHODS: A total of 81 TAO patients (50 non-DON and 31 DON), and 24 control subjects participated in the study. CSF was measured with the quick CSF (qCSF) method. Optical coherence tomography angiography (OCTA) images of the ganglion cell complex layer (GCCL), superficial and deep retinal capillary plexuses (SRCP and DRCP) in a 3 mm diameter area around the macula were evaluated. RESULTS: Compared with the controls, the area under the log contrast sensitivity function (AULCSF) and SRCP density were significantly reduced in non-DON and DON patients (all P < 0.05). The GCCL thickness of the DON patients was thinner than that of the controls and non-DON patients (all P < 0.05). The AULCSF was significantly correlated with spherical equivalent refractive error, muscle index, SRCP density and GCCL thickness in TAO patients, respectively (all P < 0.05). However, stepwise multi-regression analysis showed that the AULCSF was only significantly correlated with SRCP density (P < 0.001). Receiver operating characteristic curve analysis showed that the AULCSF produced the most accurate discrimination between non-DON and DON patients from the controls (AUC = 0.831, 0.987, respectively; all P < 0.001). CONCLUSIONS: CSF change in the early stage of DON is related to SRCP density. It can be an early indicator of visual impairments associated with DON in TAO patients.

Perceptions on Their Own Social Participation: A Qualitative Exploration of Ethiopian Secondary Students with Visual Impairments.

Social participation is a vital part of life and has multifaceted positive outcomes on personal health and wellbeing. Social participation or the lack thereof might have more profound psychological impacts on individuals in a collectivist culture than its counterpart. The current study explored personal and environmental barriers that have hindered the effective social participation of secondary students with visual impairments. Exploration addressed various activities in and outside school settings in Ethiopia and discussed findings in relation to the prevailing cultural orientation. In-depth semi-structured interviews were conducted to gather qualitative data on barriers to social participation of 17 secondary students with visual impairments in Addis Ababa, Ethiopia. The qualitative data were analysed thematically, yielding four major themes and identifying twenty sub-themes that limited the social participation of students with visual impairments, such as personal, attitudinal, sociocultural, and practical barriers. The study showed a range of barriers that participants experienced related to social participation, the criticality of cultural orientation in providing context to understand the impacts of social participation, and the need for future research in the area.

From vision to cognition: potential contributions of cerebral visual impairment to neurodevelopmental disorders.

Vision has a crucial role to play in human development and functioning. It is, therefore, not surprising that vision plays a fundamental role in the development of the child. As a consequence, an alteration in visual function is, therefore, likely to hinder the child's development. Although ocular disorders are well known, diagnosed and taken into account, cerebral visual impairments (CVI) resulting from post-chiasmatic damage are largely underdiagnosed. However, among the disorders resulting from an episode of perinatal asphyxia and/or associated with prematurity, or neonatal hypoglycaemia, CVIs are prominent. In this article, we focus on the role of the possible effects of CVI on a child's learning abilities, leading to major difficulty in disentangling the consequences of CVI from other neurodevelopmental disorders (NDD) such as dyslexia, dyscalculia, dysgraphia, attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD) and autism spectrum disorders (ASD). Although we focus here on the possible overlap between children with CVI and children with other NDD, De Witt et al. (Wit et al. Ear Hear 39:1-19, 2018) have raised exactly the same question regarding children with auditory processing disorders (the equivalent of CVI in the auditory modality). We underline how motor, social and cognitive development as well as academic success can be impaired by CVI and raise the question of the need for systematic evaluation for disorders of vision, visual perception and cognition in all children presenting with a NDD and/or previously born under adverse neurological conditions.

Understanding the perceptions and experiences of the deafblind community about digital games.

PURPOSE: Participation and accessibility issues faced by gamers with multi-sensory disabilities are themes yet to be fully understood by accessible technology researchers. In this work, we examine the personal experiences and perceptions of individuals with deafblindness who play games despite their disability, as well as the reasons that lead some of them to stop playing games. MATERIALS AND METHODS: We conducted 60 semi-structured interviews with individuals living with deafblindness in five European countries: United Kingdom, Germany, Netherlands, Greece and Sweden. RESULTS: Participants stated that reasons for playing games included them being a fun and entertaining hobby, for socialization and meeting others, or for occupying the mind. Reasons for stop playing games included essentially accessibility issues, followed by high cognitive demand, changes in gaming experience due their disability, financial reasons, or because the accessible version of a specific game was not considered as fun as the original one. CONCLUSIONS: We identified that a considerable number of individuals with deafblindness enjoy playing casual mobile games such as Wordfeud and Sudoku as a pastime activity. Despite challenging accessibility issues, games provide meaningful social interactions to players with deafblindness. Finally, we introduce a set of user-driven recommendations for making digital games more accessible to players with a diverse combination of sensory abilities.IMPLICATIONS FOR REHABILITATIONDigital games were considered a fun and entertaining hobby by participants with deafblindness. Furthermore, participants play games for socialization and meeting others, or for occupying the mind.Digital games provide meaningful social interactions and past time to persons with deafblindness.On top of accessibility implications, our findings draw attention to the importance of the social element of gaming for persons with deafblindness.Based on interviews, we introduce a set of user-driven recommendations for making digital games more accessible to players with a diverse combination of sensory abilities.