Beyond visual acuity: development of a simple test of the slow-to-see phenomenon in children with infantile nystagmus syndrome

Weaterton, Ruaridh, Tan, Shinn, Adam, John, Kaur, Harneet, Rennie, Katherine, Dunn, Matt ORCID: https://orcid.org/0000-0002-0295-2182, Ewings, Sean, Theodorou, Maria, Osborne, Dan, Evans, Megan, Lee, Helena and Self, James 2021. Beyond visual acuity: development of a simple test of the slow-to-see phenomenon in children with infantile nystagmus syndrome. Current Eye Research 46 (2) , pp. 263-270. 10.1080/02713683.2020.1784438

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Abstract

Purpose Conventional static visual acuity testing profoundly underestimates the impact of infantile nystagmus on functional vision. The slow-to-see phenomenon explains why many patients with nystagmus perform well in non-time restricted acuity tests but experience difficulty in certain situations. This is often observed by parents when their child struggles to recognise familiar faces in crowded scenes. A test measuring more than visual acuity could permit a more real-world assessment of visual impact and provide a robust outcome measure for clinical trials. Methods Children with nystagmus and, age and acuity matched controls attending Southampton General Hospital were recruited for two tasks. In the first, eye-tracking measured the time participants spent looking at an image of their mother when alongside a stranger, this was then repeated with a sine grating and a homogenous grey box. Next, a tablet-based app was developed where participants had to find and press either their mother or a target face from up to 16 faces. Here, the response time was measured. The tablet task was refined over multiple iterations. Results In the eye-tracking task, controls spent significantly longer looking at their mother and the grating (P < .05). Interestingly, children with nystagmus looked significantly longer at the grating (P < .05) but not their mother (P > .05). This confirmed a facial target was key to further development. The tablet-based task demonstrated that children with nystagmus take significantly longer to identify the target; this was most pronounced using a 3-min test with 12-face displays. Conclusion This study has shown a facial target is key to identifying the time-to-see deficit in infantile nystagmus and provides the basis for an outcome measure for use in clinical treatment trials.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Optometry and Vision Sciences
Publisher:	Informa Healthcare
ISSN:	0271-3683
Date of Acceptance:	13 June 2020
Last Modified:	07 Nov 2022 10:56
URI:	https://orca.cardiff.ac.uk/id/eprint/134011

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