Automated Measurement of Resolution Acuity in Infants Using Remote Eye-Tracking

Jones, Pete R.; Kalwarowsky, Sarah; Atkinson, Janette; Braddick, Oliver; Nardini, Marko

doi:10.1167/iovs.14-15108

Cited by 52 publications

(58 citation statements)

References 47 publications

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“…The presented extension of observation-based results with elaborate analysis methods provides standardized and detailed results on visual processing functions. This is in line with work on the assessment of infant visual acuity with an eye tracker 14 , and work on gaze control in various disorders 7 . The method is flexible and enables mobile assessment which is indispensable when performing clinical assessments in young children or children with multiple disabilities.…”

Section: Discussionsupporting

confidence: 79%

“…The major gain of the presented method lies in the possibility to assess more visual functions than is currently done in visual function assessments at a young age, and to assess them in a quantitative manner 26 . A limitation with respect to existing methods is that, without adaptations, it is not yet possible to thoroughly assess visual acuity or visual field with the present test battery 14 .…”

Section: Discussionmentioning

confidence: 99%

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A Method to Quantify Visual Information Processing in Children Using Eye Tracking

Kooiker

Pel

Steen-Kant

et al. 2016

JoVE

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Visual problems that occur early in life can have major impact on a child's development. Without verbal communication and only based on observational methods, it is difficult to make a quantitative assessment of a child's visual problems. This limits accurate diagnostics in children under the age of 4 years and in children with intellectual disabilities. Here we describe a quantitative method that overcomes these problems. The method uses a remote eye tracker and a four choice preferential looking paradigm to measure eye movement responses to different visual stimuli. The child sits without head support in front of a monitor with integrated infrared cameras. In one of four monitor quadrants a visual stimulus is presented. Each stimulus has a specific visual modality with respect to the background, e.g., form, motion, contrast or color. From the reflexive eye movement responses to these specific visual modalities, output parameters such as reaction times, fixation accuracy and fixation duration are calculated to quantify a child's viewing behavior. With this approach, the quality of visual information processing can be assessed without the use of communication. By comparing results with reference values obtained in typically developing children from 0-12 years, the method provides a characterization of visual information processing in visually impaired children. The quantitative information provided by this method can be advantageous for the field of clinical visual assessment and rehabilitation in multiple ways. The parameter values provide a good basis to: (i) characterize early visual capacities and consequently to enable early interventions; (ii) compare risk groups and follow visual development over time; and (iii), construct an individual visual profile for each child.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

A Method to Quantify Visual Information Processing in Children Using Eye Tracking

Kooiker

Pel

Steen-Kant

et al. 2016

JoVE

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“…2.Neu 1997Cross sectional n = 210Group = NVAge = 1–6 yearsProcedure: Monocular TAC, KAC (resolution acuity) and C-test (recognition acuity)Range stimuli: TAC: 0.32–0.38c/cm (half-octave steps), KAC: 0.40–49.2 c/cm, C-test: 0.1–1.4 (decimal)Distance: TAC and KAC: 38, 55 and 84 cm; C-test: 40 cmThreshold used: TAC as above (Salomao); C-test (3/4) 75%% Successful: TAC 40% < 2y; 96% 2-4y;See Fig. 2.C-test gives lower acuity estimates than TAC and KAC and has higher sensitivity of the C-test for detecting uncorrected refractive errors.Jones 2014 [19]Cross sectional n = 30Group = NVAge = 2.6–12.7 monthsProcedure: Binocular validation of computerized acuity card procedure using an eye tracker (ACTIVE)Range stimuli: 0.18–12.5 cpd (KIAC), ACTIVE started at 0.36 cpd and used the same staircase procedure as TIACDistance: 38 cm (KIAC) and 84 cm (ACTIVE)Threshold used: ACTIVE 33.3% (up2-down 1 staircase)% Successful: 100%ACTIVE acuities fell within the 90% range of TAC acuity norms.In 101 s a reliable VA could be obtained. Test-retest data showed difference of 0.04 octaves, which is very small.…”

Section: Resultsmentioning

confidence: 99%

“…These low boundaries affect the test’s sensitivity to pick up near vision problems. The second critique is that the visual acuity that is measured relies heavily upon the subjective judgement of an observer [19]. …”

Section: Resultsmentioning

confidence: 99%

Assessment of near visual acuity in 0–13 year olds with normal and low vision: a systematic review

Huurneman

Boonstra

2016

BMC Ophthalmol

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BackgroundThe inclusion for rehabilitation of visually impaired children is partly based on the measurement of near vision, but guidelines for near visual acuity assessment are currently lacking. The twofold purpose of this systematic review was to: (i) provide an overview of the impact of the chart design on near visual acuity measured, and (ii) determine the method of choice for near vision assessments in children of different developmental ages.MethodsA literature search was conducted by using the following electronic databases: PubMed, Cochrane Library, and EMBASE. The last search was run on March 26th 2016. Additional studies were identified by contacting experts and searching for relevant articles in reference lists of included studies. Search terms were: vision test(s), vision assessment(s), visual acuity, chart(s) and near.ResultsFor children aged 0–3 years the golden standard is still the preferential looking procedure. Norms are available for this procedure for 6–36 month old children. For 4–7 year olds, we recommend using the LEA symbols, because these symbols have been properly validated and can be used in preliterate children. Responses can be verbal or by matching the target symbol. In children aged 8–13 years, the recommended method is the ETDRS letter chart, because letter acuity is more predictive for functional vision and reading than symbol acuity. In 8–13 year olds, letter acuity is 0.1–0.2 logMAR poorer than symbol acuity.ConclusionsChart design, viewing distance, and threshold choice have a serious impact on near visual acuity measurements. Near visual acuity measured with symbols is lower than near visual acuity measured with gratings, and near visual acuity measured with letters is lower than near visual acuity measured with symbols. Viewing distance, chart used, and letter spacing should be adapted to the child’s development and reported in order to allow comparisons between measurements.

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“…Recent developments in eye-tracking-based testing of infant cognition [28][29][30] have opened new possibilities for automated testing of infants' visual acuity, visuospatial orienting (gaze shifts to a novel visual stimulus), and attention to salient social stimuli, such as faces [31][32][33][34][35]. These processes provide the key "building blocks" of later emerging advanced cognitive, academic, and social skills [36,37].…”

Section: Introductionmentioning

confidence: 99%

Evidence for spared attention to faces in 7-month-old infants after prenatal exposure to antiepileptic drugs

Videman

Stjerna

Roivainen

et al. 2016

Epilepsy & Behavior

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a b s t r a c t a r t i c l e i n f oIntroduction: Prenatal antiepileptic drug (AED) exposure is associated with an increased risk of cognitive impairment and autism spectrum disorders detected mainly at the age of two to six years. We examined whether the developmental aberrations associated with prenatal AED exposure could be detected already in infancy and whether effects on visual attention can be observed at this early age. Material and methods: We compared a prospective cohort of infants with in utero exposure to AED (n = 56) with infants without drug exposures (n = 62). The assessments performed at the age of seven months included standardized neurodevelopmental scores (Griffiths Mental Developmental Scale and Hammersmith Infant Neurological Examination) as well as a novel eye-tracking-based test for visual attention and orienting to faces. Background information included prospective collection of AED exposure data, pregnancy outcome, neuropsychological evaluation of the mothers, and information on maternal epilepsy type. Results: Carbamazepine, oxcarbazepine, and valproate, but not lamotrigine or levetiracetam, were associated with impaired early language abilities at the age of seven months. The general speed of visuospatial orienting or attentional bias for faces measured by eye-tracker-based tests did not differ between AED-exposed and control infants. Discussion: Our findings support the idea that prenatal AED exposure may impair verbal abilities, and this effect may be detected already in infancy. In contrast, the early development of attention to faces was spared after in utero AED exposure.

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Automated Measurement of Resolution Acuity in Infants Using Remote Eye-Tracking

Cited by 52 publications

References 47 publications

A Method to Quantify Visual Information Processing in Children Using Eye Tracking

A Method to Quantify Visual Information Processing in Children Using Eye Tracking

Assessment of near visual acuity in 0–13 year olds with normal and low vision: a systematic review

Evidence for spared attention to faces in 7-month-old infants after prenatal exposure to antiepileptic drugs

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