The Effect of Central Vision Loss on Perception of Mutual Gaze

Abstract

Purpose To evaluate the effects of central vision loss (CVL) on mutual gaze perception (knowing whether somebody else is looking at you), an important nonverbal visual cue in social interactions. Methods 23 persons with CVL (visual acuity 20/50 to 20/200), 16 with a bilateral central scotoma and 7 without, and 23 age-matched controls completed a gaze perception task, and a brief questionnaire. They adjusted the eyes of a life-size virtual head on a monitor at a 1-m distance until they appeared either to be looking straight at them, or were at the extreme left/right or up/down positions at which the eyes still appeared to be looking toward them (defining the range of mutual gaze in the horizontal and vertical planes). Results The nonscotoma group did not differ from the controls in any gaze task measure. However, the gaze direction judgments of the scotoma group had significantly greater variability than those of the nonscotoma and control groups (p < 0.001). In addition, their mutual gaze range tended to be wider (p = 0.15), suggesting a more liberal judgment criterion. Contrast sensitivity was the strongest predictor of variability in gaze direction judgments followed by self-reported difficulties. Conclusions Our results suggest that mutual gaze perception is relatively robust to CVL. However, a follow-up study that simulates less-than-optimal viewing conditions of everyday social interactions is needed. The gaze perception task holds promise as a research tool for investigating the effects of vision impairment on mutual gaze judgments. Self-reported difficulty and contrast sensitivity were both independent predictors of gaze perception performance suggesting that the task captured higher-order as well as low-level visual abilities.

The effects of simulated vision impairments on the cone of gaze

“…Thus, even complex visual processes that leave room for compensation were negatively affected by the scotoma. Surprisingly, apart from the increased variability, the central vision loss affected our patients to a remarkably small extent when judging mutual gaze (Sheldon et al, 2014). In the current study, the healthy subjects appeared to compensate for the impairment by tightening their criterion for mutual gaze when confronted with dioptric blur or a diffusing filter, which could point to a process by which patients adapt to their visual impairment and are able to achieve close to normal performance with regard to higher-order visual perception although their acuity is compromised.…”

“…We previously found that patients with central vision loss that included a central scotoma (a blind area in central vision) had significantly more variable gaze direction judgments than age-matched normally-sighted subjects (Sheldon, Quint, Hecht & Bowers, 2014). Our present simulations produced similar results in healthy subjects.…”

Impacts of impaired face perception on social interactions and quality of life in age-related macular degeneration: A qualitative study and new community resources

“…Theoretically, this finding is consistent with the fact that group situations pose the most challenging setting for face perception. That is, to fully engage in a group social interaction, one needs to be able to: rapidly identify all members of the group; pick up immediately on rapid changes of expression or emotion and what events these were in response to; use eye gaze cues to pick up on social signals such as when it might be your turn to speak or when the group's attention has shifted elsewhere [37]; and potentially use facial speech cues to help understand what others are saying (particularly in a noisy environment [38]).…”

Age-Related Macular Degeneration

“…Indeed, Ng et al 30 show that there has been a substantial increase in the usage of anti-VEGF agents for both typical AMD and PCV in one center. Sheldon et al 32 investigated this issue in patients with central vision loss and demonstrate that those with central vision loss have remarkably intact mutual gaze. That is the perception that someone is looking at them, which is an important nonverbal social cue.…”