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      Ability of Head-Mounted Display Technology to Improve Mobility in People With Low Vision: A Systematic Review

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          Abstract

          Purpose

          The purpose of this study was to undertake a systematic literature review on how vision enhancements, implemented using head-mounted displays (HMDs), can improve mobility, orientation, and associated aspects of visual function in people with low vision.

          Methods

          The databases Medline, Chinl, Scopus, and Web of Science were searched for potentially relevant studies. Publications from all years until November 2018 were identified based on predefined inclusion and exclusion criteria. The data were tabulated and synthesized to produce a systematic review.

          Results

          The search identified 28 relevant papers describing the performance of vision enhancement techniques on mobility and associated visual tasks. Simplifying visual scenes improved obstacle detection and object recognition but decreased walking speed. Minification techniques increased the size of the visual field by 3 to 5 times and improved visual search performance. However, the impact of minification on mobility has not been studied extensively. Clinical trials with commercially available devices recorded poor results relative to conventional aids.

          Conclusions

          The effects of current vision enhancements using HMDs are mixed. They appear to reduce mobility efficiency but improved obstacle detection and object recognition. The review highlights the lack of controlled studies with robust study designs. To support the evidence base, well-designed trials with larger sample sizes that represent different types of impairments and real-life scenarios are required. Future work should focus on identifying the needs of people with different types of vision impairment and providing targeted enhancements.

          Translational Relevance

          This literature review examines the evidence regarding the ability of HMD technology to improve mobility in people with sight loss.

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          Most cited references72

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          Impact of age related macular degeneration on quality of life.

          To describe the impact of age related macular degeneration (AMD) on quality of life and explore the association with vision, health, and demographic variables. Adult participants diagnosed with AMD and with impaired vision (visual acuity <6/12) were assessed with the Impact of Vision Impairment (IVI) questionnaire. Participants rated the extent that vision restricted participation in activities affecting quality of life and completed the Short Form General Health Survey (SF-12) and a sociodemographic questionnaire. The mean age of the 106 participants (66% female) was 83.6 years (range 64-98). One quarter had mild vision impairment, (VA<6/12-6/18) and 75% had moderate or severely impaired vision. Participants reported from at least "a little" concern on 23 of the 32 IVI items including reading, emotional health, mobility, and participation in relevant activities. Those with mild and moderate vision impairment were similarly affected but significantly different from those with severe vision loss (p<0.05). Distance vision was associated with IVI scores but not age, sex, or duration of vision loss. AMD affects many quality of life related activities and not just those related to reading. Referral to low vision care services should be considered for people with mild vision loss and worse.
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            The Impact of Vision Impairment Questionnaire: an evaluation of its measurement properties using Rasch analysis.

            To explore the psychometric properties of the Impact of Vision Impairment scale (IVI) by using Rasch analysis. Three hundred fourteen first-time referrals to low-vision clinics completed the 32-item IVI. The data were Rasch-analyzed with a partial credit model using RUMM2020 software (RUMM Laboratory, Perth, WA, Australia). The overall fit of the model, response scale, individual item fit, differential item functioning, unidimensionality, and person-separation reliability were assessed. Initially, 26 items displayed disordered thresholds. However, collapsing the response scale to three categories (4 items) and four categories (28 items) produced ordered response thresholds for all items. Four items with high proportions of missing responses, poor spread, high skewness, and deviation between observed and expected model curves were then removed. This adjustment produced overall fit to the Rasch model (item-trait interaction chi(2) = 118.3; P = 0.32). The final mean (SD) person and item fit residuals ere 0.06 (0.85) and -0.20 (1.45), respectively. The person-separation reliability was 0.9, indicating that the scale was able to discriminate between several different groups of participants. The revised scale was well targeted to the participants, with similar mean locations for items (0.00) and persons (0.16). A significant difference between participants of mild, moderate, and severe visual impairment (ANOVA; P 0.001) supported the criterion validity of the Rasch-scaled IVI. The results provide support for the measurement properties of the Rasch-scaled 28-item version of the IVI and of its potential for assessing outcomes of low-vision rehabilitation. A raw score-to-Rasch person measure conversion is supplied.
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              Visual factors and orientation-mobility performance.

              The ability of the person with low vision to achieve successful orientation and mobility depends on residual vision, age of onset of visual impairment, posture and balance, intelligence, body image, auditory-tactile abilities, and personality. This study assesses the role of the residual vision and looks in particular at visual fields, spatial contrast sensitivity, and visual acuity. Correlation coefficients indicate that, for low vision patients, spatial contrast sensitivity and visual fields each have more influence on orientation-mobility than does visual acuity.
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                Author and article information

                Journal
                Transl Vis Sci Technol
                Transl Vis Sci Technol
                tvst
                TVST
                Translational Vision Science & Technology
                The Association for Research in Vision and Ophthalmology
                2164-2591
                24 September 2020
                September 2020
                : 9
                : 10
                : 26
                Affiliations
                [1 ]School of Computer Science and Informatics, Cardiff University, Cardiff, UK
                [2 ]School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
                Author notes
                Correspondence: Parisa Eslambolchilar, School of Computer Science and Informatics, Cardiff University, Park Place, Cardiff CF10 3AT, UK. e-mail: eslambolchilarp@ 123456cardiff.ac.uk
                Article
                TVST-19-1485
                10.1167/tvst.9.10.26
                7521174
                6a2c7add-8fb7-4db4-be52-7793f14a286f
                Copyright 2020 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 17 August 2020
                : 12 March 2019
                Page count
                Pages: 27
                Categories
                Review
                Review

                low vision,vision enhancement,augmented reality,rehabilitation,mobility

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