Efficacy of Enhancing Low Vision Mobility Thru Visual Training in Virtual World
Condition: Low Vision
MeSH terms: Vision, Low
Study type: Observational

Summary: 
      Low vision patients have difficulty acquiring sufficient visual information in a timely
      manner for the purpose of performing challenging daily tasks, such as traveling independently
      and safely through busy streets. The advance of virtual reality techniques has provided a
      potential platform for training low vision patients to use their remaining vision more
      efficiently, but the key issue is always whether the patient's visual experiences in a
      virtual world can be transferred to the real world. The proposed study is designed to provide
      definite answer to this question.
    

Detailed description: 
      NEI's National Plan for Eye and Vision Research has identified Low Vision and Blindness
      Rehabilitation as one of the most pressing needs and opportunities in vision research. Since
      most low vision (LV) patients nowadays have useable vision, an important aspect of LV
      rehabilitation is to maximize the use of the patient's remaining vision. Visual skills are
      especially important in tasks such as traveling independently through busy streets, in which
      distant, rapidly changing events have direct impact on the patient's task efficiency and
      safety. The patient has to learn new information acquisition skills to compensate for their
      impaired vision. Current LV training for such skills is done on real streets in a one-on-one,
      trainer/trainee sessions. This way of training, however, usually does not expose clients to
      all the circumstances that they need to deal with, usually does not provide graded levels of
      task difficulty and repeatable conditions that facilitate learning, and cannot meet the needs
      of the majority of LV patients because of the shortage and the high cost of LV trainers. The
      advances of virtual reality (VR) technology have made it possible and affordable to
      realistically simulate complex and dynamic visual and auditory environments to facilitate LV
      rehabilitation. However, the most important first step in applying VR technologies to LV
      rehabilitation is to determine whether the visual experiences of a LV person can be
      transferred to the real world. Only when a positive transfer of visual skills is confirmed,
      can subsequent development of comprehensive VR training systems for all aspects of LV
      rehabilitation become worthwhile. The purpose of this study is to accomplish this first step.
      A set of visual skills for a most visually challenging task, crossing a signal-controlled
      street, is selected from standard orientation and mobility curriculum to study virtual
      experience transfer. Existing technology are used to build a desktop computer-based VR
      simulator that can generate virtual street intersection scenarios that contain visual and
      auditory information required for practicing the skills to be studied. Computer generated
      street intersections with pedestrians, traffic and control signals are projected to a large
      screen for the participant to view, like a movie. Twenty LV persons are recruited from a
      university LV rehabilitation facility. They are randomly assigned to practicing the selected
      visual skills at real or virtual street intersections. Their skill levels are evaluated at
      real intersections before and immediately after their scheduled training. The primary outcome
      of interest is the mean change of visual skills between pre- and post-training evaluations in
      the two groups. The training is not a rehabilitation intervention because only the changes in
      visual/audio information gathering skills are trained and observed. The participants are
      trained and evaluated on the sidewalks of the real and virtual street. They are never allowed
      to step down the curb to avoid exposure to any danger. The long-term goal is to develop
      interactive VR training systems that have multiple sensory and motor input and output modules
      and that incorporate the collective experiences of the LV rehabilitation profession. Adding
      such systems to LV curriculum can greatly improve the affordability, accessibility,
      efficiency and the scope of LV rehabilitation.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Low vision participants will be recruited from the patient populations of the Clinics of
        UAB School of Optometry and UAB Center for Low Vision Rehabilitation