An Open-source Static Threshold Perimetry Test Using Remote Eye-tracking (Eyecatcher): Description, Validation, and Preliminary Normative Data.

Pete R. Jones

doi:10.1167/tvst.9.8.18

Abstract

PurposeTo describe, validate, and provide preliminary normative data for an open-source eye-movement perimeter (Eyecatcher).MethodsVisual field testing was performed monocularly in 64 normally sighted young adults, using (i) a Humphrey Field Analyzer (HFA) and (ii) the novel Eyecatcher procedure. Eyecatcher used a remote eye-tracker to position stimuli relative to the current point of fixation, and observers responded by looking towards the stimulus. In both tests, Goldman III stimuli were sampled from a 24-2 grid, and were presented against a 10 cd/m2 background. Participants completed each test twice to assess test–retest repeatability.ResultsMean Sensitivity (MS) did not differ between Eyecatcher and the HFA (P = 0.086), and both tests exhibited similar test–retest repeatability (CoREyecatcher = ±1.86 dB; CoRHFA = ±1.95 dB). Eyecatcher was also able to detect changes in sensitivity across the normal visual field (the “Hill of Vision”), and could differentiate the physiological blind spot from adjacent retinal locations. Mean sensitivities and 95% limits of agreement are described for each pointwise location.ConclusionsEyecatcher can use eye movements to assess visual fields in young, normally sighted adults. In such observers, it provides results similar to the current gold standard clinical device (HFA).Translational RelevanceGiven further development, eye movement perimeters such as Eyecatcher could be particularly useful for individuals unable to perform traditional perimetric assessments, such as young children or stroke patients. Full technical details and information on how to freely acquire the source code are included.

Highlights

Visual field loss affects 3% of 16- to 60-year-olds, and 13% of those over 60 years of age.[1]
Translational Relevance: Given further development, eye movement perimeters such as Eyecatcher could be useful for individuals unable to perform traditional perimetric assessments, such as young children or stroke patients
We describe a novel threshold perimeter (Eyecatcher), that combines inexpensive eye-tracking technology with a rapid adaptive algorithm.[30,31,32,33]

Summary

Introduction

Visual field loss affects 3% of 16- to 60-year-olds, and 13% of those over 60 years of age.[1] It is a key marker for many eye diseases[2,3,4,5,6,7,8,9,10,11,12] and correlates with everyday quality of life,[13,14,15] as well as with wider visual function.[16,17,18,19,20]. Visual field loss is assessed clinically using standard automated perimetry (SAP). With current SAP devices (e.g., Octopus, Dicon, Henson Perimeters, or the Humphrey Field Analyzer [HFA]), the patient’s head is fixed in place using a chin rest. Lights are presented at one of n discrete locations, and an automated algorithm is used to adapt successive light intensities to determine the luminance detection threshold for each location

Methods

Results

Discussion

Conclusion