Broad and Long-Lasting Vision Improvements in Youth With Infantile Nystagmus After Home Training With a Perceptual Learning App.

Bianca Huurneman,Jeroen Goossens

doi:10.3389/fnins.2021.651205

Abstract

Current treatments for infantile nystagmus (IN), focused on dampening the oscillating eye movements, yield little to no improvement in visual functioning. It makes sense, however, to treat the visual impairments associated with IN with tailored sensory training. Recently, we developed such a training, targeting visual crowding as an important bottleneck in visual functioning with an eye-movement engaging letter discrimination task. This training improved visual performance of children with IN, but most children had not reached plateau performance after 10 supervised training sessions (3,500 trials). Here, we evaluate the effects of prolonged perceptual learning (14,000 trials) in 7-18-year-old children with IN and test the feasibility of tablet-based, at-home intervention. Results demonstrate that prolonged home-based perceptual training results in stable, long lasting visual acuity improvements at distance and near, with remarkably good transfer to reading and even stereopsis. Improvements on self-reported functional vision scores underline the clinical relevance of perceptual learning with e-health apps for individuals with IN.

Highlights

Infantile nystagmus (IN) refers to bilateral, involuntary oscillating eye movements with an onset in the first 6 months of life
The goal of the current study is to evaluate the effects of a home-based visual perceptual learning (VPL) app for youth with IN that targets visual crowding as an important bottleneck
We found that training did ameliorate the impact of the subjects’ visual impairment on their daily life activities

Summary

Introduction

Infantile nystagmus (IN) refers to bilateral, involuntary oscillating eye movements with an onset in the first 6 months of life. It is associated with suboptimal vision and affects the quality of life (for example driving difficulties, reliance on others and restricted career opportunities) (McLean et al, 2012). Clinical treatments for IN are missing, despite a significant prevalence of 1.4 per 1000 (Sarvananthan et al, 2009). Attempts to alleviate the life-long visual impairments by dampening the nystagmus have seen disappointing results. A significant problem especially in individuals with IN is visual crowding, the inability to identify objects in clutter (Nandy and Tjan, 2012)

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