Abstract

BackgroundThis study investigates the effect of a new computer-based visual search training (VST) that was adapted for children with homonymous hemianopia (HH).Methods22 children with HH (median age 11 years, 8 months: 6y6m-19y2m) trained at home for 15 minutes twice/day, 5 days/week, for 6 weeks. To assess performance before training (T1), directly after training (T2) and 6 weeks after the end of training (T3), we measured search times (STs) during on-screen search (with eye tracking), and in a real life search task. Additional variables analyzed during on-screen search were numbers, amplitudes, and durations of saccades, their directional patterns and the proportional number of saccades into the non-seeing field. The latter was the main variable during free viewing. Sixteen healthy age-matched children, who did not undergo the training, served as comparison group. Quality of Life (QoL)-questionnaires were also applied.ResultsSTs of the patients decreased significantly during the training and all search performance tests. This improvement persisted 6 weeks after the end of the training. Saccade amplitudes increased, total number of saccades to find the target decreased, and the proportional number of saccades to the non-seeing side increased. These changes were maintained at T3. Saccade durations did not change. During free viewing, saccades were equally distributed to both sides before and after training. Patients reported improvements in QoL and activities of daily living. Performance in the healthy children did not change by simply repeating the visual search test.ConclusionsThe improvement in STs in all search tasks, larger and fewer saccades, and an improved search strategy after VST suggests that the children with HH benefited from the training. The maintained improvement at T3 and the improvement in the real life search task indicate that the newly developed search strategy persists and can be applied to everyday life.

Highlights

  • Homonymous hemianopia (HH) causes impaired spatial orientation and diminished quality of life [1,2]

  • This study investigates the effect of a new computer-based visual search training (VST) that was adapted for children with homonymous hemianopia (HH)

  • Saccades were distributed to both sides before and after training

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Summary

Introduction

Homonymous hemianopia (HH) causes impaired spatial orientation and diminished quality of life [1,2]. Much research exists on adult patients with HH [3,4,5,6,7,8], but only few studies on children. The present study is the first using visual search training (VST), eye movements and exploration of relevance for daily living in children with HH. Several aspects are especially interesting in children: What is the best way to assess the visual fields? “Spontaneous” means “without intervention”, “natural development” describes the improvement of functions through the natural aging process (in healthy and impaired children). This study of children with HH focused on 3 main questions: 1. This study investigates the effect of a new computer-based visual search training (VST) that was adapted for children with homonymous hemianopia (HH)

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