Perceiving and interpreting motion in the visual world is an important and complex visual process involved in activities such as driving, which involves the motion of both the driver's own vehicle and that of other road users. Research has explored the association between tests of motion sensitivity and a range of indices of driving performance and safety, to better understand the role of motion sensitivity in driving and its ability to predict driving performance and safety. This review provides an overview of research that has explored associations between motion sensitivity tests and measures of driving performance and safety. Collectively, the findings suggest that motion sensitivity is important in the timely detection of hazards, as well as for visually guided vehicle control behaviours (e.g., lane-keeping). Impaired motion sensitivity has been shown to be associated with delayed hazard response times in computer-based tests, impaired driving performance assessed in closed and open road studies, as well as increased crash risk. Given the many driving performance outcomes in on-road and simulator studies related to motion sensitivity, further work should explore motion sensitivity as a risk factor for unsafe driving performance and collision involvement in older adults.

Abstract Purpose To develop a new comprehensive vision-related low luminance performance-based measure, the ‘Assessment of Low Luminance Vision-Related Activities’ (ALLVA), and evaluate its construct validity and test-retest reliability using Rasch analysis. Methods A cross-sectional observational study of 75 adults with vision impairment from various ocular conditions (mean age 70 years [SD: 15 years]; mean binocular visual acuity 0.63 logMAR [SD: 0.45 logMAR]) was conducted. Seventeen tasks were developed as items and administered to participants under low luminance, with completion time and number of errors recorded. As some items could not be completed by all participants, five categories of completion time were created for analysis (quartiles and a fifth category representing non-completion). The ‘method of successive dichotomisations’—a polytomous Rasch model that always estimates ordered response category thresholds, enabling its application to binned continuous data—was applied to create a single combined measure of performance. Errors were not analysed as they occurred infrequently and generally increased completion time. Eleven participants with age-related macular degeneration were retested after 2–4 weeks. Clinical vision measures, including visual acuity, contrast sensitivity and visual fields, were also collected. Results Initial analysis of the 17-task ALLVA led to removal of one item, walking a mobility course, due to infit and outfit mean square statistics being outside the acceptable range. For the remaining 16 tasks, item difficulty was well targeted to person ability, with only a minor floor effect. Item and person reliability values were 0.98 and 0.93, respectively. Clinical vision measures were significantly correlated with person measures. Bland–Altman analysis indicated a mean difference between test and retest person measures of −0.08 logits (95% limits of agreement 2.16 to −2.32 logits). Conclusion The ALLVA is the first comprehensive vision-related low luminance performance-based measure. It demonstrated strong Rasch psychometric properties, validity and good test-retest reliability.

To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers. It also investigates the effects of supplements dosage, intervention duration, and geographical variation on intervention results. A systematic search and screening of randomized controlled trials (RCTs) completed between 2014 and 2023 was undertaken using the PubMed, EMBASE, Cochrane Library, and Web of Science databases, in accordance with the PRISMA recommendations. The Cochrane risk of bias method was used to assess the quality of the studies. A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences (SMDs) and 95% confidence intervals (CIs). Subgroup analyses were performed to look at the effects of different doses, intervention periods, and geographic areas. Additionally, publication bias was assessed using Egger's test. Ten studies including 1035 participants with myopia were analyzed. Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group (SMD=-0.40, P=0.001), an increase in macular pigment optical density (SMD=0.50, P=0.010), and an enhancement in visual sensitivity (SMD=0.53, P=0.008). Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups (high-dose vs low-dose: SMD=-0.41 vs -0.22, P=0.003; >12mo vs 6-12mo: SMD=-0.43 vs -0.23, P=0.004, respectively). Furthermore, Egger's test indicated no significant publication bias (P=0.094). Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents, with more pronounced benefits observed in high-dose and long-term interventions. The findings provide scientific evidence for its use as an adjunctive approach in myopia control.

Purpose: We compared short-term clinical outcomes after cataract surgery with implantation of a novel refractive extended depth-of-focus TECNIS PureSee intraocular lens (IOL) between patients with stage 1 epiretinal membrane (ERM)—characterized by a thin membrane over the macula with preserved foveal depression―and those with a normal retina.Methods: This retrospective study included 60 eyes of 60 patients who underwent cataract surgery with implantation of the TECNIS PureSee IOL between January 2024 and January 2025: 30 eyes with stage 1 ERM and 30 eyes with a normal retina. Preoperative characteristics, including age, sex distribution, cataract severity, corrected distance visual acuity (CDVA), and higher-order aberrations, were compared between groups, as were IOL power and target refraction. Postoperative outcomes at 1 month―including CDVA, uncorrected distance, intermediate, and near visual acuity, ocular aberrations, and contrast sensitivity―were evaluated.Results: There were no significant differences in preoperative characteristics, such as age, sex distribution, cataract grade, CDVA, higher-order aberrations, IOL power, or target refraction between the two groups. At 1 month postoperatively, CDVA, uncorrected distance, intermediate, and near visual acuity, higher-order aberrations, and contrast sensitivity exhibited no significant differences between groups.Conclusions: In this short-term analysis, the PureSee IOL demonstrated comparable efficacy and safety in cataract patients with stage 1 ERM to those with a normal retina.

Patients suffering from persistent postural-perceptual dizziness (PPPD) often experience postural instability that worsens when exposed to visual motion stimuli. We investigated how different visual motion stimuli affect patients' postural sway and their perceived egomotion during stance. 28 PPPD patients and 26 gender and healthy control subjects (HC) underwent posturographic measurements on a firm or foam platform while being exposed to either vestibular or visual motion stimuli or their combination. Vestibular stimuli were applied via 1.3mA galvanic vestibular stimulation (GVS) or a sham stimulus. Visual stimulation (VS) was performed via 20-s video snippets of a silent movie, flow-field animation, or a rollercoaster video from the driver's perspective. Outcome measures included postural sway speed (PSS) and perceived egomotion, collected via self-ratings after each trial. Compared to HC, PSS of PPPD patients was higher on a firm surface during vestibular stimulation alone and combined visual-vestibular stimulation (except during rollercoaster VS) but not during VS alone. These group differences disappeared on foam, except during the baseline (noVS, noGVS) condition. Egomotion perception was rated consistently higher by PPPD participants in all conditions but in a non-linear ratio. Our visual motion stimuli were capable of eliciting different magnitudes of perceived egomotion and postural sway without significant group differences in postural sway challenging the notion of increased visual sensitivity in PPPD. Multisensory stimulation alleviates visual sensitivity and counteracts postural misperception in quiet stance. Patients' non-linear increase of egomotion with increasing postural sway differs from HC and reflects a non-linear perceptual-postural scaling as a crucial mechanism in PPPD.

Glaucoma is one of the leading causes of irreversible blindness and is characterised by progressive loss of retinal ganglion cells. While therapies to lower intraocular pressure slow the progression of the disease in most patients, a significant subset still shows progression despite treatment. Transcorneal electrical stimulation (TES) may potentially activate neuroprotective pathways and slow the progression of visual field defects. The OkuStim 2 System is a medical device for TES which was originally developed for the treatment of retinitis pigmentosa and similar retinal dystrophies and shall now be tested for the treatment of glaucoma. Stimulation of the diseased retina with weak currents can activate signalling pathways and the release of substances that have a protective effect on the retinal cells. This neuroprotective effect might preserve physiological functions of the retina for longer and slow down its gradual degeneration. Long-term use is required to maintain this effect. The TES-GPS study is investigating the safety and efficacy of TES in open-angle glaucoma. TES-GPS (short title for glaucoma pilot study) is a prospective, randomised, double-blind, sham-controlled, single-centre pilot study at the University Medical Center Mainz. 50 patients with progressive visual field loss due to open-angle glaucoma will be randomised 1:1 to receive either TES with the OkuStim 2 System or sham stimulation. The primary endpoint is the change in visual field sensitivity (Humphrey mean deviation) after 18 months. Secondary endpoints include changes in visual acuity, intraocular pressure, optical coherence tomography (OCT) parameters and quality of life (National Eye Institute Visual Function Questionnaire 25, NEI-VFQ 25). The intervention consists of weekly 30 min TES sessions, which are conducted in the patient's home after initial training in the clinic. The study comprises up to 13 scheduled visits over 18 months. The study is conducted in accordance with ISO14155, Medical Device Regulation (EU) 2017/745, International Council for Harmonisation Good Clinical Practice and the Declaration of Helsinki. Approval was obtained from the Ethics Committee of the Landesaerztekammer Rheinland-Pfalz in Mainz and from Bundesinstitut fuer Arzneimittel und Medizinprodukte. Results will be published in peer-reviewed journals and presented at scientific conferences. NCT06682962.

Texture image retrieval based on subjective visual descriptions remains a significant challenge due to the “semantic gap”, where conventional Content-Based Image Retrieval (CBIR) methods rely on low-level features or reference images that often diverge from human perception. To bridge this gap, this paper proposes a reference-free, perception-driven retrieval framework that enables users to query textures directly via abstract perceptual attributes. First, we constructed a human-centric perceptual feature space through controlled psychophysical experiments, quantifying 12 explicit texture attributes (e.g., granularity, directionality) using a 9-point Likert scale. Second, addressing the variability in visual sensitivity across user demographics, we developed a user-adaptive mechanism incorporating dual perceptual libraries tailored for art-major and non-art-major groups. Retrieval is formulated as a perception-aligned similarity optimization problem within this normalized space. Experimental evaluations on the Describable Textures Dataset (DTD) demonstrate that our method achieves superior perceptual consistency compared to both handcrafted descriptors (GLCM, LBP, HOG) and deep learning baselines (VGG16, ResNet50). Notably, the framework attained high PAP@3 performance across both user groups, validating its effectiveness in decoding fuzzy human intent without the need for query images. This work provides a robust solution for semantic-based texture retrieval in human–computer interaction scenarios.

Retinal Age Gap as a Biomarker for Patient Satisfaction and Visual Quality After Cataract Surgery.

Effects of optic nerve head structures on retinal nerve fiber layer defects in primary open angle glaucoma eyes. Analyses using ROTA.

Comparing the Vitreous Floaters Functional Questionnaire to the VFQ-25 in Vision Degrading Myodesopsia from Vitreous Floaters.

Higher order aberrations and visual outcomes of scleral lenses for ocular surface disease.

Gastrointestinal-controlled dipotassium glycyrrhizinate self-assembly particles enhance fucoxanthin oral bioavailability for improved visual sensitivity.

Abstract Vision is an important sense for fish and, as various properties of the water column affect how well different light wavelengths are transmitted, fishes’ visual sensitivity spectra reflect the varying ambient light conditions across habitats. Syngnathids (pipefishes & seahorses) inhabit various salt- and freshwater habitats-many affected by geological, anthropogenic and seasonal changes, challenging these visual predators. Here, we explored their visual opsin gene repertoire and found that, while retaining most common visual opsin genes, syngnathids have lost the UV-sensitive SWS1, while the subfamily of Nerophinae likely evolved a second copy of RH2 and all seahorses lost SWS2b. We further tested if the widely distributed Syngnathus typhle shows flexibility in visual capabilities throughout development and across the breeding season in its habitat, the Baltic Sea. Adult opsin expression composition was established soon after birth, with SWS2b barely being expressed. Adults changed the composition of expressed opsins across seasons, likely in response to the changing sunlight intensity and food composition & availability. Being the choosier sex, males expressed more green-light sensitive RH2 than females, possibly improving their ability to assess mate quality. S. typhle therefore showed highly dynamic opsin expression, plastically responding to fluctuations in its specifically variable habitat.

The current study aimed to optimize the measurement design for each quantity of interest, determine critical limits for clinically distinguishing glaucoma-suspect eyes from non-suspect eyes in the UGDS using the optimized design, and compare the efficiency of the measured quantities in estimating sensitivity METHODS: Data from non-glaucoma suspect eyes in the UGDS were analyzed for age and sex dependence, sources of variation, frequency distribution, and assessment of critical limits for glaucoma detection. Critical limit was defined as the extreme 95% confidence limit for the 95% one-sided tolerance. Intraocular pressure (IOP) and visual field contract sensitivity (Mean Deviation, MD), linear cup-to-disc ratio (C/D-linear), neuro-retinal rim area (NRA), nerve fiber layer thickness (cpRNFLT-Global and GDx-TSNIT) were examined RESULTS: Analysis revealed no significant age or sex dependence for the measured quantities. Variability among subjects was found to dominate, affecting the precision of measurements. Frequency distributions approximated normal distributions, enabling the estimation of tolerance limits for critical assessment. The critical limits to distinguish pathological from non-pathological were estimated as 22 mmHg, -3.7 dB, 0.84, 0.6 mm2, 56 µm and 33 µm for IOP, MD, C/D-linear, NRA, cpRNFLT-Global and GDx-TSNIT respectively CONCLUSION: It appears preferable to estimate critical limits for small samples using the extreme confidence limit of the tolerance limit. The critical limits obtained here are consistent with previously reported values for the same device models. C/D-linear and NRA-Global metrics estimated with HRT show lower sensitivity-estimation efficiency compared with the other parameters assessed. Individualized intra-patient critical limits require a small increase of the measured quantity to identify glaucoma in the patient who has the disease.

Orientation discrimination tasks provide a core measure of visual sensitivity and are widely used to study how perceptual performance varies with stimulus uncertainty and visual field location. Here, we examined how external noise, retinal eccentricity, and individual perceptual efficiency shape orientation discrimination thresholds. Forty-two adults (mean age = 32.35 years, SD = 7.23) completed a two-alternative forced-choice task judging the orientation (clockwise vs. counterclockwise) of briefly presented Gabor patches under varying levels of external noise (low, medium, high) and eccentricity (0°, 5°, 10°). Orientation offsets ranged from -8° to +8°. Thresholds were estimated using psychometric functions and analyzed via rm ANOVA, linear mixed-effects models, and supervised machine learning. Accuracy declined with increasing noise (ω2 = 0.48, p < 0.001) and improved with larger orientation offsets (ω2 = 0.62, p < 0.001). Thresholds increased with both noise (ω2 = 0.31, p = 0.002) and eccentricity (ω2 = 0.27, p = 0.003). Signal-to-noise efficiency was the strongest predictor (β = -0.72, p < 0.001); age alone was nonsignificant, but its interaction with eccentricity showed selective peripheral declines. Mixed-effects models confirmed spatial effects (β = 0.058, p < 0.001) and residual between-subject variability (σ2 = 0.14). Predictive models generalized well (R2 = 0.54). Orientation discrimination is shaped by both stimulus-level difficulty and individual differences in perceptual efficiency, which account for variability in sensitivity across visual conditions. Age-related differences emerge primarily under spatial load and depend on interactions between observer traits and task demands.

Aviation ophthalmology is an unexplored branch of ophthalmology. This specialized field combines the principles of ophthalmology and aerospace medicine to ensure optimal visual performance and ocular health in aircrew for safer flights. The unique stressors encountered in flight, such as rapid acceleration, hypoxia, glare, and sudden changes in lighting, can significantly affect visual performance. Thus, ophthalmologic evaluation forms a critical component of medical fitness assessments for flying personnel. Given the visually demanding and high-risk environment of aviation, maintaining strict visual standards is crucial for flight safety. However, controversies still exist in the different governing bodies that are responsible for aviation visual requirements. This review article aims to present a comprehensive overview of the visual standards, common ophthalmic disorders affecting aviators, and controversies in aviation ophthalmology. It discusses in detail the visual tasks essential in flight-such as distance and near visual acuity, color perception, depth judgment, contrast sensitivity, and night vision-and the minimum standards set by regulatory authorities like the Directorate General of Civil Aviation (DGCA), Federal Aviation Administration (FAA), and others. It also highlights ocular diseases disposal in aviation.

The MP-3 CII program may be useful for assessing central visual field function in mild-stage glaucoma, particularly in settings where direct structure-function mapping is desired. This cross-sectional study aimed to evaluate the performance of the newly developed MP-3 Central Goldmann size II program by comparing its central visual field sensitivity measurements with those obtained from the Humphrey Field Analyzer 10-2 SITA-Standard in patients with preperimetric and mild-stage glaucoma. This study included 35 eyes from 26 patients with mild-stage glaucoma with macular ganglion cell analysis of optical coherence tomography abnormalities. All participants underwent comprehensive ophthalmologic examinations, including Humphrey Field Analyzer (HFA) 10-2 SITA-Standard and MP-3 Central Goldmann size II visual field testing. The MP-3 Central Goldmann size II program employs a smaller Goldmann II stimulus size and a reduced number of test points compared to the HFA 10-2 SITA-Standard to enhance the detection of subtle central visual field defects. The MP-3 Central Goldmann size II demonstrated a significantly shorter examination time compared to the HFA 10-2 SITA-Standard (278.8±45.1 seconds vs. 331.7±64.1 seconds, P<0.05). For the measurement points common to both programs, a positive correlation was observed between the two devices in hemifields corresponding to ganglion cell analysis abnormalities (Spearman's rank correlation coefficient, R=0.86; P<0.05) and in the hemifield corresponding to normal ganglion cell analysis (R=0.57; P<0.05). The MP-3 Central Goldmann size II program showed strong correlation with HFA 10-2 SITA-Standard in measuring central visual field sensitivity.

Geographic atrophy (GA) is a progressive cause of central vision loss with limited rehabilitation options. This prospective case series aimed to evaluate the effects of biofeedback fixation training (BFT) on visual function and vision-related quality of life (QoL) in patients with GA. Eighteen patients with total central vision loss in one eye underwent BFT on the fellow eye (study eye) using the Macular Integrity Assessment (MAIA) system, which was used to select a new, previously chosen preferred retinal locus (PRL) to stabilize fixation or adopt a new fixation locus. Patients were followed for an average of 13.2 months (range 3–26 months). Functional outcomes included best corrected visual acuity (ETDRS chart), reading performance (Radner test), and contrast sensitivity (Spot Checks test). MAIA parameters comprised average retinal sensitivity, fixation distance and stability (P1, P2), and changes in the bivariate contour ellipse area (BCEA). Vision-related quality of life was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25). Following BFT, visual acuity, reading ability and contrast sensitivity improved significantly (p value: p < 0.02), and fixation stability and NEI-VFQ-25 scores showed a positive trend. These findings indicate that BFT is a feasible and promising rehabilitation approach for patients with GA.

Familial dysautonomia (FD) is an autosomal recessive sensory and autonomic neurodevelopmental and degenerative disorder characterized by complex neurological phenotypes. One of its most debilitating features is progressive optic neuropathy, which leads to severe visual impairment in FD patients by the third decade of life. Although several preclinical approaches have shown partial rescue of retinal ganglion cell (RGC) degeneration through increasing Elongator acetyltransferase complex subunit 1 (ELP1) expression in the retina, currently no treatments exist to prevent vision loss in FD. In this study, we performed a comprehensive analysis of visual function in a retina-specific FD mouse model ( Pax6-Cre ⁺ ;Elp1 loxp/loxp ) and evaluated a gene supplementation strategy to restore human ELP1 protein levels in the retina. Longitudinal retinal assessments indicated that FD mice exhibit significant retinal nerve fiber layer (RNFL) thinning, as observed in FD patients. FD mice also showed reduced flash visual evoked potentials (VEPs), pattern electroretinography (pERGs), and photopic negative responses (phNRs) amplitudes, along with impaired visual acuity and contrast sensitivity, as assessed using optomotor response assay (OMR). Full-field electroretinography (ffERG) revealed reduced amplitude of dark-adapted a-waves, dark and light-adapted b-waves, indicating combined RGC and bipolar cell dysfunction. Intravitreal delivery of an adeno associated vector (AAV) vector (AAV2.U1a.hELP1) effectively restored physiological ELP1 protein expression, which resulted in a significant rescue of retinal structure and function. Gene supplementation with AAV2.U1a.hELP1 resulted in broad functional and structural improvement compared with untreated FD mice. In summary, our findings provide the first demonstration that ELP1 gene supplementation can effectively rescue RGC function in an FD mouse model and support AAV2.hELP1 at an optimized dose (5.4×10 8 vg) as a promising therapeutic approach for FD-associated optic neuropathy.

This study evaluates the performance and safety of the Optiflex Trio trifocal intraocular lens (IOLs) in Indian cataract patients. Single-arm prospective clinical study. Patients undergoing phacoemulsification for senile cataracts received bilateral Optiflex Trio trifocal IOLs. Visual outcomes, spherical equivalent, reading performance, contrast sensitivity, stereo acuity, and high-order aberrations were assessed at 1 week, 1 month, 3 months, 6 months, and 12 months. A total of 93 eyes were implanted with IOL and showed significant improvement from pre-op to 12 months in the uncorrected distance (UDVA: 0.74 ± 0.33 to 0.01 ± 0.04 logMAR, P = 0.0001), intermediate (UIVA: 0.62 ± 0.20 to 0.01 ± 0.03 logMAR, P = 0.0001) and near visual acuity (UNVA: 0.57 ± 0.20 to 0.01 ± 0.02 logMAR, P = 0.0001), best-corrected distance visual acuity (BCDVA: 0.45 ± 0.29 to 0.00 ± 0.01 logMAR, P = 0.0001), and distance-corrected visual acuities (DCIVA and DCNVA: 0.32 ± 0.23 to 0.00 logMAR, P = 0.0001). The contrast sensitivity increased from 0.52 ± 0.40 to 1.49 ± 0.05 (P = 0.0001), while high-order and total aberrations decreased (0.87 ± 0.71 to 0.16 ± 0.11 mm and 1.55 ± 1.13 to 0.21 ± 0.07 mm, both P = 0.0001). Near/intermediate reading speeds improved by 5.18 ± 8.72 and 5.15 ± 8.72 words/min (P = 0.000). Stereo acuity significantly enhanced, with FD2 from 265.14 ± 124.93 to 83.41 ± 12.56 and Near Radnor from 211.71 ± 114.60 to 74.77 ± 6.98 (P < 0.0001). No adverse events were reported. Optiflex Trio trifocal IOL enhances vision, reduces aberrations, and supports spectacle independence.