Evaluation of a Paradigm to Investigate Detection of Road Hazards when Using a Bioptic Telescope.

SIGNIFICANCE: A new driving simulator paradigm was developed and evaluated that will enable future investigations of the effects of the ring scotoma in bioptic drivers with diverse vision impairments and different telescope designs. PURPOSE: The ring scotoma may impair detection of peripheral hazards when viewing through a bioptic telescope. To investigate this question, we developed and tested a sign-reading and pedestrian-detection paradigm in a driving simulator. METHODS: Twelve normally sighted subjects with simulated acuity loss (median 20/120) used a 3.0× monocular bioptic to read 36 road signs while driving in a simulator. Thirteen of 21 pedestrian hazards appeared and ran on the road for 1 second within the ring scotoma while participants were reading signs through the bioptic. Head movements were analyzed to determine whether the pedestrian appeared before or only while using the bioptic. Six subjects viewed binocularly, and six viewed monocularly (fellow eye patched). Two patients with real visual acuity loss in one eye and no light perception in the other performed the same tasks using their own telescopes. RESULTS: For the monocular simulated acuity loss group, detection rates were significantly higher when the pedestrian appeared before using the bioptic than when it appeared while using the bioptic and was likely within the area of the ring scotoma (77% vs. 28%, P < .001). For the binocular simulated acuity loss group, there was no significant difference in detection rates for pedestrians that appeared before or while using the bioptic (80% vs. 91%, P = .20). The two monocular patients detected only 17% of pedestrians that appeared while looking through the bioptic. CONCLUSIONS: Our results confirm the utility of the testing paradigm and suggest that the fellow eye of normally sighted observers with simulated acuity loss was able to compensate for the ring scotoma when using a monocular bioptic telescope in a realistic driving task.

Effects of contour enhancement on low-vision preference and visual search.

PURPOSE: To determine whether image enhancement improves visual search performance and whether enhanced images were also preferred by subjects with vision impairment. METHODS: Subjects (n = 24) with vision impairment (vision: 20/52 to 20/240) completed visual search and preference tasks for 150 static images that were enhanced to increase object contours' visual saliency. Subjects were divided into two groups and were shown three enhancement levels. Original and medium enhancements were shown to both groups. High enhancement was shown to group 1, and low enhancement was shown to group 2. For search, subjects pointed to an object that matched a search target displayed at the top left of the screen. An "integrated search performance" measure (area under the curve of cumulative correct response rate over search time) quantified performance. For preference, subjects indicated the preferred side when viewing the same image with different enhancement levels on side-by-side high-definition televisions. RESULTS: Contour enhancement did not improve performance in the visual search task. Group 1 subjects significantly (p < 0.001) rejected the High enhancement, and showed no preference for medium enhancement over the original images. Group 2 subjects significantly preferred (p < 0.001) both the medium and the low enhancement levels over original. Contrast sensitivity was correlated with both preference and performance; subjects with worse contrast sensitivity performed worse in the search task (ρ = 0.77, p < 0.001) and preferred more enhancement (ρ = -0.47, p = 0.02). No correlation between visual search performance and enhancement preference was found. However, a small group of subjects (n = 6) in a narrow range of mid-contrast sensitivity performed better with the enhancement, and most (n = 5) also preferred the enhancement. CONCLUSIONS: Preferences for image enhancement can be dissociated from search performance in people with vision impairment. Further investigations are needed to study the relationships between preference and performance for a narrow range of mid-contrast sensitivity where a beneficial effect of enhancement may exist.

Hazard Detection With Monocular Bioptic Telescopes in a Driving Simulator.

Purpose: In most states, people with reduced visual acuity may legally drive with the aid of a bioptic telescope. However, concerns have been raised that the ring scotoma may impair detection of peripheral hazards. Using a driving simulator, we tested the hypothesis that the fellow eye would be able to compensate for the ring scotoma when using a monocular telescope. Methods: Sixteen bioptic users completed three drives with binocular viewing interleaved between three drives with monocular viewing. Forty pedestrians appeared and ran on the road for 1 second, including 26 within the ring scotoma, while participants were reading road signs through their own monocular telescopes. Head movements were analyzed to determine whether the pedestrian appeared before or only while using the telescope. Results: For pedestrians that appeared only during bioptic use and were likely in the area of the ring scotoma, detection rates were significantly higher in binocular (fellow eye can compensate) than monocular (fellow eye patched) viewing (69% vs. 32%; P < 0.001); this was true for both current and noncurrent drivers. For pedestrians appearing before or after bioptic use, detection rates did not differ in binocular and monocular viewing. However, detection rates were even higher and reaction times shorter when the telescope was not being used. Conclusions: Both current and noncurrent drivers'  fellow eyes were able to compensate, at least in part, for the ring scotoma. Translational Relevance: When using monocular telescopes, the fellow eye reduces the impact of the ring scotoma on hazard detection in binocular viewing.

The Effects of Age and Central Field Loss on Head Scanning and Detection at Intersections.

PURPOSE: Using a driving simulator, we quantified the effects of age and central field loss (CFL) on head scanning when approaching an intersection and investigated the role of inadequate head scanning in detection failures. METHODS: Participants with CFL (n = 20) and with normal vision (NV; n = 29), middle-aged (36-60 years) or older (67-87 years), drove along city routes with multiple intersections while head movements were recorded. The effects of age and CFL on scanning were analyzed at 32 intersections with stop/yield signs. The relationships between age, CFL, scanning, and detection were examined at four additional intersections with a pedestrian appearing on the far left. RESULTS: Older NV participants made fewer total scans than middle-aged NV participants and had smaller maximum scan magnitudes. Head scanning of older CFL and NV participants did not differ, but middle-aged CFL participants made fewer head scans, had higher rates of failing to scan, and made smaller head scans than middle-aged NV participants. For the older NV and both CFL groups, detection failures were high (≥58%); head scan magnitudes were 15° smaller when the pedestrian was not detected than when it was detected. CONCLUSIONS: Both older NV and CFL participants exhibited head scanning deficits relative to middle-aged NV participants. Unexpectedly, however, it was the middle-aged CFL group that performed least well when scanning, a finding that warrants further investigation. TRANSLATIONAL RELEVANCE: Failing to head scan sufficiently far at intersections may place older drivers and drivers with vision impairment at a higher risk for causing collisions.

Are attractive men's faces masculine or feminine? The importance of type of facial stimuli.

The authors investigated whether differences in facial stimuli could explain the inconsistencies in the facial attractiveness literature regarding whether adults prefer more masculine- or more feminine-looking male faces. Their results demonstrated that use of a female average to dimorphically transform a male facial average produced stimuli that did not accurately reflect the relationship between masculinity and attractiveness. In contrast, use of averages of masculine males and averages of feminine males produced stimuli that did accurately reflect the relationship between masculinity and attractiveness. Their findings suggest that masculinity contributes more to male facial attractiveness than does femininity, but future research should investigate how various combinations of facial cues contribute to male facial attractiveness.

High prevalence of strabismic visual field expansion in pediatric homonymous hemianopia.

If homonymous hemianopia develops in childhood it is frequently accompanied by strabismus. In some of these cases the strabismus increases the size of the binocular visual field. We determined how prevalent visual-field-expanding strabismus is in children who have homonymous hemianopia. Medical records were examined from 103 hemianopic patients with exotropia (XT) or esotropia (ET). For each participant, we determined whether their strabismus was in a direction that resulted in visual field expansion (i.e. left exotropia with left homonymous hemianopia). Ages at which hemianopia and strabismus were first noted were compared to determine which developed first. The prevalence of XT (24%) and ET (9%) with homonymous hemianopia were both much higher than in the general population (1.5% and 5%, respectively). More strabismic eyes pointed to the blind than seeing side (62 vs 41, 60% vs. 40%, p = 0.02). Exotropic eyes were five times more likely to point to the blind side than esotropic eyes (85% vs 15%). Strabismus, especially exotropia, is much more common in pediatric homonymous hemianopia than in the general population. The strabismus is significantly more often in a visual field-expanding direction. These results support an adaptive role for the strabismus. Patients with HH and exotropia or esotropia should be aware that their visual field could be reduced by strabismus surgery.

Restoration of Vision After Brain Injury Using Magnet Glasses.

Visual impairments are common after traumatic brain injury (TBI) and negatively affect quality of life. We describe a 39-year-old woman with a severe TBI who was evaluated by the inpatient optometry and vision rehabilitation service with findings of complete right homonymous hemianopia and right cranial nerve III palsy with 30-degree right exotropia (eye turn out) and complete right ptosis (eyelid will not open). The 30-degree exotropia advantageously generated 30 degrees of right visual field expansion when the right ptosis was treated with a magnetic levator prosthesis, which restores eyelid opening. Once opened, the patient used visual field expansion derived from a right exotropia to overcome functional impairments caused by right hemianopia. Field expansion improved the patient's wheelchair mobility and reaching tasks during inpatient therapy. This is the first report of visual field expansion by strabismus facilitated by correction of ptosis. Strabismus should be considered for its potential field expansion benefits when homonymous visual deficits are present, before considering patching. A multidisciplinary vision rehabilitation team is well suited to make this determination.

Driving with central field loss III: vehicle control.

BACKGROUND: Visual impairment associated with central field loss may make vehicle control more difficult due to the degraded view of the road. We evaluated how central field loss affects vehicle control in a driving simulator. METHODS: Nineteen participants with binocular central field loss (acuity 6/9 to 6/60) and 15 controls with normal vision drove 10 scenarios, each about eight to 12 minutes. Speed, lane offset and steering wheel reversal rate were measured on straights, left and right curves, along city (approximately 50 km/h) and rural highway (approximately 100 km/h) routes. Following distance was measured on two city straight segments. RESULTS: Subjects with central field loss had higher steering wheel reversal rates (0.55 versus 0.45 reversals per second, p = 0.015), suggesting that the steering task was more demanding for them, requiring more steering corrections; however, they did not differ in other performance measures. Nearly all maintained a safe following distance, although they were more likely than controls with normal vision to lose sight of the lead car in scenarios that required following a car. CONCLUSIONS: Most measures of vehicle control did not significantly differ between participants with central field loss and those with normal vision; however, the higher steering wheel reversal rates suggest that, in compensating for their vision impairment, drivers with central field loss had to allocate extra steering effort to maintain their lane position, which in turn could reduce attentional resources for other driving tasks.

Driving with Central Visual Field Loss II: How Scotomas above or below the Preferred Retinal Locus (PRL) Affect Hazard Detection in a Driving Simulator.

We determined whether binocular central scotomas above or below the preferred retinal locus affect detection of hazards (pedestrians) approaching from the side. Seven participants with central field loss (CFL), and seven age-and sex-matched controls with normal vision (NV), each completed two sessions of 5 test drives (each approximately 10 minutes long) in a driving simulator. Participants pressed the horn when detecting pedestrians that appeared at one of four eccentricities (-14°, -4°, left, 4°, or 14°, right, relative to car heading). Pedestrians walked or ran towards the travel lane on a collision course with the participant's vehicle, thus remaining in the same area of the visual field, assuming participant's steady forward gaze down the travel lane. Detection rates were nearly 100% for all participants. CFL participant reaction times were longer (median 2.27s, 95% CI 2.13 to 2.47) than NVs (median 1.17s, 95%CI 1.10 to 2.13; difference p<0.01), and CFL participants would have been unable to stop for 21% of pedestrians, compared with 3% for NV, p<0.001. Although the scotomas were not expected to obscure pedestrian hazards, gaze tracking revealed that scotomas did sometimes interfere with detection; late reactions usually occurred when pedestrians were entirely or partially obscured by the scotoma (time obscured correlated with reaction times, r = 0.57, p<0.001). We previously showed that scotomas lateral to the preferred retinal locus delay reaction times to a greater extent; however, taken together, the results of our studies suggest that any binocular CFL might negatively impact timely hazard detection while driving and should be a consideration when evaluating vision for driving.

Individual Aesthetic Preferences for Faces Are Shaped Mostly by Environments, Not Genes.

Although certain characteristics of human faces are broadly considered more attractive (e.g., symmetry, averageness), people also routinely disagree with each other on the relative attractiveness of faces. That is, to some significant degree, beauty is in the "eye of the beholder." Here, we investigate the origins of these individual differences in face preferences using a twin design, allowing us to estimate the relative contributions of genetic and environmental variation to individual face attractiveness judgments or face preferences. We first show that individual face preferences (IP) can be reliably measured and are readily dissociable from other types of attractiveness judgments (e.g., judgments of scenes, objects). Next, we show that individual face preferences result primarily from environments that are unique to each individual. This is in striking contrast to individual differences in face identity recognition, which result primarily from variations in genes [1]. We thus complete an etiological double dissociation between two core domains of social perception (judgments of identity versus attractiveness) within the same visual stimulus (the face). At the same time, we provide an example, rare in behavioral genetics, of a reliably and objectively measured behavioral characteristic where variations are shaped mostly by the environment. The large impact of experience on individual face preferences provides a novel window into the evolution and architecture of the social brain, while lending new empirical support to the long-standing claim that environments shape individual notions of what is attractive.

Visual attention measures predict pedestrian detection in central field loss: a pilot study.

PURPOSE: The ability of visually impaired people to deploy attention effectively to maximize use of their residual vision in dynamic situations is fundamental to safe mobility. We conducted a pilot study to evaluate whether tests of dynamic attention (multiple object tracking; MOT) and static attention (Useful Field of View; UFOV) were predictive of the ability of people with central field loss (CFL) to detect pedestrian hazards in simulated driving. METHODS: 11 people with bilateral CFL (visual acuity 20/30-20/200) and 11 age-similar normally-sighted drivers participated. Dynamic and static attention were evaluated with brief, computer-based MOT and UFOV tasks, respectively. Dependent variables were the log speed threshold for 60% correct identification of targets (MOT) and the increase in the presentation duration for 75% correct identification of a central target when a concurrent peripheral task was added (UFOV divided and selective attention subtests). Participants drove in a simulator and pressed the horn whenever they detected pedestrians that walked or ran toward the road. The dependent variable was the proportion of timely reactions (could have stopped in time to avoid a collision). RESULTS: UFOV and MOT performance of CFL participants was poorer than that of controls, and the proportion of timely reactions was also lower (worse) (84% and 97%, respectively; p = 0.001). For CFL participants, higher proportions of timely reactions correlated significantly with higher (better) MOT speed thresholds (r = 0.73, p = 0.01), with better performance on the UFOV divided and selective attention subtests (r = -0.66 and -0.62, respectively, p<0.04), with better contrast sensitivity scores (r = 0.54, p = 0.08) and smaller scotomas (r = -0.60, p = 0.05). CONCLUSIONS: Our results suggest that brief laboratory-based tests of visual attention may provide useful measures of functional visual ability of individuals with CFL relevant to more complex mobility tasks.

Driving with central field loss I: effect of central scotomas on responses to hazards.

OBJECTIVES: To determine how central field loss (CFL) affects reaction time to pedestrians and to test the hypothesis that scotomas lateral to the preferred retinal locus will delay detection of hazards approaching from that side. METHODS: Participants with binocular CFL (scotoma diameter, 7°-25°; visual acuity, 0.3-1.0 logMAR) using lateral preferred retinal fixation loci and matched controls with normal vision drove in a simulator for approximately 1½ hours per session for 2 sessions a week apart. Participants responded to frequent virtual pedestrians who appeared on either the left or right sides and approached the participant's lane on a collision trajectory that, therefore, caused them to remain in approximately the same area of the visual field. RESULTS: The study included 11 individuals with CFL and 11 controls with normal vision. The CFL participants had more detection failures for pedestrians who appeared in areas of visual field loss than did controls in corresponding areas (6.4% vs 0.2%). Furthermore, the CFL participants reacted more slowly to pedestrians in blind than nonscotomatous areas (4.28 vs 2.43 seconds, P < .001) and overall had more late and missed responses than controls (29% vs 3%, P < .001). Scotoma size and contrast sensitivity predicted outcomes in blind and seeing areas, respectively. Visual acuity was not correlated with response measures. CONCLUSIONS: In addition to causing visual acuity and contrast sensitivity loss, the central scotoma per se delayed hazard detection even though small eye movements could potentially compensate for the loss. Responses in nonscotomatous areas were also delayed, although to a lesser extent, possibly because of the eccentricity of fixation. Our findings will help practitioners advise patients with CFL about specific difficulties they may face when driving.

Factors affecting enhanced video quality preferences.

The development of video quality metrics requires methods for measuring perceived video quality. Most of these metrics are designed and tested using databases of images degraded by compression and scored using opinion ratings. We studied video quality preferences for enhanced images of normally-sighted participants using the method of paired comparisons with a thorough statistical analysis. Participants (n=40) made pair-wise comparisons of high definition video clips enhanced at four different levels using a commercially available enhancement device. Perceptual scales were computed with binary logistic regression to estimate preferences for each level and to provide statistical inference of the differences among levels and the impact of other variables. While moderate preference for enhanced videos was found, two unexpected effects were also uncovered: 1) participants could be broadly classified into two groups: a) those who preferred enhancement ("Sharp") and b) those who disliked enhancement ("Smooth") and 2) enhancement preferences depended on video content, particularly for human faces to be enhanced less. The results suggest that algorithms to evaluate image quality (at least for enhancement) may need to be adjusted or applied differentially based on video content and viewer preferences. The possible impact of similar effects on image quality of compressed video needs to be evaluated.

Skin and bones: the contribution of skin tone and facial structure to racial prototypicality ratings.

Previous research reveals that a more 'African' appearance has significant social consequences, yielding more negative first impressions and harsher criminal sentencing of Black or White individuals. This study is the first to systematically assess the relative contribution of skin tone and facial metrics to White, Black, and Korean perceivers' ratings of the racial prototypicality of faces from the same three groups. Our results revealed that the relative contribution of metrics and skin tone depended on both perceiver race and face race. White perceivers' racial prototypicality ratings were less responsive to variations in skin tone than were Black or Korean perceivers' ratings. White perceivers ratings' also were more responsive to facial metrics than to skin tone, while the reverse was true for Black perceivers. Additionally, across all perceiver groups, skin tone had a more consistent impact than metrics on racial prototypicality ratings of White faces, with the reverse for Korean faces. For Black faces, the relative impact varied with perceiver race: skin tone had a more consistent impact than metrics for Black and Korean perceivers, with the reverse for White perceivers. These results have significant implications for predicting who will experience racial prototypicality biases and from whom.

Computational models of facial attractiveness judgments.

We designed two computational models to replicate human facial attractiveness ratings. The primary model used partial least squares (PLS) to identify image factors associated with facial attractiveness from facial images and attractiveness ratings of those images. For comparison we also made a model similar to previous models of facial attractiveness, in that it used manually derived measurements between features as inputs, though we took the additional step of dimensionality reduction via principal component analysis (PCA) and weighting of PCA dimensions via a perceptron. Strikingly, both models produced estimates of facial attractiveness that were indistinguishable from human ratings. Because PLS extracts a small number of image factors from the facial images that covary with attractiveness ratings of the images, it is possible to determine the information used by the model. The image factors that the model discovered correspond to two of the main contemporary hypotheses of averageness judgments: facial attractiveness and sexual dimorphism. In contrast, facial symmetry was not important to the model, and an explicit feature-based measurement of symmetry was not correlated with human judgments of facial attractiveness. This provides novel evidence for the importance of averageness and sexual dimorphism, but not symmetry, in human judgments of facial attractiveness.

Beauty is in the 'we' of the beholder: greater agreement on facial attractiveness among close relations.

Scientific research on facial attractiveness has focused primarily on elucidating universal factors to which all raters respond consistently. However, recent work has shown that there is also substantial disagreement between raters, highlighting the importance of determining how attractiveness preferences vary among different individuals. We conducted a typical attractiveness ratings study, but took the unusual step of recruiting pairs of subjects who were spouses, siblings, or close friends. The agreement between pairs of affiliated friends, siblings, and spouses was significantly greater than between pairs of strangers drawn from the same race and culture, providing evidence that facial-attractiveness preferences are socially organized.