Radial bias in face identification.

Human vision in the periphery is most accurate for stimuli that point towards the fovea. This so-called radial bias has been linked with the organization and spatial selectivity of neurons at the lowest levels of the visual system, from retinal ganglion cells onwards. Despite evidence that the human visual system is radially biased, it is not yet known whether this bias persists at higher levels of processing, or whether high-level representations are invariant to this low-level orientation bias. We used the case of face identity recognition to address this question. The specialized high-level mechanisms that support efficient face recognition are highly dependent on horizontally oriented information, which convey the most useful identity cues in the fovea. We show that face selective mechanisms are more sensitive on the horizontal meridian (to the left and right of fixation) compared to the vertical meridian (above and below fixation), suggesting that the horizontal cues in the face are better extracted on the horizontal meridian, where they align with the radial bias. The results demonstrate that the radial bias is maintained at high-level recognition stages and emphasize the importance of accounting for the radial bias in future investigation of visual recognition processes in peripheral vision.

A demonstration of cone function plasticity after gene therapy in achromatopsia.

Recent advances in regenerative therapy have placed the treatment of previously incurable eye diseases within arms' reach. Achromatopsia is a severe monogenic heritable retinal disease that disrupts cone function from birth, leaving patients with complete colour blindness, low acuity, photosensitivity and nystagmus. While successful gene-replacement therapy in non-primate models of achromatopsia has raised widespread hopes for clinical treatment, it was yet to be determined if and how these therapies can induce new cone function in the human brain. Using a novel multimodal approach, we demonstrate for the first time that gene therapy can successfully activate dormant cone-mediated pathways in children with achromatopsia (CNGA3- and CNGB3-associated, 10-15 years). To test this, we combined functional MRI population receptive field mapping and psychophysics with stimuli that selectively measure cone photoreceptor signalling. We measured cortical and visual cone function before and after gene therapy in four paediatric patients, evaluating treatment-related change against benchmark data from untreated patients (n = 9) and normal-sighted participants (n = 28). After treatment, two of the four children displayed strong evidence for novel cone-mediated signals in visual cortex, with a retinotopic pattern that was not present in untreated achromatopsia and which is highly unlikely to emerge by chance. Importantly, this change was paired with a significant improvement in psychophysical measures of cone-mediated visual function. These improvements were specific to the treated eye, and provide strong evidence for successful read-out and use of new cone-mediated information. These data show for the first time that gene replacement therapy in achromatopsia within the plastic period of development can awaken dormant cone-signalling pathways after years of deprivation. This reveals unprecedented neural plasticity in the developing human nervous system and offers great promise for emerging regenerative therapies.

Dissociable effects of visual crowding on the perception of color and motion.

Our ability to recognize objects in peripheral vision is fundamentally limited by crowding, the deleterious effect of clutter that disrupts the recognition of features ranging from orientation and color to motion and depth. Previous research is equivocal on whether this reflects a singular process that disrupts all features simultaneously or multiple processes that affect each independently. We examined crowding for motion and color, two features that allow a strong test of feature independence. "Cowhide" stimuli were presented 15° in peripheral vision, either in isolation or surrounded by flankers to give crowding. Observers reported either the target direction (clockwise/counterclockwise from upward) or its hue (blue/purple). We first established that both features show systematic crowded errors (biased predominantly toward the flanker identities) and selectivity for target-flanker similarity (with reduced crowding for dissimilar target/flanker elements). The multiplicity of crowding was then tested with observers identifying both features. Here, a singular object-selective mechanism predicts that when crowding is weak for one feature and strong for the other that crowding should be all-or-none for both. In contrast, when crowding was weak for color and strong for motion, errors were reduced for color but remained for motion, and vice versa with weak motion and strong color crowding. This double dissociation reveals that crowding disrupts certain combinations of visual features in a feature-specific manner, ruling out a singular object-selective mechanism. Thus, the ability to recognize one aspect of a cluttered scene, like color, offers no guarantees for the correct recognition of other aspects, like motion.

Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years.

BACKGROUND: Current treatments for amblyopia, typically patching or pharmacological blurring, have limited success. Less than two-thirds of children achieve good acuity of 0.20 logMAR in the amblyopic eye, with limited improvement of stereopsis, and poor adherence to treatment. A new approach, based on presentation of movies or computer games separately to each eye, may yield better results and improve adherence. These treatments aim to balance the input of visual information from each eye to the brain.  OBJECTIVES: To determine whether binocular treatments in children, aged three to eight years, with unilateral amblyopia result in better visual outcomes than conventional patching or pharmacological blurring treatment. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register), MEDLINE, Embase, ISRCTN, ClinicalTrials.gov, and the WHO ICTRP to 19 November 2020, with no language restrictions. SELECTION CRITERIA: Two review authors independently screened the results of the search for relevant studies. We included randomised controlled trials (RCTs) that enrolled children between the ages of three and eight years old with unilateral amblyopia. Amblyopia was classed as present when the best-corrected visual acuity (BCVA) was worse than 0.200 logMAR in the amblyopic eye, with BCVA 0.200 logMAR or better in the fellow eye, in the presence of an amblyogenic risk factor, such as anisometropia, strabismus, or both. To be eligible, children needed to have undergone cycloplegic refraction and  ophthalmic examination, including fundal examination and optical treatment, if indicated, with stable BCVA in the amblyopic eye despite good adherence with wearing glasses. We included any type of binocular viewing intervention, on any device (e.g. computer monitors viewed with liquid-crystal display shutter glasses; hand-held screens, including mobile phones with lenticular prism overlay; or virtual reality displays). Control groups received standard amblyopia treatment, which could include patching or pharmacological blurring of the better-seeing eye. We included full-time (all waking hours) and part-time (between 1 and 12 hours a day) patching regimens. We excluded children who had received any treatment other than optical treatment; and studies with less than 8-week follow-up. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. The primary outcome of the review was the change from baseline of distance BCVA in the amblyopic eye after 16 (± 2) weeks of treatment, measured in logMAR units on an age-appropriate acuity test. MAIN RESULTS: We identified one eligible RCT of conventional patching treatment versus novel binocular treatment, and analysed a subset of 68 children who fulfilled the age criterion of this review. We obtained data for the mean change in amblyopic eye visual acuity, adverse events (diplopia), and adherence to prescribed treatment at 8- and 16-week follow-up intervals, though no data were available for change in BCVA after 52 weeks. Risk of bias for the included study was considered to be low. The certainty of evidence for the visual acuity outcomes at 8 and 16 weeks of treatment and adherence to the study intervention was rated moderate using the GRADE criteria, downgrading by one level due to imprecision. The certainty of evidence was downgraded by two levels and rated low for the proportion of participants reporting adverse events due to the sample size.  Acuity improved in the amblyopic eye in both the binocular and patching groups following 16 weeks of treatment (improvement of -0.21 logMAR in the binocular group and -0.24 logMAR in the patching group, mean difference (MD) 0.03 logMAR (95% confidence interval (CI) -0.10 to 0.04; 63 children). This difference was non-significant and the improvements in both the binocular and patching groups are also considered clinically similar. Following 8 weeks of treatment, acuity improved in both the binocular and patching groups (improvement of -0.18 logMAR in the patching group compared to -0.16 logMAR improvement in the binocular-treatment group) (MD 0.02, 95% CI -0.04 to 0.08). Again this difference was statistically non-significant, and the differences observed between the patching and binocular groups are also clinically non-significant. No adverse event of permanent diplopia was reported. Adherence was higher in the patching group (47% of participants in the iPad group achieved over 75% compliance compared with 90% of the patching group).  Data were not available for changes in stereopsis nor for contrast sensitivity following treatment. AUTHORS' CONCLUSIONS: Currently, there is only one RCT that offers evidence of the safety and effectiveness of binocular treatment. The authors are moderately confident that after 16 weeks of treatment, the gain in amblyopic eye acuity with binocular treatment is likely comparable to that of conventional patching treatment. However, due to the limited sample size and lack of long term (52 week) follow-up data, it is not yet possible to draw robust conclusions regarding the overall safety and sustained effectiveness of binocular treatment. Further research, using acknowledged methods of visual acuity and stereoacuity assessment with known reproducibility, is required to inform decisions about the implementation of binocular treatments for amblyopia in clinical practice, and should incorporate longer term follow-up to establish the effectiveness of binocular treatment. Randomised controlled trials should also include outcomes reported by users, adherence to prescribed treatment, and recurrence of amblyopia after cessation of treatment.

Crowding changes appearance systematically in peripheral, amblyopic, and developing vision.

Visual crowding is the disruptive effect of clutter on object recognition. Although most prominent in adult peripheral vision, crowding also disrupts foveal vision in typically developing children and those with strabismic amblyopia. Do these crowding effects share the same mechanism? Here we exploit observations that crowded errors in peripheral vision are not random: Target objects appear either averaged with the flankers (assimilation) or replaced by them (substitution). If amblyopic and developmental crowding share the same mechanism, then their errors should be similarly systematic. We tested foveal vision in children aged 3 to 8 years with typical vision or strabismic amblyopia and peripheral vision in typical adults. The perceptual effects of crowding were measured by requiring observers to adjust a reference stimulus to match the perceived orientation of a target "Vac-Man" element. When the target was surrounded by flankers that differed by ± 30°, all three groups (adults and children with typical or amblyopic vision) reported orientations between the target and flankers (assimilation). Errors were reduced with ± 90° differences but primarily matched the flanker orientation (substitution) when they did occur. A population pooling model of crowding successfully simulated this pattern of errors in all three groups. We conclude that the perceptual effects of amblyopic and developing crowding are systematic and resemble the near periphery in adults, suggesting a common underlying mechanism.

Heritable functional architecture in human visual cortex.

How much of the functional organization of our visual system is inherited? Here we tested the heritability of retinotopic maps in human visual cortex using functional magnetic resonance imaging. We demonstrate that retinotopic organization shows a closer correspondence in monozygotic (MZ) compared to dizygotic (DZ) twin pairs, suggesting a partial genetic determination. Using population receptive field (pRF) analysis to examine the preferred spatial location and selectivity of these neuronal populations, we estimate a heritability around 10-20% for polar angle preferences and spatial selectivity, as quantified by pRF size, in extrastriate areas V2 and V3. Our findings are consistent with heritability in both the macroscopic arrangement of visual regions and stimulus tuning properties of visual cortex. This could constitute a neural substrate for variations in a range of perceptual effects, which themselves have been found to be at least partially genetically determined. These findings also add convergent evidence for the hypothesis that functional map topology is linked with cortical morphology.

Eye movements elevate crowding in idiopathic infantile nystagmus syndrome.

Idiopathic infantile nystagmus syndrome is a disorder characterised by involuntary eye movements, which leads to decreased acuity and visual function. One such function is visual crowding - a process whereby objects that are easily recognised in isolation become impaired by nearby flankers. Crowding typically occurs in the peripheral visual field, although elevations in foveal vision have been reported in congenital nystagmus, similar to those found with amblyopia. Here, we examine whether elevated foveal crowding with nystagmus is driven by similar mechanisms to those of amblyopia - long-term neural changes associated with a sensory deficit - or by the momentary displacement of the stimulus through nystagmus eye movements. A Landolt-C orientation identification task was used to measure threshold gap sizes with and without either horizontally or vertically placed Landolt-C flankers. We assume that a sensory deficit should give equivalent crowding in these two dimensions, whereas an origin in eye movements should give stronger crowding with horizontal flankers given the predominantly horizontal eye movements of nystagmus. We observe elevations in nystagmic crowding that are above crowding in typical vision but below that of amblyopia. Consistent with an origin in eye movements, elevations were stronger with horizontal than vertical flankers in nystagmus, but not in typical or amblyopic vision. We further demonstrate the same horizontal elongation in typical vision with stimulus movement that simulates nystagmus. Consequently, we propose that the origin of nystagmic crowding lies in the eye movements, either through image smear of the target and flanker elements or through relocation of the stimulus into the peripheral retina.

Variations in crowding, saccadic precision, and spatial localization reveal the shared topology of spatial vision.

Visual sensitivity varies across the visual field in several characteristic ways. For example, sensitivity declines sharply in peripheral (vs. foveal) vision and is typically worse in the upper (vs. lower) visual field. These variations can affect processes ranging from acuity and crowding (the deleterious effect of clutter on object recognition) to the precision of saccadic eye movements. Here we examine whether these variations can be attributed to a common source within the visual system. We first compared the size of crowding zones with the precision of saccades using an oriented clock target and two adjacent flanker elements. We report that both saccade precision and crowded-target reports vary idiosyncratically across the visual field with a strong correlation across tasks for all participants. Nevertheless, both group-level and trial-by-trial analyses reveal dissociations that exclude a common representation for the two processes. We therefore compared crowding with two measures of spatial localization: Landolt-C gap resolution and three-dot bisection. Here we observe similar idiosyncratic variations with strong interparticipant correlations across tasks despite considerably finer precision. Hierarchical regression analyses further show that variations in spatial precision account for much of the variation in crowding, including the correlation between crowding and saccades. Altogether, we demonstrate that crowding, spatial localization, and saccadic precision show clear dissociations, indicative of independent spatial representations, whilst nonetheless sharing idiosyncratic variations in spatial topology. We propose that these topological idiosyncrasies are established early in the visual system and inherited throughout later stages to affect a range of higher-level representations.

Population receptive field estimates for motion-defined stimuli.

The processing of motion changes throughout the visual hierarchy, from spatially restricted 'local motion' in early visual cortex to more complex large-field 'global motion' at later stages. Here we used functional magnetic resonance imaging (fMRI) to examine spatially selective responses in these areas related to the processing of random-dot stimuli defined by differences in motion. We used population receptive field (pRF) analyses to map retinotopic cortex using bar stimuli comprising coherently moving dots. In the first experiment, we used three separate background conditions: no background dots (dot-defined bar-only), dots moving coherently in the opposite direction to the bar (kinetic boundary) and dots moving incoherently in random directions (global motion). Clear retinotopic maps were obtained for the bar-only and kinetic-boundary conditions across visual areas V1-V3 and in higher dorsal areas. For the global-motion condition, retinotopic maps were much weaker in early areas and became clear only in higher areas, consistent with the emergence of global-motion processing throughout the visual hierarchy. However, in a second experiment we demonstrate that this pattern is not specific to motion-defined stimuli, with very similar results for a transparent-motion stimulus and a bar defined by a static low-level property (dot size) that should have driven responses particularly in V1. We further exclude explanations based on stimulus visibility by demonstrating that the observed differences in pRF properties do not follow the ability of observers to localise or attend to these bar elements. Rather, our findings indicate that dorsal extrastriate retinotopic maps may primarily be determined by the visibility of the neural responses to the bar relative to the background response (i.e. neural signal-to-noise ratios) and suggests that claims about stimulus selectivity from pRF experiments must be interpreted with caution.

Childhood amblyopia: current management and new trends.

INTRODUCTION OR BACKGROUND: With a prevalence of 2-5%, amblyopia is the most common vision deficit in children in the UK and the second most common cause of functional low vision in children in low-income countries. SOURCES OF DATA: Pubmed, Cochrane library and clinical trial registries (clinicaltrials.gov, ISRCTN, UKCRN portfolio database). AREAS OF AGREEMENT: Screening and treatment at the age of 4-5 years are cost efficient and clinically effective. Optical treatment (glasses) alone can improve visual acuity, with residual amblyopia treated by part-time occlusion or pharmacological blurring of the better-seeing eye. Treatment after the end of the conventional 'critical period' can improve vision, but in strabismic amblyopia carries a low risk of double vision. AREAS OF CONTROVERSY: It is not clear whether earlier vision screening would be cost efficient and associated with better outcomes. Optimization of treatment by individualized patching regimes or early start of occlusion, and novel binocular treatment approaches may enhance adherence to treatment, provide better outcomes and shorten treatment duration. GROWING POINTS: Binocular treatments for amblyopia. AREAS TIMELY FOR DEVELOPING RESEARCH: Impact of amblyopia on education and quality of life; optimal screening timing and tests; optimal administration of conventional treatments; development of child-friendly, effective and safe binocular treatments.

Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years.

BACKGROUND: Current treatments for amblyopia in children, occlusion and pharmacological blurring, have had limited success, with less than two-thirds of children achieving good visual acuity of at least 0.20 logMAR in the amblyopic eye, limited improvement of stereopsis, and poor compliance. A new treatment approach, based on the dichoptic presentation of movies or computer games (images presented separately to each eye), may yield better results, as it aims to balance the input of visual information from each eye to the brain. Compliance may also improve with these more child-friendly treatment procedures. OBJECTIVES: To determine whether binocular treatments in children aged three to eight years with unilateral amblyopia result in better visual outcomes than conventional occlusion or pharmacological blurring treatment. SEARCH METHODS: We searched the Cochrane Eyes and Vision Group Trials Register (last date of searches: 14 April 2015), the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to April 2015), EMBASE (January 1980 to April 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. SELECTION CRITERIA: Two review authors independently screened the results of the search in order to identify studies that met the inclusion criteria of the review: randomised controlled trials (RCTs) that enrolled participants between the ages of three and eight years old with unilateral amblyopia, defined as best-corrected visual acuity (BCVA) worse than 0.200 logMAR in the amblyopic eye, and BCVA 0.200 logMAR or better in the fellow eye, in the presence of an amblyogenic risk factor such as anisometropia, strabismus, or both. Prior to enrolment, participants were to have undergone a cycloplegic refraction and comprehensive ophthalmic examination including fundal examination. In addition, participants had to have completed a period of optical treatment, if indicated, and BCVA in the amblyopic eye had to remain unchanged on two consecutive assessments despite reportedly good compliance with glasses wearing. Participants were not to have received any treatment other than optical treatment prior to enrolment. We planned to include any type of binocular viewing intervention; these could be delivered on different devices including computer monitors viewed with LCD shutter glasses or hand-held screens including mobile phone screens with lenticular prism overlay. Control groups were to have received standard amblyopia treatment; this could include occlusion or pharmacological blurring of the better-seeing eye. We planned to include full-time (all waking hours) and part-time (between 1 and 12 hours a day) occlusion regimens. DATA COLLECTION AND ANALYSIS: We planned to use standard methodological procedures expected by The Cochrane Collaboration. We had planned to meta-analyse the primary outcome, that is mean distance BCVA in the amblyopic eye at 12 months after the cessation of treatment. MAIN RESULTS: We could identify no RCTs in this subject area. AUTHORS' CONCLUSIONS: Further research is required to allow decisions about implementation of binocular treatments for amblyopia in clinical practice. Currently there are no clinical trials offering standardised evidence of the safety and effectiveness of binocular treatments, but results from non-controlled cohort studies are encouraging. Future research should be conducted in the form of RCTs, using acknowledged methods of visual acuity and stereoacuity assessment with known reproducibility. Other important outcome measures include outcomes reported by users, compliance with treatment, and recurrence of amblyopia after cessation of treatment.

A common visual metric for approximate number and density.

There is considerable interest in how humans estimate the number of objects in a scene in the context of an extensive literature on how we estimate the density (i.e., spacing) of objects. Here, we show that our sense of number and our sense of density are intertwined. Presented with two patches, observers found it more difficult to spot differences in either density or numerosity when those patches were mismatched in overall size, and their errors were consistent with larger patches appearing both denser and more numerous. We propose that density is estimated using the relative response of mechanisms tuned to low and high spatial frequencies (SFs), because energy at high SFs is largely determined by the number of objects, whereas low SF energy depends more on the area occupied by elements. This measure is biased by overall stimulus size in the same way as human observers, and by estimating number using the same measure scaled by relative stimulus size, we can explain all of our results. This model is a simple, biologically plausible common metric for perceptual number and density.

Foveal target repetitions reduce crowding.

Crowding is the limitation of peripheral vision by clutter. Objects that are easily identified when presented in isolation are hard to identify when presented flanked by similar close-by objects. It is often assumed that the signal of a crowded target is irretrievably lost because it is combined with the signals of the flankers. Here, we asked whether a target signal can be enhanced (or retrieved) by items presented far outside the crowding region. We investigated whether remote items matching a peripheral, crowded target enhanced discrimination compared to remote items not matching the target. In Experiment 1, we presented the remote item at different locations in the visual field and found that, when presented in the fovea, a matching remote item improved target discrimination compared to a nonmatching remote item. In Experiment 2, we varied stimulus onset asynchronies between target and remote items and found a strong effect when the remote item was presented simultaneously with the target. The effect diminished (or was absent) with increasing temporal separation. In Experiment 3, we asked whether semantic knowledge of a target was sufficient to improve target discrimination and found that this was not the case. We conclude that crowded target signals are not irretrievably lost. Rather, their accurate recognition is facilitated in the presence of remote items that match the target. We suggest that long-range grouping mechanisms underlie this "uncrowding" effect.

Crowding is reduced by onset transients in the target object (but not in the flankers).

In peripheral vision, objects that are visible in isolation become difficult to identify in clutter. This crowding effect is typically strong when objects are similar in a given dimension (e.g., color) and weak when they differ. Here we examine the selectivity of crowding for temporal differences-namely, the transient signals associated with object onsets and offsets. Observers judged the orientation of a peripheral Gabor target surrounded by four flankers. Midway through each trial, selected elements "blinked" off and on again. Performance was poor (crowding was strong) when all Gabors blinked simultaneously or when only the flankers blinked. In contrast, performance improved dramatically when the target alone blinked despite the continued presence of the flankers. This asymmetric release from crowding occurs across a range of blink durations and target-flanker separations. A similar release was found when the target onset was delayed relative to the flanker onsets, though varying the target offset had little effect. This suggests that blinks (composed of offset and onset events) reduce crowding specifically because they separate target and flanker onsets. Finally, with luminance pedestals added to the Gabors, crowding was reduced by blinks in the target pedestal only when the target Gabor was present; pedestal blinks before/after the stimulus Gabors (as precues/postcues) had no effect. That is, transients do not simply cue the target location. The asymmetry of this effect (reduced crowding with target transients, no effect with flanker transients) also precludes explanations based on similarity or grouping. We attribute our findings to the isolation of the target in transient (vs. sustained) visual channels.

The resolution of face perception varies systematically across the visual field.

Visual abilities tend to vary predictably across the visual field-for simple low-level stimuli, visibility is better along the horizontal vs. vertical meridian and in the lower vs. upper visual field. In contrast, face perception abilities have been reported to show either distinct or entirely idiosyncratic patterns of variation in peripheral vision, suggesting a dissociation between the spatial properties of low- and higher-level vision. To assess this link more clearly, we extended methods used in low-level vision to develop an acuity test for face perception, measuring the smallest size at which facial gender can be reliably judged in peripheral vision. In 3 experiments, we show the characteristic inversion effect, with better acuity for upright faces than inverted, demonstrating the engagement of high-level face-selective processes in peripheral vision. We also observe a clear advantage for gender acuity on the horizontal vs. vertical meridian and a smaller-but-consistent lower- vs. upper-field advantage. These visual field variations match those of low-level vision, indicating that higher-level face processing abilities either inherit or actively maintain the characteristic patterns of spatial selectivity found in early vision. The commonality of these spatial variations throughout the visual hierarchy means that the location of faces in our visual field systematically influences our perception of them.

Visual hallucinations induced by Ganzflicker and Ganzfeld differ in frequency, complexity, and content.

Visual hallucinations can be phenomenologically divided into those of a simple or complex nature. Both simple and complex hallucinations can occur in pathological and non-pathological states, and can also be induced experimentally by visual stimulation or deprivation-for example using a high-frequency, eyes-open flicker (Ganzflicker) and perceptual deprivation (Ganzfeld). Here we leverage the differences in visual stimulation that these two techniques involve to investigate the role of bottom-up and top-down processes in shifting the complexity of visual hallucinations, and to assess whether these techniques involve a shared underlying hallucinatory mechanism despite their differences. For each technique, we measured the frequency and complexity of the hallucinations produced, utilising button presses, retrospective drawing, interviews, and questionnaires. For both experimental techniques, simple hallucinations were more common than complex hallucinations. Crucially, we found that Ganzflicker was more effective than Ganzfeld at eliciting simple hallucinations, while complex hallucinations remained equivalent across the two conditions. As a result, the likelihood that an experienced hallucination was complex was higher during Ganzfeld. Despite these differences, we found a correlation between the frequency and total time spent hallucinating in Ganzflicker and Ganzfeld conditions, suggesting some shared mechanisms between the two methodologies. We attribute the tendency to experience frequent simple hallucinations in both conditions to a shared low-level core hallucinatory mechanism, such as excitability of visual cortex, potentially amplified in Ganzflicker compared to Ganzfeld due to heightened bottom-up input. The tendency to experience complex hallucinations, in contrast, may be related to top-down processes less affected by visual stimulation.

Positional averaging explains crowding with letter-like stimuli.

Visual crowding is a breakdown in object identification that occurs in cluttered scenes, a process that represents the principle restriction on visual performance in the periphery. When crowded objects are presented experimentally, a key finding is that observers frequently report nearby flanking items instead of the target. This observation has led to the proposal that crowding reflects increased noise in the positional code for objects; although how the presence of nearby objects might disrupt positional encoding remains unclear. We quantified this disruption using cross-like stimuli, where observers judged whether the horizontal target line was positioned above or below the stimulus midpoint. Overall, observers were poorer at judging position in the presence of crowding flankers. However, offsetting horizontal lines in the flankers also led observers to report that the horizontal line in the target was shifted in the same direction, an effect that held for subthreshold flanker offsets. In short, crowding induced both random and systematic errors in observers' judgment of position, with or without the detection of flanker structure. Computational modeling reveals that perceived position in the presence of flankers follows a weighted average of noisy target- and flanker-line positions, rather than a substitution of flanker-features into the target, as has been proposed previously. Together, our results suggest that crowding is a preattentive process that uses averaging to regularize the noisy representation of position in the periphery.

Crowding follows the binding of relative position and orientation.

Crowding--the deleterious influence of clutter on object recognition--disrupts the identification of visual features as diverse as orientation, motion, and color. It is unclear whether this occurs via independent feature-specific crowding processes (preceding the feature binding process) or via a singular (late) mechanism tuned for combined features. To examine the relationship between feature binding and crowding, we measured interactions between the crowding of relative position and orientation. Stimuli were a target cross and two flanker crosses (each composed of two near-orthogonal lines), 15 degrees in the periphery. Observers judged either the orientation (clockwise/counterclockwise) of the near-horizontal target line, its position (up/down relative to the stimulus center), or both. For single-feature judgments, crowding affected position and orientation similarly: thresholds were elevated and responses biased in a manner suggesting that the target appeared more like the flankers. These effects were tuned for orientation, with near-orthogonal elements producing little crowding. This tuning allowed us to separate the predictions of independent (feature specific) and combined (singular) models: for an independent model, reduced crowding for one feature has no effect on crowding for other features, whereas a combined process affects either all features or none. When observers made conjoint judgments, a reduction of orientation crowding (by increasing target-flanker orientation differences) increased the rate of correct responses for both position and orientation, as predicted by our combined model. In contrast, our independent model incorrectly predicted a high rate of position errors, since the probability of positional crowding would be unaffected by changes in orientation. Thus, at least for these features, crowding is a singular process that affects bound position and orientation values in an all-or-none fashion.

Number and density discrimination rely on a common metric: Similar psychophysical effects of size, contrast, and divided attention.

While observers are adept at judging the density of elements (e.g., in a random-dot image), it has recently been proposed that they also have an independent visual sense of number. To test the independence of number and density discrimination, we examined the effects of manipulating stimulus structure (patch size, element size, contrast, and contrast-polarity) and available attentional resources on both judgments. Five observers made a series of two-alternative, forced-choice discriminations based on the relative numerosity/density of two simultaneously presented patches containing 16-1,024 Gaussian blobs. Mismatches of patch size and element size (across reference and test) led to bias and reduced sensitivity in both tasks, whereas manipulations of contrast and contrast-polarity had varied effects on observers, implying differing strategies. Nonetheless, the effects reported were consistent across density and number judgments, the only exception being when luminance cues were made available. Finally, density and number judgment were similarly impaired by attentional load in a dual-task experiment. These results are consistent with a common underlying metric to density and number judgments, with the caveat that additional cues may be exploited when they are available.

Phase 2a randomised controlled feasibility trial of a new 'balanced binocular viewing' treatment for unilateral amblyopia in children age 3-8 years: trial protocol.

INTRODUCTION: Treatments for amblyopia, the most common vision deficit in children, often have suboptimal results. Occlusion/atropine blurring are fraught with poor adherence, regression and recurrence. These interventions target only the amblyopic eye, failing to address imbalances of cortical input from the two eyes ('suppression'). Dichoptic treatments manipulate binocular visual experience to rebalance input. Poor adherence in early trials of dichoptic therapies inspired our development of balanced binocular viewing (BBV), using movies as child-friendly viewable content. Small observational studies indicate good adherence and efficacy. A feasibility trial is needed to further test safety and gather information to design a full trial. METHODS/ANALYSIS: We will carry out an observer-masked parallel-group phase 2a feasibility randomised controlled trial at two sites, randomising 44 children aged 3-8 years with unilateral amblyopia to either BBV or standard occlusion/atropine blurring, with 1:1 allocation ratio. We will assess visual function at baseline, 8 and 16 weeks. The primary outcome is intervention safety at 16 weeks, measured as change in interocular suppression, considered to precede the onset of potential diplopia. Secondary outcomes include safety at other time points, eligibility, recruitment/retention rates, adherence, clinical outcomes. We will summarise baseline characteristics for each group and assess the treatment effect using analysis of covariance. We will compare continuous clinical secondary endpoints between arms using linear mixed effect models, and report feasibility endpoints using descriptive statistics. ETHICS/DISSEMINATION: This trial has been approved by the London-Brighton & Sussex Research Ethics Committee (18/LO/1204), National Health Service Health Research Authority and Medicines and Healthcare products Regulatory Agency. A lay advisory group will be involved with advising on and disseminating the results to non-professional audiences, including on websites of funder/participating institutions and inputting on healthcare professional audience children would like us to reach. Reporting to clinicians and scientists will be via internal and external meetings/conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03754153.