Impact of blur on clinical and occupational colour vision test results.

PURPOSE: To evaluate whether colour vision normal (CVN) adults pass two Fletcher-Evans (CAM) lantern tests and to investigate the impact of imposed blur on Ishihara, CAM lantern and computerised colour discrimination test (colour assessment and diagnosis test [CAD] and Cambridge colour test [CCT]) results. METHODS: In a pilot experiment, 20 (16 CVN and 4 colour vision deficient [CVD]) participants with normal VA were tested with the CAM lantern. In the main experiment, the impact of imposed dioptric blur (up to +8.00 D) on visual acuity and the Ishihara test, CAM lantern, CAD and CCT was assessed for 15 CVN participants. RESULTS: CVN participants can fail the CAM lantern, with specificity of 81.25% (aviation mode) and 75% (clinical mode), despite following the test requirements of participants having at least 0.18 logMAR (6/9) in the better eye. With blur, test accuracy was affected. As expected, significant detrimental effects of blur on test results were found for logMAR VA and CAM lantern (aviation) with +1.00 D or higher. Ishihara, CAD and CCT results were not detrimentally affected until +8.00 D. Yellow-blue discrimination was more affected by blur for the CAD than the CCT, which was not explained by the different colour spaces used or vectors tested. CONCLUSION: False-positive findings on lantern colour vision tests with small apertures are likely to be increased in patients with blur due to uncorrected refractive error or ocular and visual pathway disease. Other colour vision tests with larger stimuli are more robust to blur.

Interocular ND filter suppression: Eccentricity and luminance polarity effects.

The depth and extent of interocular suppression were measured in binocularly normal observers who unilaterally adapted to neutral density (ND) filters (0, 1.5, 2, and 3 ND). Suppression was measured by dichoptically matching sectors of a ring presented to the adapted eye to a fixed contrast contiguous ring presented to the non-adapted eye. Other rings of alternating polarity were viewed binocularly. Rings were defined by luminance (L), luminance with added dynamic binary luminance noise (LM), and contrast modulating the same noise (CM). Interocular suppression depth increased with increasing ND, nearing significance (p = 0.058) for 1.5 ND. For L and LM stimuli, suppression depth across eccentricity (±12° visual field) differed for luminance increment (white) versus luminance decrement (black) stimuli, potentially confounding eccentricity results. Suppression for increment-only (white) luminance stimuli was steeper centrally and extended across the visual field, but was deeper for L than for LM stimuli. Suppression for decrement-only (black) luminance stimuli revealed only central suppression. Suppression was deeper with CM than LM stimuli, suggesting that CM stimuli are extracted in areas receiving predominantly binocular input which may be more sensitive to binocular disruption. Increment (white) luminance stimuli demonstrate deeper interocular suppression in the periphery than decrement (black) stimuli, so they are more sensitive to changes in peripheral suppression. Asymmetry of suppression in the periphery for opposite polarity luminance stimuli may be due to interocular receptive field size mismatch as a result of dark adaptation separately affecting ON and OFF pathways. Clinically, measurement of suppression with CM stimuli may provide the best information about post-combination binocularity.

Interocular suppression patterns in binocularly abnormal observers using luminance- and contrast-modulated noise stimuli.

In binocular viewing, images presented to the amblyopic eye are suppressed in the cortex to prevent confusion or diplopia. The present study measures depth and extent of interocular suppression across the central circular 24° visual field in observers with strabismus and microstrabismus. Visual stimuli were concentric rings of alternating polarity, each divided into sectors. Rings were defined by luminance (L), luminance-modulated noise (LM), or contrast-modulated noise (CM). They were viewed binocularly except for the tested ring, which was viewed dichoptically, so that the modulation of one sector presented to the weaker or amblyopic eye was adjusted to perceptually match the surrounding ring presented to the preferred eye. A two alternative forced-choice paradigm combined with a staircase procedure allowed for measurement of the point of subjective equality, or perceptual match. Depth of suppression was calculated as the difference between physical modulations presented to the two eyes at this point. Strabismic participants showed suppression deeper centrally than peripherally, and in one hemifield of the visual field more than the other. Suppression was deeper for L than LM, and CM than LM stimuli. Microstrabismic suppression was weaker than that of strabismics, central for L and LM stimuli, with suppression of CM stimuli being broader, deeper and more in one hemifield. Suppression depth was positively correlated with interocular visual acuity difference and stereoacuity reduction. Clinically, LM stimuli could be used for assessment of deeper amblyopes to assess suppression patterns, while more sensitive detection of mild suppression would be possible using CM stimuli.

Evidence for an eye-movement contribution to normal foveal crowding.

PURPOSE: Along with contour interaction, inaccurate and imprecise eye movements and attention have been suggested to contribute to poorer acuity for "crowded" versus uncrowded targets. To investigate the role of eye movements in foveal crowding, we compared percent correct letter identification for short and long lines of near-threshold letters with different separations. METHODS: Five normal observers read short (4 to 6 letters) and long (10 to 12 letters) lines of near-threshold, Sloan letters with edge-to-edge letter separations of 0.5, 1, and 2 letter spaces. Percent correct letter identification for the 2 to 4 interior letters in short strings and the 8 to 10 interior letters in long strings was compared with a no-crowding condition. RESULTS: Letter identification was significantly worse than the no-crowding condition for long letter strings with a separation of 1 letter space and for both long and short letter strings with a separation of 0.5 letter spaces. Observers more often reported the incorrect number of letters in long than in short letter strings, even for a separation of 2 letter spaces. Similar results were obtained during straight-ahead gaze and while viewing in 30 to 40 degrees left gaze, where two of the five observers exhibited an increase in horizontal fixational instability. CONCLUSIONS: We argue that lower percent correct letter identification and more frequent errors in reporting the number of letters in long compared with short letter strings reflect an eye-movement contribution to foveal crowding.

Investigation of interocular blur suppression using luminance-modulated and contrast-modulated noise stimuli.

Presenting two sufficiently dissimilar images, one to each eye, may result in interocular suppression. The present study measured interocular suppression depth and extent in binocularly normal participants when blurring one eye only with varying dioptric lens powers (+0.5, +1, +2, and +4 D). Visual stimuli consisted of eight concentric rings of alternate polarity, divisible into eight sectors, within the central circular 24° visual field. Binocular "ring" stimuli therefore consisted of 64 individually testable dichoptic sectors. Using a two-alternative forced choice paradigm with a staircase procedure, signal strength of each dichoptic sector in the blurred eye was adjusted to perceptually match that of the surrounding ring from the nonblurred eye, determining the point of subjective equality. Rings were defined by differences in luminance (L), luminance-modulated noise (LM), or contrast-modulated noise (CM). Suppression depth was similar irrespective of sector location within the visual field and increased with increasing difference in interocular blur. Adding dynamic noise (LM vs. L stimuli) reduced the effect of blur on measured suppression depth. Significantly deeper suppression was measured for CM than for LM stimuli, both created using dynamic noise, the difference increasing at higher levels of interocular blur. As binocularity is disrupted with interocular blur, this result suggests that CM envelope combination may be processed by later mechanisms receiving binocular input than those required for the processing of LM stimuli. Differences in suppression depth between LM and CM stimuli could not be attributed to differences in spatial summation properties, stimulus visibility, noise modulation, or differential effects on blur discriminability.

Foveal visual acuity is worse and shows stronger contour interaction effects for contrast-modulated than luminance-modulated Cs.

Contrast-modulated (CM) stimuli are processed by spatial mechanisms that operate at larger spatial scales than those processing luminance-modulated (LM) stimuli and may be more prone to deficits in developing, amblyopic, and aging visual systems. Understanding neural mechanisms of contour interaction or crowding will help in detecting disorders of spatial vision. In this study, contour interaction effects on visual acuity for LM and CM C and bar stimuli are assessed in normal foveal vision. In Experiment 1, visual acuity is measured for all-LM and all-CM stimuli, at ~3.5× above their respective modulation thresholds. In Experiment 2, visual acuity is measured for Cs and bars of different type (LM C with CM bars and vice versa). Visual acuity is degraded for CM compared with LM Cs (0.46 ± 0.04 logMAR vs. 0.18 ± 0.04 logMAR). With nearby bars, CM acuity is degraded further (0.23 ± 0.01 logMAR or ~2 lines on an acuity chart), significantly more than LM acuity (0.11 ± 0.01 logMAR, ~1 line). Contour interaction for CM stimuli extends over greater distances (arcmin) than it does for LM stimuli, but extents are similar with respect to acuities (~3.5× the C gap width). Contour interaction is evident when the Cs and bars are defined differently: it is stronger when an LM C is flanked by CM bars (0.17 ± 0.03 logMAR) than when a CM C is flanked by LM bars (0.08 ± 0.02 logMAR). Our results suggest that contour interaction for foveally viewed acuity stimuli involves feature integration, such that the outputs of receptive fields representing Cs and bars are combined. Contour interaction operates at LM and CM representational stages, it can occur across stage, and it is enhanced at the CM stage. Greater contour interaction for CM Cs and bars could hold value for visual acuity testing and earlier diagnosis of conditions for which crowding is important, such as in amblyopia.

Coloured filters can simulate colour deficiency in normal vision but cannot compensate for congenital colour vision deficiency.

Red-green colour vision deficiency (CVD) affects ~ 4% of Caucasians. Notch filters exist to simulate CVD when worn by colour vision normal (CVN) observers (simulation tools), or to improve colour discrimination when worn by CVD observers (compensation tools). The current study assesses effects of simulation (Variantor) and compensation (EnChroma) filters on performance in a variety of tasks. Experiments were conducted on 20 CVN and 16 CVD participants under no-filter and filter conditions (5 CVN used Variantor; 15 CVN and 16 CVD used EnChroma). Participants were tested on Ishihara and Farnsworth-Munsell 100 hue tests, CVA-UMinho colour discrimination and colour naming tasks and a board-game colour-sorting task. Repeated-measures ANOVAs found Variantor filters to significantly worsen CVN performance, mimicking protanopia. Mixed-model and repeated-measures ANOVAs demonstrate that EnChroma filters do not significantly enhance performance in CVD observers. Key EnChroma results were replicated in 8 CVD children (Ishihara test) and a sub-sample of 6 CVD adults (CVA-UMinho colour discrimination and colour naming tasks) for a smaller stimulus size. Pattern similarity exists across hue for discrimination thresholds and naming errors. Variantor filters are effective at mimicking congenital colour vision defects in CVN observers for all tasks, however EnChroma filters do not significantly compensate for CVD in any.

Contrast-modulated stimuli produce more superimposition and predominate perception when competing with comparable luminance-modulated stimuli during interocular grouping.

Interocular grouping (IOG) is a binocular visual function that can arise during multi-stable perception. IOG perception was initiated using split-grating stimuli constructed from luminance (L), luminance-modulated noise (LM) and contrast-modulated noise (CM). In Experiment 1, three different visibility levels were used for L and LM (or first-order) stimuli, and compared to fixed-visibility CM (or second-order) stimuli. Eight binocularly normal participants indicated whether they perceived full horizontal or vertical gratings, superimposition, or other (piecemeal and eye-of-origin) percepts. CM stimuli rarely generated full IOG, but predominantly generated superimposition. In Experiment 2, Levelt's modified laws were tested for IOG in nine participants. Split-gratings presented to each eye contained different visibility LM gratings, or LM and CM gratings. The results for the LM-vs-LM conditions mostly followed the predictions of Levelt's modified laws, whereas the results for the LM-vs-CM conditions did not. Counterintuitively, when high-visibility LM and low-visibility CM split-gratings were used, high-visibility LM components did not predominate IOG perception. Our findings suggest that higher proportions of superimposition during CM-vs-CM viewing are due to binocular combination, rather than mutual inhibition. It implies that IOG percepts are more likely to be mediated at an earlier monocular, rather than a binocular stage. Our previously proposed conceptual framework for conventional binocular rivalry, which includes asymmetric feedback, visual saliency, or a combination of both (Skerswetat et al. Sci Rep 8:14432, 2018), might also account for IOG. We speculate that opponency neurons might mediate coherent percepts when dissimilar information separately enters the eyes.

Grouping Effects on Foveal Spatial Interactions in Children.

Purpose: Grouping of flankers from the target can modulate crowding in adults. Visual acuity in children is measured clinically using charts with targets and different flankers to enhance spatial interactions. We investigated grouping effects on interactions using visual acuity letters, flanked by contours and letters, in children. Methods: Visual acuity for isolated and flanked letters was measured in 155 three- to 11-year old children and 32 adults. Flankers were one stroke width from the target and were a box or four bars and black or red letters. Magnitudes of interaction were flanked minus isolated logMAR acuities. Psychometric function slopes were also examined. Results: Magnitudes of interaction by contours did not change significantly with age. They were 0.047 ± 0.014 logMAR more with bars than a box. Interaction from flanking letters reduced with age, adults being not different from 9- to 11-year-olds for black and red letter surrounds. It was weaker by 0.033 ± 0.013 logMAR when a black letter was surrounded by red rather than black letters. Psychometric function slopes for visual acuity were steepest for the youngest children (3-5 years). Conclusions: For contour and letter flankers, grouping effects on interaction magnitude are age independent. Grouping bars into a box forming a single object reduces magnitude of effect. Grouping letter flankers by color and ungrouping them from the target reduce interaction magnitude by ∼8%, suggesting that luminance-defined form dominates. Differently colored letter flankers of high-luminance contrast on acuity charts could draw attention to the target but retain significant interaction strength.

Levelt's laws do not predict perception when luminance- and contrast-modulated stimuli compete during binocular rivalry.

Incompatible patterns viewed by each of the two eyes can provoke binocular rivalry, a competition of perception. Levelt's first law predicts that a highly visible stimulus will predominate over a less visible stimulus during binocular rivalry. In a behavioural study, we made a counterintuitive observation: high visibility patterns do not always predominate over low visibility patterns. Our results show that none of Levelt's binocular rivalry laws hold when luminance-modulated (LM) patterns compete with contrast-modulated (CM) patterns. We discuss visual saliency, asymmetric feedback, and a combination of both as potential mechanisms to explain the CM versus LM findings. Competing orthogonal LM stimuli do follow Levelt's laws, whereas only the first two laws hold for competing CM stimuli. The current results provide strong psychophysical evidence for the existence of separate processing stages for LM and CM stimuli.

More superimposition for contrast-modulated than luminance-modulated stimuli during binocular rivalry.

Luminance-modulated noise (LM) and contrast-modulated noise (CM) gratings were presented with interocularly correlated, uncorrelated and anti-correlated binary noise to investigate their contributions to mixed percepts, specifically piecemeal and superimposition, during binocular rivalry. Stimuli were sine-wave gratings of 2 c/deg presented within 2 deg circular apertures. The LM stimulus contrast was 0.1 and the CM stimulus modulation depth was 1.0, equating to approximately 5 and 7 times detection threshold, respectively. Twelve 45 s trials, per noise configuration, were carried out. Fifteen participants with normal vision indicated via button presses whether an exclusive, piecemeal or superimposed percept was seen. For all noise conditions LM stimuli generated more exclusive visibility, and lower proportions of superimposition. CM stimuli led to greater proportions and longer periods of superimposition. For both stimulus types, correlated interocular noise generated more superimposition than did anti- or uncorrelated interocular noise. No significant effect of stimulus type (LM vs CM) or noise configuration (correlated, uncorrelated, anti-correlated) on piecemeal perception was found. Exclusive visibility was greater in proportion, and perceptual changes more numerous, during binocular rivalry for CM stimuli when interocular noise was not correlated. This suggests that mutual inhibition, initiated by non-correlated noise CM gratings, occurs between neurons processing luminance noise (first-order component), as well as those processing gratings (second-order component). Therefore, first- and second-order components can contribute to overall binocular rivalry responses. We suggest the addition of a new well to the current energy landscape model for binocular rivalry that takes superimposition into account.

Very few exclusive percepts for contrast-modulated stimuli during binocular rivalry.

Binocular rivalry properties for contrast-modulated (CM) gratings were examined to gain insight into their locus of processing. Two orthogonally orientated gratings were presented, one to each eye. Perceptual change rates, proportions of exclusivity and mixed percepts, and mean durations were calculated. Stimuli were noiseless luminance-defined (L), luminance-modulated noise (LM) and contrast-modulated noise (CM) gratings with sizes of 1, 2 and 4deg and spatial frequencies of 4, 2 and 1c/deg, respectively. For the LM and CM gratings, binary noise was fully correlated between eyes. Maximum producible modulations were used (1.0 for CM, 0.78 for LM and 0.98 for L stimuli). In a control experiment, contrasts of LM gratings were reduced until the multiples over detection threshold were similar to those of CM stimuli. Trial durations of 120s were analyzed. Exclusive visibility decreased with increasing stimulus size regardless of the stimulus type. Even with visibilities at similar multiples above detection threshold, significantly lower proportions of exclusive percepts and perceptual changes were found for CM, compared to LM gratings. The results obtained with dichoptically presented orthogonal CM gratings are significantly different from those obtained for orthogonal gratings presented to one eye. CM stimuli therefore do engage in binocular rivalry but with different characteristics to those found for LM stimuli. These results suggest that CM stimuli are processed by a mechanism that promotes binocular combination rather than rivalry, and therefore may involve cells in a higher visual area than those that initially process LM information.

Crowding and visual acuity measured in adults using paediatric test letters, pictures and symbols.

Crowding refers to the degradation of visual acuity for target optotypes with, versus without, surrounding features. Crowding is important clinically, however the effect of target-flanker spacing on acuity for symbols and pictures, compared to letters, has not been investigated. Five adults with corrected-to-normal vision had visual acuity measured for modified single target versions of Kay Pictures, Lea Symbols, HOTV and Cambridge Crowding Cards, tests. Single optotypes were presented in isolation and with surrounding features placed 0-5 stroke-widths away. Visual acuity measured with Kay Picture optotypes is 0.13-0.19logMAR better than for other test optotypes and varies significantly across picture. The magnitude of crowding is strongest when the surrounding features abut, or are placed 1 stroke-width away from the target optotype. The slope of the psychometric function is steeper in the region just beyond maximum crowding. Crowding is strongest and the psychometric function steepest, with the Cambridge Crowding Cards arrangement, than when any single optotype is surrounded by a box. Estimates of crowding extent are less variable across test when expressed in units of stroke-width, than optotype-width. Crowding for single target presentations of letters, symbols and pictures used in paediatric visual acuity tests can be maximised and made more sensitive to change in visual acuity, by careful selection of optotype, by surrounding the target with similar flankers, and by using a closer target-flanker separation than half an optotype-width.

The effects of blur and eccentric viewing on adult acuity for pediatric tests: implications for amblyopia detection.

PURPOSE: The detection of amblyopia in children relies on an accurate assessment of visual acuity. Visual deficits in anisometropic and strabismic amblyopia are different, but the influence of chart design, in particular position, and type of crowding features on visual acuity in the two types of amblyopia, is not clear. Certain aspects of amblyopic spatial vision are mimicked in healthy individuals by imposing increasing levels of blur and retinal eccentricity. We measured the effects of these conditions on visual acuity in healthy adults, with crowded and uncrowded vision tests. METHODS: Visual acuity was measured under conditions of blur (0-4 D) and eccentric viewing (0-5 degrees) using high-contrast optotypes derived from common children's acuity charts. Optotypes were presented in isolation, in commercially available crowded configurations, and in configurations with closer target-flanker separations than those currently available. RESULTS: Dioptric blur had similar degradative effects on crowded and isolated visual acuity (P > 0.05), whereas eccentric viewing resulted in a larger deterioration of visual acuity for crowded tests (E2 of 0.86-1.06) than for isolated optotypes (E2 of 1.57-1.72) (P < 0.05). Maximum crowding effects occurred for closer target-flanker separations than those currently used commercially. CONCLUSIONS: In so far as blur and eccentric viewing mimic spatial acuity deficits in amblyopia, the results suggest that crowded tests might be of limited value in the detection of anisometropic amblyopia, but should be valuable in the detection of strabismic amblyopia. Crowding effects would be greater if flanking features were placed closer to the target than they currently are in commercially available charts.

The psychophysics of detecting binocular discrepancies of luminance.

In the natural world, a binocular discrepancy of luminance can signal a glossy surface. Using a spatial forced choice task, we have measured the ability of subjects to detect binocular luminance disparities. We show that the detection of binocular luminance disparity shares several basic psychophysical features with the detection of surface properties such as lightness and chromaticity: an approximation to Weber's Law, spatial summation, temporal summation, and a deterioration with increasing eccentricity. We also discuss whether color-deficient subjects could derive reliable information about chromaticity from the binocular disparities of luminance induced by a monocularly worn color filter.