Comparison of Depth-Related Visuomotor Task Performance in Uniocular Individuals and in Binocular Controls With and Without Temporary Monocular Occlusion.

Purpose: Do one-eyed (uniocular) humans use monocular depth cues differently from those with intact binocularity to perform depth-related visuomotor tasks that emulate complex activities of daily living? If so, does performance depend on the participant's age, duration of uniocularity and head movements? Methods: Forty-five uniocular cases (age range 6-37 years; 2.4 months-31.0 years of uniocularity) and 46 age-similar binocular controls performed a task that required them to pass a hoop around an electrified wire convoluted in depth multiple times, while avoiding contact as indicated by auditory feedback. The task was performed with and without head restraint, in random order. The error rate and speed were calculated from the frequency of contact between the hoop and wire and the total task duration (adjusting for error time), respectively, all determined from video recordings of the task. Head movements were analyzed from the videos using face-tracking software. Results: Error rate decreased with age (P < 0.001) until the late teen years while speed revealed no such trend. Across all ages, the error rate increased and speed decreased in the absence of binocularity (P < 0.001). There was no additional error reduction with duration of uniocularity (P = 0.16). Head movements provided no advantage to task performance, despite generating parallax disparities comparable to binocular viewing. Conclusions: Performance in a dynamic, depth-related visuomotor task is reduced in the absence of binocular viewing, independent of age-related performance level. This study finds no evidence for a prolonged experience with monocular depth cues being advantageous for such tasks over transient loss of binocularity.

Structure-Function Relationship in Keratoconus: Spatial and Depth Vision.

Purpose: The purpose of this study was to determine changes in spatial and depth vision with increasing severity of keratoconus and to model the structure-function relationship to identify distinct phases of loss in visual function with disease severity. Methods: Best-spectacle corrected, monocular high-contrast visual acuity, contrast sensitivity function (CSF) and stereoacuity of 155 cases (16-31 years) with mild to advanced bilateral keratoconus was determined using standard psychophysical tests. Disease severity was quantified using the multimetric D-index. The structure-function relationship was modeled using linear, positive exponential, negative exponential, and logistic nonlinear regression equations. Results: The logistic regression model explained the highest proportion of variance for spatial vision, without bias in the residual plots (R2 ≥ 66%, P < 0.001). Visual acuity showed a distinct ceiling phase and a steeper loss rate with increasing D-index (1.8 units/D-index) in this model. The area under the CSF lacked this ceiling phase and had a shallower loss rate (0.28 units/D-index). Stereoacuity loss with D-index was poorly explained by all models tested (P ≤ 0.2). Cases with lower and bilaterally symmetric D-index had better stereoacuity (181.6-376 arc seconds) than those with higher D-index (>400 arc second); both were significantly poorer than controls (approximately 30 arc second). Conclusions: Vision loss in keratoconus varies with the visual function parameter tested. Contrast sensitivity may be an earlier indicator of spatial vision loss than visual acuity. Depth perception is significantly deteriorated from very early stages of the disease. Translational Relevance: The study outcomes may be used to forecast longitudinal vision loss in keratoconus and to apply appropriate interventions for timely preservation/enhancement of vulnerable visual functions.