Vision, Volume 6, Issue 2 (June 2022) – 18 articles

This discussion paper supplements our two theoretical contributions previously published in this journal on the geometric nature of visual space. We first show here how our Riemannian formulation explains the recent experimental finding (published in this special issue on size constancy) that, contrary to conclusions from past work, vergence does not affect perceived size. We then turn to afterimage experiments connected to that work. Beginning with the Taylor illusion, we explore how our proposed Riemannian visual–somatosensory–hippocampal association memory network accounts in the following way for perceptions that occur when afterimages are viewed in conjunction with body movement. The Riemannian metric incorporated in the association memory network accurately emulates the warping of 3D visual space that is intrinsically introduced by the eye. The network thus accurately anticipates the change in size of retinal images of objects with a change in Euclidean distance between the egocentre and the object. An object will only be perceived to change in size when there is a difference between the actual size of its image on the retina and the anticipated size of that image provided by the network. This provides a central mechanism for size constancy. If the retinal image is the afterimage of a body part, typically a hand, and that hand moves relative to the egocentre, the afterimage remains constant but the proprioceptive signals change to give the new hand position. When the network gives the anticipated size of the hand at its new position this no longer matches the fixed afterimage, hence a size-change illusion occurs. Full article

The World Health Organization (WHO) is developing a Package of Eye Care Interventions (PECI) to facilitate the integration of eye care into Universal Health Coverage. This paper presents the results of a systematic review of clinical practice guidelines for cataract in adults, to help inform PECI development. We searched academic and guideline databases, and websites of professional associations, for guidelines published between January 2010 and April 2020. Guidelines were excluded if there was commercial funding or unmanaged conflicts of interest. Quality appraisal was conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. We identified 3778 reports, 35 related to cataract guidelines, four of which met the inclusion criteria (United Kingdom: 2, United States: 1, Iran: 1). The recommendations across the four guidelines covered pre-operative (43%), intra-operative (37%), and post-operative interventions (20%). Most ‘strong’ recommendations were supported by good quality evidence. Differences in recommendations across guidelines may be attributable to time of publication or regional differences in surgical practice. Few guidelines met the quality criteria, and only three countries were represented. The results of this step of the PECI development process will inform subsequent phases for development of the WHO’s package of evidence-based eye care interventions for cataract. Full article

What is fundamental in vision has been discussed for millennia. For philosophical realists and the physiological approach to vision, the objects of the outer world are truly given, and failures to perceive objects properly, such as in illusions, are just sporadic misperceptions. The goal is to replace the subjectivity of the mind by careful physiological analyses. Continental philosophy and the Gestaltists are rather skeptical or ignorant about external objects. The percepts themselves are their starting point, because it is hard to deny the truth of one own′s percepts. I will show that, whereas both approaches can well explain many visual phenomena with classic visual stimuli, they both have trouble when stimuli become slightly more complex. I suggest that these failures have a deeper conceptual reason, namely that their foundations (objects, percepts) do not hold true. I propose that only physical states exist in a mind independent manner and that everyday objects, such as bottles and trees, are perceived in a mind-dependent way. The fundamental processing units to process objects are extended windows of unconscious processing, followed by short, discrete conscious percepts. Full article

The Groffman visual tracing (GVT) test is an indirect psychometric measure of oculomotor performance, used for the clinical assessment of eye movements. The test consists of two cards with five contorted lines of increasing overlap, crowding, and difficulty. The task starts from each of the letters at the top of the page, follows the line from the letter to the corresponding number at the bottom of the page, and the number is named. Although the GVT test was developed for the evaluation of children, it has also been applied to adults with visual and cognitive deficits. However, it lacks reference values. Therefore, the aim of the study was to assess oculomotor behavior across the typical human lifespan and to define normative data in an adult population. A total of 526 adults aged between 20 and 79 years, all without neurological or psychiatric deficits, were enrolled in the study. The results were analyzed by considering the accuracy and execution times separately. An influence of age, education and sex for accuracy was found, and age for the execution times was found. Norms for adults were developed considering the specific structure of the test and the accuracy and the execution time separately. The GVT test can now be applied in healthy and neurological adult populations for the evaluation of oculomotor performance. Full article

A growing body of literature offers exciting perspectives on the use of brain stimulation to boost training-related perceptual improvements in humans. Recent studies suggest that combining visual perceptual learning (VPL) training with concomitant transcranial electric stimulation (tES) leads to learning rate and generalization effects larger than each technique used individually. Both VPL and tES have been used to induce neural plasticity in brain regions involved in visual perception, leading to long-lasting visual function improvements. Despite being more than a century old, only recently have these techniques been combined in the same paradigm to further improve visual performance in humans. Nonetheless, promising evidence in healthy participants and in clinical population suggests that the best could still be yet to come for the combined use of VPL and tES. In the first part of this perspective piece, we briefly discuss the history, the characteristics, the results and the possible mechanisms behind each technique and their combined effect. In the second part, we discuss relevant aspects concerning the use of these techniques and propose a perspective concerning the combined use of electric brain stimulation and perceptual learning in the visual system, closing with some open questions on the topic. Full article

Seasonal affective disorder (SAD) is characterized by depressive episodes related to changes in the seasons. Patients with severe vision loss are at an increased risk of SAD. This study seeks to determine the extent to which patients with moderate vision loss report symptoms of SAD. In this cross-sectional, comparative case series, the Seasonal Pattern Assessment Questionnaire (SPAQ) and the National Eye Institute Visual Function Questionnaire (VFQ-39) were used to screen 111 patients with age-related macular degeneration (AMD) and/or primary open-angle glaucoma (POAG). A multiple regression analysis was performed to create a predictive model for SAD based on the Global Seasonality Score (GSS) using the VFQ-39. Subjects who reported symptoms of SAD (GSS > 8) had lower vision-related quality of life (composite score: 57.2 versus 73.2, p < 0.001). Exploratory factor analysis revealed that the items on the VFQ-39 split into two distinct dimensions that together accounted for 63.2% of the total variance in the GSS. One group of questions addressed vision-related problems; the other group comprised questions related to the quality of life. Whereas this model successfully identified patients with vision loss at risk of SAD, a model restricted to the questions available on the shorter, widely used VFQ-25 instrument did not reliably identify patients at risk of SAD. Full article

Multisensory stimulation is associated with behavioural benefits, including faster processing speed, higher detection accuracy, and increased subjective awareness. These effects are most likely explained by multisensory integration, alertness, or a combination of the two. To examine changes in subjective awareness under multisensory stimulation, we conducted three experiments in which we used Continuous Flash Suppression to mask subthreshold visual targets for healthy observers. Using the Perceptual Awareness Scale, participants reported their level of awareness of the visual target on a trial-by-trial basis. The first experiment had an audio-visual Redundant Signal Effect paradigm, in which we found faster reaction times in the audio-visual condition compared to responses to auditory or visual signals alone. In two following experiments, we separated the auditory and visual signals, first spatially (experiment 2) and then temporally (experiment 3), to test whether the behavioural benefits in our multisensory stimulation paradigm could best be explained by multisensory integration or increased phasic alerting. Based on the findings, we conclude that the largest contributing factor to increased awareness of visual stimuli accompanied by auditory tones is a rise in phasic alertness and a reduction in temporal uncertainty with a small but significant contribution of multisensory integration. Full article

Visuospatial working memory (WM) requires the activity of a spread network, including right parietal regions, to sustain storage capacity, attentional deployment, and active manipulation of information. Notably, while the electrophysiological correlates of such regions have been explored using many different indices, evidence for a functional involvement of the individual frequency peaks in the alpha (IAF) and theta bands (ITF) is still poor despite their relevance in many influential theories regarding WM. Interestingly, there is also a parallel lack of literature about the effect of short-term practice on WM performance. Here, we aim to clarify whether the simple repetition of a change-detection task might be beneficial to WM performance and to which degree these effects could be predicted by IAF and ITF. For this purpose, 25 healthy participants performed a change-detection task at baseline and in a retest session, while IAF and ITF were also measured. Results show that task repetition improves WM performance. In addition, right parietal IAF, but not ITF, accounts for performance gain such that faster IAF predicts higher performance gain. Our findings align with recent literature suggesting that the faster the posterior alpha, the finer the perceptual sampling rate, and the higher the WM performance gain. Full article

Dynamic Glass patterns (GPs) are visual stimuli commonly employed to study form–motion interactions. There is brain imaging evidence that non-directional motion induced by dynamic GPs and directional motion induced by random dot kinematograms (RDKs) depend on the activity of the human motion complex (hMT+). However, whether dynamic GPs and RDKs rely on the same processing mechanisms is still up for dispute. The current study uses a visual perceptual learning (VPL) paradigm to try to answer this question. Identical pre- and post-tests were given to two groups of participants, who had to discriminate random/noisy patterns from coherent form (dynamic GPs) and motion (RDKs). Subsequently, one group was trained on dynamic translational GPs, whereas the other group on RDKs. On the one hand, the generalization of learning to the non-trained stimulus would indicate that the same mechanisms are involved in the processing of both dynamic GPs and RDKs. On the other hand, learning specificity would indicate that the two stimuli are likely to be processed by separate mechanisms possibly in the same cortical network. The results showed that VPL is specific to the stimulus trained, suggesting that directional and non-directional motion may depend on different neural mechanisms. Full article

For two centuries, visual illusions have attracted the attention of neurobiologists and comparative psychologists, given the possibility of investigating the complexity of perceptual mechanisms by using relatively simple patterns. Animal models, such as primates, birds, and fish, have played a crucial role in understanding the physiological circuits involved in the susceptibility of visual illusions. However, the comprehension of such mechanisms is still a matter of debate. Despite their different neural architectures, recent studies have shown that some arthropods, primarily Hymenoptera and Diptera, experience illusions similar to those humans do, suggesting that perceptual mechanisms are evolutionarily conserved among species. Here, we review the current state of illusory perception in bees. First, we introduce bees’ visual system and speculate which areas might make them susceptible to illusory scenes. Second, we review the current state of knowledge on misperception in bees (Apidae), focusing on the visual stimuli used in the literature. Finally, we discuss important aspects to be considered before claiming that a species shows higher cognitive ability while equally supporting alternative hypotheses. This growing evidence provides insights into the evolutionary origin of visual mechanisms across species. Full article

We report the case of a 52-year-old woman who presented to the emergency department with acute retinal necrosis in her left eye secondary to herpes simplex virus type 1 encephalitis for which she had been hospitalized four months before. Treatment with intravitreal foscarnet and intravenous acyclovir was promptly commenced followed by the addition of oral prednisolone. PCR analysis of aqueous humor detected HSV type 1 DNA. The condition responded to therapy with partial resolution of intraocular inflammation and improvement of visual acuity, but the presence of Kyrieleis plaques was observed two weeks after the initiation of treatment, when five intravitreal foscarnet injections had been administered. The patient was switched to oral therapy with valacyclovir, and 10 weeks after commencing treatment, the patient’s left eye was free of inflammation, having achieved a BCVA of 20/20. Oral steroid treatment was gradually tapered off, and the patient was instructed to remain on prophylactic antiviral therapy. Kyrieleis arteriolitis is an uncommon finding in the context of acute retinal necrosis. As far as we are aware, we report the first case of Kyrieleis arteriolitis in acute retinal necrosis secondary to viral encephalitis and the second one presenting Kyrieleis plaques in acute retinal necrosis caused by herpes simplex virus type 1. Prior reports of cases of Kyrieleis arteriolitis in acute retinal necrosis are also presented. Full article

Background: Endothelial cells damage and thromboinflammation are considered key elements in the generation of organ impairment in patients with COVID-19 disease. The endothelial function is evaluated by measuring flow-mediated dilation (FMD). We aimed to analyze the association between FMD impairment and retinal vascular parameters in early post-COVID-19 patients. 00118-00199Tomography (OCT), OCT Angiography (OCTA) and slit lamp examination were performed. FMD ≤ 7% was considered as pathological. Our primary outcome was to assess potential differences in the radial peripapillary capillary plexus flow index (RPCP-FI) and RPCP density (RPCP-D) values between post-COVID-19 patients with and without FMD impairment. The associations of other retinal vascular parameters with FMD impairment were assessed as secondary endpoints. Results: FMD impairment was detected in 31 patients (37.8%). RPCP-FI (p = 0.047), age (p = 0.048) and prevalence of diabetes (p = 0.046) significantly differed in patients with FMD ≤ 7% in regression analysis. RPCP-FI was linearly correlated with FMD values (R = 0.244, p =0.027). SCT was found to be lower in patients with impaired FMD (p = 0.004), although this difference was only a trend in binary logistic regression output (p = 0.07). Conclusions: Early post-COVID-19 patients showed a higher prevalence of FMD impairment compared to the general population. Age, diabetes and RPCP-FI were independently correlated with the presence of endothelial impairment in the early post-infective period. Full article

Depth information is limited in a 2D scene and for people to perceive the distance of an object, they need to rely on pictorial cues such as perspective, size constancy and elevation in the scene. In this study, we tested whether people could use an object’s size and its position in a 2D image to determine its distance. In a series of online experiments, participants viewed a target representing their smartphone rendered within a 2D scene. They either positioned it in the scene at the distance they thought was correct based on its size or adjusted the target to the correct size based on its position in the scene. In all experiments, the adjusted target size and positions were not consistent with their initially presented positions and sizes and were made larger and moved further away on average. Familiar objects influenced adjusted position from size but not adjusted size from position. These results suggest that in a 2D scene, (1) people cannot use an object’s visual size and position relative to the horizon to infer distance reliably and (2) familiar objects in the scene affect perceived size and distance differently. The differences found demonstrate that size and distance perception processes may be independent. Full article

Our senses are constantly reached by a multitude of stimuli from all different sensory modalities. To create a coherent representation of the environment, we must integrate the various unimodal inputs that refer to the same object into a single multimodal representation. In some cases, however, we tend to bind certain properties of the stimuli without any apparent reason, which is a phenomenon named crossmodal correspondence. For instance, we match a spiky or a rounded shape with the sound “Kiki” or “Bouba”, respectively. Similarly, we associate the left hemispace with low luminance and the right one with high luminance. Instances of crossmodal correspondences were described also in other mammals, and recently, a case of space-luminance crossmodal correspondence was reported in birds (i.e., domestic chicks). Here, we investigate the presence of pitch–luminance crossmodal correspondence in three-day-old chicks, employing experimental methods that exploit either predisposed or learned processes. While failing to report evidence for this phenomenon, we discuss the difference between statistical and structural crossmodal correspondences and the possible role of environmental factors in determining their emergence. Moreover, we discuss the importance of the different experimental methodologies to investigate distinct aspects of this perceptual phenomenon to reach a deeper understanding and unveil the role of innate vs. learned mechanisms. Full article

A prerequisite for efficient prehension is the ability to estimate an object’s distance and size. While most studies demonstrate that binocular viewing is associated with a more efficient grasp programming and execution compared to monocular viewing, the factors contributing to this advantage are not fully understood. Here, we examined how binocular vision facilitates grasp scaling using two tasks: prehension and manual size estimation. Participants (n = 30) were asked to either reach and grasp an object or to provide an estimate of an object’s size using their thumb and index finger. The objects were cylinders with a diameter of 0.5, 1.0, or 1.5 cm placed at three distances along the midline (40, 42, or 44 cm). Results from a linear regression analysis relating grip aperture to object size revealed that grip scaling during monocular viewing was reduced similarly for both grasping and estimation tasks. Additional analysis revealed that participants adopted a larger safety margin for grasping during monocular compared to binocular viewing, suggesting that monocular depth cues do not provide sufficient information about an object’s properties, which consequently leads to a less efficient grasp execution. Full article

Subjective preferences for visual qualities of shapes and fonts have been separately reported. Such preferences are often similarly attributed to factors such as aesthetic impressions, attributed meaning from the visual properties, or processing fluency. Because shapes and fonts were rarely studied together, we investigated whether these qualities had a similar impact on preference judgment of object-word pairs. Each pair consisted of an abstract object with either preferred or disliked shape qualities and a pseudoword with either preferred or disliked font qualities. We found that only shape qualities, but not font qualities, influenced preference ratings of the object-word pairs, with higher preferences for pairs with preferred than disliked shapes. Moreover, eye movement results indicated that while participants fixated the word before the object, their prolonged fixation on the object when first attending to it might have contributed to the preference ratings. Nonetheless, other measures, including response times, total fixation numbers, and total dwell time, showed different patterns for shape and font qualities, revealing that participants attended more to objects with preferred than disliked shapes, and to words with disliked than preferred fonts. Taken together, these results suggest that shape and font qualities have differential influences on preferences and processing of objects and words. Full article

The current diagnostic aids for acute vision loss are static flowcharts that do not provide dynamic, stepwise workups. We tested the diagnostic accuracy of a novel dynamic Bayesian algorithm for acute vision loss. Seventy-nine “participants” with acute vision loss in Windsor, Canada were assessed by an emergency medicine or primary care provider who completed a questionnaire about ocular symptoms/findings (without requiring fundoscopy). An ophthalmologist then attributed an independent “gold-standard diagnosis”. The algorithm employed questionnaire data to produce a differential diagnosis. The referrer diagnostic accuracy was 30.4%, while the algorithm’s accuracy was 70.9%, increasing to 86.1% with the algorithm’s top two diagnoses included and 88.6% with the top three included. In urgent cases of vision loss (n = 54), the referrer diagnostic accuracy was 38.9%, while the algorithm’s top diagnosis was correct in 72.2% of cases, increasing to 85.2% (top two included) and 87.0% (top three included). The algorithm’s sensitivity for urgent cases using the top diagnosis was 94.4% (95% CI: 85–99%), with a specificity of 76.0% (95% CI: 55–91%). This novel algorithm adjusts its workup at each step using clinical symptoms. In doing so, it successfully improves diagnostic accuracy for vision loss using clinical data collected by non-ophthalmologists. Full article

Myopia is becoming more common across the world, affecting approximately two billion people and rising. Different kinds of therapies (optical, pharmaceutical, environmental, or behavioral) have been proposed to decrease myopia progression, but with variable results and a lack of standardization. The evidence that targeted myopic defocus inhibits eye length growth has paved the way for several contact and spectacle lense designs to induce a peripheral defocus, thus slowing myopia progression, but the perfect configuration has yet to be defined. One of the newest and more promising approaches in this field is the use of Defocus Incorporated Multiple Segments (DIMS) lenses. These lenses are built from the assumption that targeted myopic defocus, produced by 396 mid-peripheral lenslets with positive power, inhibits eye length growth. Recent studies have highlighted the effectiveness of these lenses compared to children who had worn single vision spectacle lenses, in terms of myopia control and tolerability. Despite the evidence that these lenses can help slow down the progression of myopia, the occasional mid-peripheral aberrations they can induce, as well as the overall eye strain that comes with wearing them, should not be overlooked. The aim of this review is to give attention to the advantages and the shortfalls of this new approach and to evaluate its effectiveness in clinical practice. Full article