The use of visual feedback is independent of visual awareness: evidence from visual extinction

Milner and Goodale (The visual brain in action, Oxford Press, 1995) made a distinction between vision for perception and vision for action. In contrast to perception, many action tasks have strict temporal constraints, which can only be met if the visual information is relayed directly to the motor system without first passing through a conscious decision making process. Milner and Goodale therefore predict that visual stimuli do not have to reach visual awareness in order to guide rapid motor responses. Online visual feedback provides a good example of visual information that is used under tight temporal constraints to guide rapid motor responses. Online visual feedback provides information about the position of the moving limb. This information can be used to improve the accuracy of our movements. If vision for action operates independently of visual awareness, visual feedback should be beneficial even if the subject is unaware of this information. We tested this prediction in a patient (V.E.) with left-sided visual extinction, a condition in which a visual stimulus typically fails to reach awareness if a second stimulus is presented simultaneously at a more rightward location. V.E. was asked to point towards a central target with his left hand. In some trials a light-emitting diode (LED) provided brief visual feedback from the moving hand. However, in the majority of trials, V.E. was unaware of this LED, due to his extinction. His performance was nevertheless significantly better when visual feedback was present, regardless of whether or not the information was available for verbal report. We conclude that visual awareness is not essential for the effective use of online visual feedback.