Eccentric gaze direction in patients with central field loss

Area of Science:

• Ophthalmology
• Vision Science
• Neuroscience

Background:

• Central field loss significantly impacts daily activities.
• Eccentric gaze direction (EGD) is a compensatory strategy for individuals with central vision impairment.
• Previous studies primarily focused on monocular EGD, potentially not reflecting true binocular behavior.

Purpose of the Study:

• To describe the binocular eccentric gaze direction (bEGD) in a large cohort of patients with bilateral central scotomas.
• To compare the observed bEGD with findings from previous studies on eccentric gaze behavior.
• To investigate factors influencing EGD, including ocular pathology and investigation methods.

Main Methods:

• Retrospective review of 434 patients with bilateral central scotomas who had not undergone eccentric viewing training.
• Data collection included monocular and binocular EGD, visual acuity, and underlying ocular pathology.
• Comparison of findings with existing literature on gaze behavior in central field loss.

Main Results:

• Age-related macular disease was the most common pathology (77%).
• The majority of patients exhibited a binocular EGD (bEGD) to the right (50%), followed by superior (25%), left (14%), and inferior (11%) directions.
• Literature review indicated a prevalence of monocular EGD in the superior direction.

Conclusions:

• Binocular eccentric gaze direction in patients with bilateral central scotomas is guided by the better-seeing eye.
• The observed preference for rightward bEGD contrasts with previous findings, suggesting methodology influences results.
• Monocular investigation techniques may not accurately represent an individual's natural binocular EGD relevant to daily life.