Demonstrating correction of low levels of astigmatism with realistic scenes

Modern standard visual acuity tests are primarily designed as diagnostic tools for use during subjective refraction and normally bear little relation to real-world situations. We have developed a methodology to create realistic rendered scenes that demonstrate potential vision improvement in a relevant and engaging way. Low-cylindrical refractive error can be made more noticeable by optimizing the contrast and spatial frequencies, and by testing four different visual perception skills: motion tracking, pattern recognition, visual clutter differentiation and contrast sensitivity. Using a 1.00DC lens during iteration, we created a range of still and video scenes before optimizing to a selection 3-D rendered street scenes. These were assessed on everyday relevance, emotional and visual engagement and sensitivity to refractive correction for low-cylinder astigmats (0.75-1.00DC, n=74) wearing best spherical equivalent correction and then with astigmatism corrected.

The most promising visual elements involved or combined optimized textures, distracting patterns behind text, faces at a distance, and oblique text. 91.9% of subjects (95% CI: 83.2, 97.0) reported an overall visual improvement when viewing the images with astigmatic correction, and 96% found the images helpful to determine which type of contact lens to use. Our method, which combines visual science with design thinking, takes a new approach to creating vision tests. The resultant test scenes can be used to improve patient interaction and help low cylinder astigmats see relevant, every-day benefits in correcting low levels (0.75 & 1.00DC) of astigmatism.