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Development of a Gaze-Contingent Display Framework Designed for Perceptual and Oculomotor Research with Simulated Central Vision Loss
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The impact of visual function on staircase use performance in glaucoma.

Chien-Chia Su1,2, Tsing-Hong Wang1,2, Jehn-Yu Huang1,2

  • 1Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Eye (London, England)
|August 22, 2023
PubMed
Summary

Visual function significantly impacts staircase navigation in glaucoma patients. Impaired contrast sensitivity and visual field defects are linked to slower stair descent and increased difficulty, highlighting the need for low-vision referrals.

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Area of Science:

  • Ophthalmology
  • Vision Science
  • Gerontology

Background:

  • Glaucoma is a leading cause of irreversible blindness.
  • Impaired vision significantly affects mobility and daily activities, including staircase navigation.
  • Understanding the relationship between visual function and staircase use is crucial for patient safety and independence.

Purpose of the Study:

  • To investigate the association between various visual function parameters and staircase use in patients with glaucoma.
  • To determine which visual parameters are most predictive of stair descent/ascent time and perceived stair difficulty.

Main Methods:

  • A cross-sectional study involving 181 glaucoma patients with best-corrected visual acuity ≥20/400.
  • Patients were categorized into mild-to-moderate and advanced glaucoma based on mean deviation (MD).
  • Staircase use was assessed via stair descent/ascent time (SDT/SAT) and self-reported difficulty, correlated with visual acuity, integrated visual field (IVF), and contrast sensitivity (CS).

Main Results:

  • Stair descent time (SDT) showed a stronger correlation with visual function than self-reported difficulty.
  • In mild-to-moderate glaucoma, area under the log CS function (AULCSF) significantly predicted SDT.
  • In advanced glaucoma, both AULCSF and MD of the inferior integrated visual field (IVFINF0-24) were associated with SDT. AULCSF also significantly predicted SAT and stair difficulty.

Conclusions:

  • Stair descent time is a more sensitive measure of visual impairment's impact on staircase navigation than subjective reports.
  • Patients with reduced contrast sensitivity or inferior visual field defects require counseling on stair safety.
  • Referral to low-vision services is recommended for glaucoma patients experiencing difficulties with staircase use.