Demonstrating correction of low levels of astigmatism with realistic scenes. Issue 1 (February 2016)

• Record Type: Journal Article
• Authors: Milton, Andy; Murphy, Michael; Rose, Ben; Olivares, Giovanna; Little, Borm Kim; Lau, Charis; Sulley, Anna
• Is Part Of: Contact lens & anterior eye. Volume 39:Issue 1(2016)
• Page Start: 26
• Page End: 37
• Publication Date: 2016-02
• Subjects: Subjective refraction -- Toric -- Low-cylinder -- Correction assessment -- Relevance; Anterior segment (Eye) -- Periodicals; Contact lenses -- Periodicals; Segment antérieur (Œil) -- Périodiques; Lentilles de contact -- Périodiques; 617.752305
• DOI: 10.1016/j.clae.2015.07.004
• Languages: English
• ISSNs: 1367-0484

Abstract

Graphical abstract: Highlights: Pattern, visual clutter & low contrast create a sensitive subjective refraction tool. Building in real-life scenes makes the test more emotionally relevant. 96% of subjects found these tests helpful to realize the advantage of toric lenses. Abstract: Purpose and Method: 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 1.00 DC 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 (0.75–1.00 DC, n = 74) wearing best spherical equivalent correction and then with astigmatism corrected. Results and Conclusions: 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 & 1.00 DC) of astigmatism.