Background: With the arrival of a new standardized tool and considering the multiple disadvantages of the actual method used for assesses lighting needs, the goal of the study was to compare the actual lighting assessment method used by the clinicians working in a rehabilitation center with the use of the LuxIQTM. As reading is found to be the main difficulty mentioned by the majority of the clients at the rehabilitation centre and that past studies have shown the impact of lighting on improving reading speed and deceasing print size, the hypothesis stated that the use of the standardized tool would be statistically significantly superior than the use of the standard method on the variables on reading speed, print size, ocular fatigue, application of the recommendations and satisfaction of the length of time read.

Methods: Three clinicians proceeded to home lighting assessments for 28 participants aged from 19 to 100 years (mean =75, SD =27) old diagnosed with age-related macular degeneration or glaucoma. The study evaluated and compared pre and post results between the two methods.

Results: The intervention did not have a statistically significant impact on any of the variables mentioned. The lighting assessment itself, with either the standard method or using the LuxIQ, statistically significantly decreased print size for reading (P<0.001, ω² =0.47).

Conclusions: Lighting has a significant impact on reading print size. Participants value the assessment but encounter various obstacles that prevent them from applying the lighting recommendations. Considering the positive impact of lighting, finding a solution so participants may profit from the benefits of this intervention is crucial.

Background: With the arrival of a new standardized tool and considering the multiple disadvantages of the actual method used for assesses lighting needs, the goal of the study was to compare the actual lighting assessment method used by the clinicians working in a rehabilitation center with the use of the LuxIQTM. As reading is found to be the main difficulty mentioned by the majority of the clients at the rehabilitation centre and that past studies have shown the impact of lighting on improving reading speed and deceasing print size, the hypothesis stated that the use of the standardized tool would be statistically significantly superior than the use of the standard method on the variables on reading speed, print size, ocular fatigue, application of the recommendations and satisfaction of the length of time read.

Methods: Three clinicians proceeded to home lighting assessments for 28 participants aged from 19 to 100 years (mean =75, SD =27) old diagnosed with age-related macular degeneration or glaucoma. The study evaluated and compared pre and post results between the two methods.

Results: The intervention did not have a statistically significant impact on any of the variables mentioned. The lighting assessment itself, with either the standard method or using the LuxIQ, statistically significantly decreased print size for reading (P<0.001, ω² =0.47).

Conclusions: Lighting has a significant impact on reading print size. Participants value the assessment but encounter various obstacles that prevent them from applying the lighting recommendations. Considering the positive impact of lighting, finding a solution so participants may profit from the benefits of this intervention is crucial.

Background: Understanding the neurophysiological mechanisms of Amblyopia, a neurodevelopmental disorder of the visual cortex, will bring us closer to full recovery. Past findings have been contradictory. Results have shown that despite having severe acuity impairment, amblyopes can nonetheless perceive sharp edges. In this study, we explore the representation of blur through a series of image blur-discrimination and matching tasks, to understand more about the amblyopes’ visual system.

Methods: Monocular image blur-discrimination thresholds were measured in a spatial two-alternative forced-choice procedure whereby subjects had to decide which image was the blurriest. Subjects also had to interocularly match pictures that were identical to those used for the image blur discrimination task. Ten amblyopes, as well as a group of ten controls were under study.

Results: Data on amblyopes and controls will be presented for both experiments. According to previous research that was done on blur-edge discrimination and matching, we predict that subjects’ performance will follow a dipper function, that is, all observers will be better at discriminating between both images when a small amount of blur is applied rather than when the image is either sharp or very blurry. We also predict that amblyopes’ blur discrimination will be noisier, but that they will paradoxically be able to match the sharpness of the images presented in the matching task.

Conclusions: This would confirm our hypothesis about amblyopes’ visual system, that they can represent blur levels defined by spatial frequencies that are beyond their resolution limit, and would also raise interesting questions about the visual system in general regarding the different perceptions driven by images versus edges.

Background: Understanding the neurophysiological mechanisms of Amblyopia, a neurodevelopmental disorder of the visual cortex, will bring us closer to full recovery. Past findings have been contradictory. Results have shown that despite having severe acuity impairment, amblyopes can nonetheless perceive sharp edges. In this study, we explore the representation of blur through a series of image blur-discrimination and matching tasks, to understand more about the amblyopes’ visual system.

Methods: Monocular image blur-discrimination thresholds were measured in a spatial two-alternative forced-choice procedure whereby subjects had to decide which image was the blurriest. Subjects also had to interocularly match pictures that were identical to those used for the image blur discrimination task. Ten amblyopes, as well as a group of ten controls were under study.

Results: Data on amblyopes and controls will be presented for both experiments. According to previous research that was done on blur-edge discrimination and matching, we predict that subjects’ performance will follow a dipper function, that is, all observers will be better at discriminating between both images when a small amount of blur is applied rather than when the image is either sharp or very blurry. We also predict that amblyopes’ blur discrimination will be noisier, but that they will paradoxically be able to match the sharpness of the images presented in the matching task.

Conclusions: This would confirm our hypothesis about amblyopes’ visual system, that they can represent blur levels defined by spatial frequencies that are beyond their resolution limit, and would also raise interesting questions about the visual system in general regarding the different perceptions driven by images versus edges.

Background: Dementia is a syndrome that affects a person’s ability to understand and express information. The higher prevalence of vision and/or hearing losses among persons with dementia in long-term care (LTC) facilities interferes with the ability of nurses to provide optimal care because communication is compromised. Therefore, the detection and screening for sensory impairment is of the utmost importance in LTC facilities; however, there is currently no agreement among nursing professionals on how to best identify such losses for the purpose of further referral, and the need for a validated screening measure suitable for nurses in LTC facilities is clear. The present project aims to close this gap by investigating the screening recommendations of vision- and hearing-care professionals working with clients affected by dementia.

Methods: Eleven experts in audiology, optometry, deafblindness, and technology participated in individual semi-structured interviews on the topic of tools and strategies that can be used to screen individuals with dementia for sensory loss. Interview transcripts were coded by two evaluators using verbal agreement and consensus building.

Results: Three main themes emerged from the interviews with experts: barriers, facilitators, and strategies. Barriers to sensory screening were often mentioned, particularly impaired communication and lack of staff cooperation. Facilitators consisted uniquely of people, such as family members, intervenors, and nurses. Strategies for sensory screening in this population consisted of improving communication through repetition and encouragements; considerations based on familiarity; and inferring an impairment on the basis of patient behaviour. Few of our interviewees were knowledgeable on the topic of screening apps.

Conclusions: Our findings, to be integrated with a similar environmental scan conducted among LTC nurses, can inform the administration of sensory impairment screening tests among a population with dementia in order to optimize care.

Background: Dementia is a syndrome that affects a person’s ability to understand and express information. The higher prevalence of vision and/or hearing losses among persons with dementia in long-term care (LTC) facilities interferes with the ability of nurses to provide optimal care because communication is compromised. Therefore, the detection and screening for sensory impairment is of the utmost importance in LTC facilities; however, there is currently no agreement among nursing professionals on how to best identify such losses for the purpose of further referral, and the need for a validated screening measure suitable for nurses in LTC facilities is clear. The present project aims to close this gap by investigating the screening recommendations of vision- and hearing-care professionals working with clients affected by dementia.

Methods: Eleven experts in audiology, optometry, deafblindness, and technology participated in individual semi-structured interviews on the topic of tools and strategies that can be used to screen individuals with dementia for sensory loss. Interview transcripts were coded by two evaluators using verbal agreement and consensus building.

Results: Three main themes emerged from the interviews with experts: barriers, facilitators, and strategies. Barriers to sensory screening were often mentioned, particularly impaired communication and lack of staff cooperation. Facilitators consisted uniquely of people, such as family members, intervenors, and nurses. Strategies for sensory screening in this population consisted of improving communication through repetition and encouragements; considerations based on familiarity; and inferring an impairment on the basis of patient behaviour. Few of our interviewees were knowledgeable on the topic of screening apps.

Conclusions: Our findings, to be integrated with a similar environmental scan conducted among LTC nurses, can inform the administration of sensory impairment screening tests among a population with dementia in order to optimize care.

Background: A growing number of older adults with vision loss require vision rehabilitation services to address reading difficulties. Braille may be the most appropriate option for those with functional blindness, poor visual prognoses or dual sensory loss. While standardized braille assessment and training protocols are in place to guide interventions with children, there is a high degree of inconsistency and a lack of evidence-based knowledge about best practices to use with adults and seniors who require braille training. Age-related declines in tactile acuity, motor dexterity and cognition present unique barriers to braille training, but very little is known about the impact of aging on factors related to braille reading performance. The aim of this scoping review is to identify the perceptual, motor, and cognitive factors related to braille reading performance and to determine how these factors have been assessed or measured among blind adults and elderly individuals in prior studies.

Methods: Using the scoping review method, a comprehensive search was conducted in three databases: PubMed, Educational Resource Information Center (ERIC), and the Cochrane library. Two reviewers screened articles for inclusion to ensure internal agreement, based on identified exclusion criteria.

Results: The initial search resulted in 1,565 qualitative and quantitative articles. The results synthesize the perceptual, motor and cognitive factors known to predict braille reading performance, how these variables are impacted by the aging process, and how they have been measured in prior studies.

Conclusions: This scoping review is the first step in working towards the development of evidence-based assessment and training protocols to standardized practice with adult and senior clients who require braille training. It also serves to clarify where current knowledge gaps exist in order to guide future studies on braille reading and aging.

Background: A growing number of older adults with vision loss require vision rehabilitation services to address reading difficulties. Braille may be the most appropriate option for those with functional blindness, poor visual prognoses or dual sensory loss. While standardized braille assessment and training protocols are in place to guide interventions with children, there is a high degree of inconsistency and a lack of evidence-based knowledge about best practices to use with adults and seniors who require braille training. Age-related declines in tactile acuity, motor dexterity and cognition present unique barriers to braille training, but very little is known about the impact of aging on factors related to braille reading performance. The aim of this scoping review is to identify the perceptual, motor, and cognitive factors related to braille reading performance and to determine how these factors have been assessed or measured among blind adults and elderly individuals in prior studies.

Methods: Using the scoping review method, a comprehensive search was conducted in three databases: PubMed, Educational Resource Information Center (ERIC), and the Cochrane library. Two reviewers screened articles for inclusion to ensure internal agreement, based on identified exclusion criteria.

Results: The initial search resulted in 1,565 qualitative and quantitative articles. The results synthesize the perceptual, motor and cognitive factors known to predict braille reading performance, how these variables are impacted by the aging process, and how they have been measured in prior studies.

Conclusions: This scoping review is the first step in working towards the development of evidence-based assessment and training protocols to standardized practice with adult and senior clients who require braille training. It also serves to clarify where current knowledge gaps exist in order to guide future studies on braille reading and aging.

Background: (I) To describe the development and components of the automobile simulator driving behavior evaluation system developed by CRIR-Institut Nazareth et Louis-Braille; (II) to present the preliminary results of the content evaluation of the driving behavior evaluation grid.

Methods: The evaluation system consists of five components: (I) the VS500M Car Simulator (Virage Simulation); (II) four VS500M driving scenarios, modified to minimize the occurrence of simulator sickness and expose subjects to commonly encountered driving situations on highways and city boulevards; (III) the Tobii Pro Glasses 2 eye tracking device; (IV) a car simulator driving behavior observation grid (DBOG); (V) a software application used during the behaviour evaluation phase, where synchronized video tracking, certain data from the simulator (e.g., speed) and the DBOG grid are presented. Initially, the expected safe driving behaviors were identified, including 235 of a visual nature, supported by literature data and consultation of the project steering committee and an expert in driving assessment. Driving behaviors were assessed in 22 subjects without visual impairment (mean age 55±20 years). Subsequently, the items were revised to determine their relevance based on their importance in terms of road safety or on the frequency with which behaviors were observed among participants. For analysis purpose, the items of the DBOG were grouped according to their content, by type of expected driving behavior (e.g., following a stop, look to the left and right before crossing the intersection) or element to be detected (e.g., pedestrians).

Results: Some visual behaviors are difficult to observe with the eye tracker device because they are more dependent on peripheral than central vision. Others are rarely observed, possibly because they are little or not realized in daily life or the representation of reality on the simulator does not stimulate their adoption. On the other hand, the visual detection behaviors expected in a situation where safety can be compromised are mostly carried out (e.g., detection of oncoming vehicles, side mirror verification when changing lanes).

Conclusions: This first phase of the study has made possible to better target the items to be kept in the car simulator driving behavior observation grid, and those that will have to be removed as they are too difficult to observe or too rarely adopted by the participants. Content validity and inter-rater reliability will be assessed from the simplified grid.

Background: (I) To describe the development and components of the automobile simulator driving behavior evaluation system developed by CRIR-Institut Nazareth et Louis-Braille; (II) to present the preliminary results of the content evaluation of the driving behavior evaluation grid.

Methods: The evaluation system consists of five components: (I) the VS500M Car Simulator (Virage Simulation); (II) four VS500M driving scenarios, modified to minimize the occurrence of simulator sickness and expose subjects to commonly encountered driving situations on highways and city boulevards; (III) the Tobii Pro Glasses 2 eye tracking device; (IV) a car simulator driving behavior observation grid (DBOG); (V) a software application used during the behaviour evaluation phase, where synchronized video tracking, certain data from the simulator (e.g., speed) and the DBOG grid are presented. Initially, the expected safe driving behaviors were identified, including 235 of a visual nature, supported by literature data and consultation of the project steering committee and an expert in driving assessment. Driving behaviors were assessed in 22 subjects without visual impairment (mean age 55±20 years). Subsequently, the items were revised to determine their relevance based on their importance in terms of road safety or on the frequency with which behaviors were observed among participants. For analysis purpose, the items of the DBOG were grouped according to their content, by type of expected driving behavior (e.g., following a stop, look to the left and right before crossing the intersection) or element to be detected (e.g., pedestrians).

Results: Some visual behaviors are difficult to observe with the eye tracker device because they are more dependent on peripheral than central vision. Others are rarely observed, possibly because they are little or not realized in daily life or the representation of reality on the simulator does not stimulate their adoption. On the other hand, the visual detection behaviors expected in a situation where safety can be compromised are mostly carried out (e.g., detection of oncoming vehicles, side mirror verification when changing lanes).

Conclusions: This first phase of the study has made possible to better target the items to be kept in the car simulator driving behavior observation grid, and those that will have to be removed as they are too difficult to observe or too rarely adopted by the participants. Content validity and inter-rater reliability will be assessed from the simplified grid.

Background: The perceptions surrounding assistive technology have been shown to be increasingly stigmatizing in older adult populations. This stigmatization can lead individuals to the abandonment of the assistive device. Until now, the methods of identifying or predicting the stigma surrounding assistive technology has mostly been qualitative in nature. Here we present a novel quantitate and qualitative research study that uses neuro-cognitive (psychophysics and EEG) and eye tracking technology, in addition to a new questionnaire to investigate the stigma associated with assistive devices. Therefore, this approach plays a major role in understanding and predicting the neural and physiological correlates associated to stigma.

Methods: Thirty-four older adults (>50 years) took part in the study. To determine the psychophysiological predictors of stigma surrounding assistive technologies, we monitored brain activity using EEG, heart rate and eye movements using an eye-tracker while participants viewed a series of images containing either an older or younger individual in different social scenarios (e.g., talking to doctor, at coffee shop). In each scenario, the individual uses either no assistive device, a low stigmatizing device (e.g., iPad), or a high stigmatizing device (e.g., electronic magnifier).

Results: Here we present preliminary analysis of the eye movement data. Analysis shows that in comparison to images that contained a low stigmatizing device, in images that contain high stigmatizing devices, the latency to fixate the device is shorter, first fixation duration is longer, and the total number of fixations on the device are higher. The environment that the devices is used in has no effect on eye movement metrics.

Conclusions: Although the sample size is small, and based on a healthy older-adult population, these initial observations would indicate that latency to fixate and first fixation duration are predictors of stigma associated with assistive devices. Future research should expand this prediction to those actively using assistive devices, and how the measures predict abandonment over time.

Background: The perceptions surrounding assistive technology have been shown to be increasingly stigmatizing in older adult populations. This stigmatization can lead individuals to the abandonment of the assistive device. Until now, the methods of identifying or predicting the stigma surrounding assistive technology has mostly been qualitative in nature. Here we present a novel quantitate and qualitative research study that uses neuro-cognitive (psychophysics and EEG) and eye tracking technology, in addition to a new questionnaire to investigate the stigma associated with assistive devices. Therefore, this approach plays a major role in understanding and predicting the neural and physiological correlates associated to stigma.

Methods: Thirty-four older adults (>50 years) took part in the study. To determine the psychophysiological predictors of stigma surrounding assistive technologies, we monitored brain activity using EEG, heart rate and eye movements using an eye-tracker while participants viewed a series of images containing either an older or younger individual in different social scenarios (e.g., talking to doctor, at coffee shop). In each scenario, the individual uses either no assistive device, a low stigmatizing device (e.g., iPad), or a high stigmatizing device (e.g., electronic magnifier).

Results: Here we present preliminary analysis of the eye movement data. Analysis shows that in comparison to images that contained a low stigmatizing device, in images that contain high stigmatizing devices, the latency to fixate the device is shorter, first fixation duration is longer, and the total number of fixations on the device are higher. The environment that the devices is used in has no effect on eye movement metrics.

Conclusions: Although the sample size is small, and based on a healthy older-adult population, these initial observations would indicate that latency to fixate and first fixation duration are predictors of stigma associated with assistive devices. Future research should expand this prediction to those actively using assistive devices, and how the measures predict abandonment over time.

Background: This infrastructure delivers biological material necessary for several research projects to Vision Health Research Network investigators (VHRN).

Methods: Héma-Québec is the organism in charge obtaining consent and retrieving donor eyes for patient treatment or for research. In Quebec City, donor eyes are sent to the eye bank of the “Centre Universitaire d’Ophtalmologie” (CUO) of Saint-Sacrement hospital. Technicians at the eye bank evaluate the quality of the tissues. Those unfit for graft are transferred to the infrastructure where the coordinator encodes samples prior to their distribution.

Results: Between 2013 and 2017, 27 fundamental investigators, clinical investigators and collaborators supported by 60 students, trainees and laboratory assistants used this infrastructure to move forward their projects. Since 2013, results from those projects generated 21 scientific publications and 232 presentations. The infrastructure helped VHRN investigators obtain near 4 million dollars in grants from many organisms (CIHR, NSERC, Foundations, etc.). These grants allowed recruitment and formation of highly qualified personnel. Last year (April 2016 to March 2017), 189 corneas and 23 eyes transited through the infrastructure.

Conclusions: This infrastructure is available for all investigators that are members of the VHRN. Many original projects have been elaborated thanks to the human ocular tissues provided by this infrastructure. These projects will advance our knowledge in vision health. A better understanding of eye functions will lead to new treatments for eye diseases.

Background: This infrastructure delivers biological material necessary for several research projects to Vision Health Research Network investigators (VHRN).

Methods: Héma-Québec is the organism in charge obtaining consent and retrieving donor eyes for patient treatment or for research. In Quebec City, donor eyes are sent to the eye bank of the “Centre Universitaire d’Ophtalmologie” (CUO) of Saint-Sacrement hospital. Technicians at the eye bank evaluate the quality of the tissues. Those unfit for graft are transferred to the infrastructure where the coordinator encodes samples prior to their distribution.

Results: Between 2013 and 2017, 27 fundamental investigators, clinical investigators and collaborators supported by 60 students, trainees and laboratory assistants used this infrastructure to move forward their projects. Since 2013, results from those projects generated 21 scientific publications and 232 presentations. The infrastructure helped VHRN investigators obtain near 4 million dollars in grants from many organisms (CIHR, NSERC, Foundations, etc.). These grants allowed recruitment and formation of highly qualified personnel. Last year (April 2016 to March 2017), 189 corneas and 23 eyes transited through the infrastructure.

Conclusions: This infrastructure is available for all investigators that are members of the VHRN. Many original projects have been elaborated thanks to the human ocular tissues provided by this infrastructure. These projects will advance our knowledge in vision health. A better understanding of eye functions will lead to new treatments for eye diseases.