ABSTRACT
Central visual field loss due to diseases like age-related macular degeneration (AMD) is a large and growing
problem, particularly in the elderly. Although much has been done to understand visual limitations associated
with this problem in a static context, studies of binocular oculomotor behaviors in a naturalistic context are
lacking. As a result, little is known about how those with central field loss (CFL) meet daily demands, such as
shifting their gaze between targets in depth, stabilizing images on the retina during linear motion, or coordinating
eye and head movements in situations where vestibularly-driven compensatory reflexes are in conflict with visual
gaze shifting demands. These essential behaviors, developed to place and maintain the fovea on target, and
thus use it as the reference in healthy vision. Deficits in these behaviors become particularly dangerous in the
context of mobility and navigation of busy environments, where gaze shifting and retinal stabilization play a key
role in preventing stumbling, collisions, and falls – which can lead to injury or be fatal in older adults most affected
by AMD. These individuals often do not have a functional fovea, commonly using an eccentric fixational locus
that may not be symmetric in the two eyes.
This proposal seeks to address the gap in our understanding of how loss of foveal fixation and acuity, as well as
loss of binocular information affects these essential behaviors. The first Aim examines binocular eye movements
to targets in depth, looking at not only the capacity for vergence, but also accuracy of the eye movement and
depth cues needed to improve gaze placement in individuals with CFL. The world is inherently three-dimensional
and understanding how those with central field deficits are able to acquire information can help better understand
how challenges posed by known visual deficits are further exacerbated in daily living. The second Aim
investigates the interaction of linear motion and retinal stabilization of targets at different depths. We will use
fore-aft motion that emulates translations during forward walking to test individuals’ ability to stabilize objects at
different viewing eccentricities and depths. The experiments in this Aim are the first of their kind and will explicitly
address the capacity for retinal stabilization during linear motion in CFL. The findings can inform specific training
and rehabilitation strategies to reduce instability and falls. The final Aim examines the capacity for cancellation
of the vestibuloocular response (VOR) when it is in conflict with visually-driven oculomotor demands. When the
head moves, the VOR counterrotates the eyes to maintain retinal stability. However, when an individual uses
the head and eyes to track or visually acquire a target, the VOR can pull the eyes away from the object of interest.
If deficient, head movements become disadvantageous, suggesting a different set of strategies for gaze shifting
in CFL. Combined, these experiments could have significant implications on how individuals with CFL are
advised and trained to interact with their environment while maintaining an active and productive lifestyle.