Improving Accessibility of Vision Research and Therapy using an Open-Source, Extended-Reality Platform - Abstract This project seeks to develop an open XR platform that can make accessible basic vision science assessments and interventions to people living with visual impairment. In the US alone, over 6 million people live with low- vision, which negatively impacts well-being, economic independence and societal participation. Despite significant advances in healthcare, many researchers, clinicians and patients remain without ready access to the specialized, lab-based instrumentation and software required for the accurate assessment and treatment of vision loss. Our team seeks to leverage vision science insights, software development know-how, and extended- reality (XR) headsets to develop a software/hardware platform that can render basic vision science assessments and interventions widely accessible for all stakeholders. We take advantage of modern, commoditized, XR systems to “bring the lab” to participants. Our proposal builds upon decades of research from the vision science community, whose insights have long been used to benefit people with low vision. For example, automated gaze- contingent procedures that measure basic perimetry, as well as contrast sensitivity, acuity and motion discrimination in specific areas of the visual field have been transformative for understanding vision in those with either peripheral or central visual field loss. Likewise, eye-tracking based interventions that target training to the edges of functional visual fields in those with cortical vision loss, or to the preferred retinal loci of people with macular degeneration have been transformative in helping patients regain visual function that is often not accessible using other means. In this project, we will combine easy-to-use, high-resolution displays, with eye- tracking and optional non-invasive electrical brain stimulation into a single device. This will revolutionize ability to study low vision, and to deploy home-based but well-controlled visual “treatments”. In the R61, we will build and test feasibility of research grade assessments and interventions addressing retinal blindness (macular degeneration) and adult cortical blindness (stroke-induced). The R33 will support stage-1 feasibility trials targeting these two low-vision populations as well as new projects to address pediatric cortical visual impairments and amblyopia, and an open call for seed grants to support additional groups, extending the use cases of this accessible XR platform. At all stages of design, development and implementation, teams of researchers, clinicians, engineers and patients will work together to ensure that developed procedures address the needs and goals of all stakeholders. This principled, trans-disciplinary, team-based approach is designed to maximize access and thus, ultimately serve the lived realities of a great number of people with low-vision.
