The Effect of Simulated Visual Field Loss on Optokinetic Nystagmus

Purpose Assessment of functional vision across the visual field is hampered by a reliance on patients' subjective judgement of the presence of a stimulus, and the accompanying demands (time and attention) this places on them. As a first step toward determining whether an objective measure of an involuntary eye movement (optokinetic nystagmus [OKN]) could provide an objective measure of field loss, we determined how various measures of OKN depend on the extent of simulated visual field loss (SVFL). Methods We used infrared eye-tracking to measure the eye movements of 16 healthy participants viewing horizontally translating 2-dimensional noise patterns over trials of varying contrasts and different levels of SVFL. We quantified the strength of OKN by estimating the velocity of tracking eye movements compared to the stimulus (OKN gain). These measurements were made using an open-loop SVFL paradigm, where a varying amount of gaze-contingent peripheral stimuli was occluded. Results Full-field stimulation led to an average OKN gain of 0.92 ± 0.15. This value fell steadily with increasing SVFL to a value of 0.38 ± 0.20 when the periphery was not stimulated at all (i.e., the stimulus was a 5-deg. diameter foveal patch). We note considerable individual variation in OKN gain in all conditions. Conclusions Measuring the extent of visual field loss using an objective measure of OKN gain is feasible. Translational Relevance Simulated visual field loss reduces optokinetic nystagmus, but further refinement of this technique would be required to overcome individual differences and to pick up clinically relevant field defects.