Visual Field Size Criteria for Mobility Rehabilitation Referral

Purpose. To investigate evidence-based visual field size criteria for referral of low-vision (LV) patients for mobility rehabilitation. Methods. One hundred and nine participants with LV and 41 age-matched participants with normal sight (NS) were recruited. The LV group was heterogeneous with diverse causes of visual impairment. We measured binocular kinetic visual fields with the Humphrey Field Analyzer and mobility performance on an obstacle-rich, indoor course. Mobility was assessed as percent preferred walking speed (PPWS) and number of obstacle-contact errors. The weighted kappa coefficient of association (&kgr;r) was used to discriminate LV participants with both unsafe and inefficient mobility from those with adequate mobility on the basis of their visual field size for the full sample and for subgroups according to type of visual field loss and whether or not the participants had previously received orientation and mobility training. Results. LV participants with both PPWS <38% and errors >6 on our course were classified as having inadequate (inefficient and unsafe) mobility compared with NS participants. Mobility appeared to be first compromised when the visual field was less than about 1.2 steradians (sr; solid angle of a circular visual field of about 70° diameter). Visual fields <0.23 and 0.63 sr (31 to 52° diameter) discriminated patients with at-risk mobility for the full sample and across the two subgroups. A visual field of 0.05 sr (15° diameter) discriminated those with critical mobility. Conclusions. Our study suggests that: practitioners should be alert to potential mobility difficulties when the visual field is less than about 1.2 sr (70° diameter); assessment for mobility rehabilitation may be warranted when the visual field is constricted to about 0.23 to 0.63 sr (31 to 52° diameter) depending on the nature of their visual field loss and previous history (at risk); and mobility rehabilitation should be conducted before the visual field is constricted to 0.05 sr (15° diameter; critical).

[1]  Julian L. Simon,et al.  Basic research methods in social science : the art of empirical investigation , 1970 .

[2]  N. Drasdo.  Visual Field Expanders , 1976, American journal of optometry and physiological optics.

[3]  M. Levin,et al.  A Field Expander for Patients with Retinitis Pigmentosa: A Clinical Study , 1977, American journal of optometry and physiological optics.

[4]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[5]  R. Welsh.  Foundations of Orientation and Mobility , 1979 .

[6]  Frederick C. Blodi,et al.  The Visual Fields: A Textbook and Atlas of Clinical Perimetry , 1982 .

[7]  Denis G. Pelli,et al.  Visual requirements of mobility (A) , 1983 .

[8]  J. Webster,et al.  Visual scanning training with stroke patients , 1984 .

[9]  W. Feinbloom,et al.  Amorphic lenses: a mobility aid for patients with retinitis pigmentosa. , 1985, American journal of optometry and physiological optics.

[10]  C I Howarth,et al.  The efficiency and walking speed of visually impaired people. , 1986, Ergonomics.

[11]  B Brown,et al.  Contribution of Vision Variables to Mobility in Age‐Related Maculopathy Patients , 1986, American journal of optometry and physiological optics.

[12]  D. Cunningham,et al.  Age-related changes in speed of walking. , 1988, Medicine and science in sports and exercise.

[13]  Helena C. Kraemer,et al.  Assessment of 2 × 2 Associations: Generalization of Signal-Detection Methodology , 1988 .

[14]  D. Cunningham,et al.  Age-related changes in speed of walking. , 1988 .

[15]  J J Anderson,et al.  Impaired Vision and Hip Fracture , 1989, Journal of the American Geriatrics Society.

[16]  H. Kraemer,et al.  2 x 2 kappa coefficients: measures of agreement or association. , 1989, Biometrics.

[17]  D. Snydacker,et al.  Blindness and visual impairment in an American urban population. , 1990, Archives of ophthalmology.

[18]  J Katz,et al.  Blindness and visual impairment in an American urban population. The Baltimore Eye Survey. , 1990, Archives of ophthalmology.

[19]  J. Lovie-Kitchin,et al.  What areas of of the visual field are important for mobility in low vision patients , 1990 .

[20]  Joanne Katz,et al.  Blindness and Visual Impairment in an American Urban Population-Reply , 1990 .

[21]  Gislin Dagnelie,et al.  Technical note. Conversion of planimetric visual field data into solid angles and retinal areas , 1990 .

[22]  M. Reding,et al.  Fresnel prisms improve visual perception in stroke patients with homonymous hemianopia or unilateral visual neglect , 1990, Neurology.

[23]  L.B. Straw,et al.  A Program in Orientation and Mobility for Visually Impaired Persons over Age 60 , 1991 .

[24]  L.B. Straw,et al.  Assessment and Training in Orientation and Mobility for Older Persons: Program Development and Testing , 1991 .

[25]  G. Kerkhoff,et al.  Rehabilitation of hemianopic alexia in patients with postgeniculate visual field disorders , 1992 .

[26]  J. Wild,et al.  Assessment of physiologic statokinetic dissociation by automated perimetry. , 1992, Investigative ophthalmology & visual science.

[27]  S. Traub,et al.  Evaluating Medical Tests: Objective and Quantitative Guidelines , 1993 .

[28]  J M Cohen,et al.  An overview of enhancement techniques for peripheral field loss. , 1993, Journal of the American Optometric Association.

[29]  Cohen Jm,et al.  An overview of enhancement techniques for peripheral field loss. , 1993 .

[30]  S. Studenski,et al.  How do physiological components of balance affect mobility in elderly men? , 1993, Archives of physical medicine and rehabilitation.

[31]  G. Kerkhoff,et al.  Neurovisual rehabilitation in cerebral blindness. , 1994, Archives of neurology.

[32]  A. Patla,et al.  The Waterloo Vision and Mobility Study: postural control strategies in subjects with ARM. , 1995, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[33]  J. Zihl,et al.  Visual scanning behavior in patients with homonymous hemianopia , 1995, Neuropsychologia.

[34]  S. Haymes,et al.  Mobility of People with Retinitis Pigmentosa as a Function of Vision and Psychological Variables , 1996, Optometry and vision science : official publication of the American Academy of Optometry.

[35]  H. Taylor,et al.  Referral to low vision services by ophthalmologists. , 1996, Australian and New Zealand journal of ophthalmology.

[36]  J. Keeffe,et al.  Referral to low vision services by optometrists , 1996 .

[37]  T. Kuyk,et al.  Environmental variables and mobility performance in adults with low vision. , 1996, Journal of the American Optometric Association.

[38]  D M Clarke,et al.  Comparing correlated kappas by resampling: is one level of agreement significantly different from another? , 1996, Journal of psychiatric research.

[39]  H. Taylor,et al.  Visual impairment and socioeconomic factors , 1997, The British journal of ophthalmology.

[40]  Richard W. Bohannon.  Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. , 1997, Age and ageing.

[41]  J. Lovie-Kitchin,et al.  Mobility performance with retinitis pigmentosa , 1997 .

[42]  Christianna S. Williams,et al.  Falls, injuries due to falls, and the risk of admission to a nursing home. , 1997, The New England journal of medicine.

[43]  K. Turano,et al.  Traditional Measures of Mobility Performance and Retinitis Pigmentosa , 1998, Optometry and vision science : official publication of the American Academy of Optometry.

[44]  K. Turano,et al.  Mental Effort Required for Walking: Effects of Retinitis Pigmentosa , 1998, Optometry and vision science : official publication of the American Academy of Optometry.

[45]  D. Gottlieb,et al.  Neuro-optometric facilitation of vision recovery after acquired brain injury. , 1998, NeuroRehabilitation.

[46]  J. L. Elliott,et al.  Visual Correlates of Obstacle Avoidance in Adults with Low Vision , 1998, Optometry and vision science : official publication of the American Academy of Optometry.

[47]  J. Szlyk,et al.  Use of Bioptic Amorphic Lenses to Expand the Visual Field in Patients with Peripheral Loss , 1998, Optometry and vision science : official publication of the American Academy of Optometry.

[48]  J. L. Elliott,et al.  Visual Correlates of Mobility in Real World Settings in Older Adults with Low Vision , 1998, Optometry and vision science : official publication of the American Academy of Optometry.

[49]  K. Turano,et al.  Mobility performance in glaucoma. , 1999, Investigative ophthalmology & visual science.

[50]  Y. Fujiwara,et al.  Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. , 2000, Age and ageing.

[51]  R. Kelsch,et al.  Measuring the effectiveness of bioptic telescopes for persons with central vision loss. , 2000, Journal of rehabilitation research and development.

[52]  A curriculum for training patients with peripheral visual field loss to use bioptic amorphic lenses. , 2000, Journal of rehabilitation research and development.

[53]  E. Peli.  OPTOMETRY AND VISION SCIENCE Copyright © 2000 American Academy of Optometry ORIGINAL ARTICLE Field Expansion for Homonymous Hemianopia by Optically Induced Peripheral Exotropia , 2022 .

[54]  E Peli,et al.  Vision Multiplexing: an Engineering Approach to Vision Rehabilitation Device Development , 2001, Optometry and vision science : official publication of the American Academy of Optometry.

[55]  JAN E. LOVIE-KITCHIN,et al.  Vision and Mobility Performance of Subjects with Age-Related Macular Degeneration , 2002, Optometry and vision science : official publication of the American Academy of Optometry.

[56]  David A Mackey,et al.  Visual field assessment and the Austroads driving standard , 2002, Clinical & experimental ophthalmology.

[57]  Christian J Foy.  Does mobility performance of visually impaired adults improve immediately after orientation and mobility training? , 2002, Optometry and vision science : official publication of the American Academy of Optometry.

[58]  F. Vargas-Martin,et al.  Augmented-View for Restricted Visual Field: Multiple Device Implementations , 2002, Optometry and vision science : official publication of the American Academy of Optometry.

[59]  A. Biderman,et al.  Depression and falls among community dwelling elderly people: a search for common risk factors , 2002, Journal of epidemiology and community health.

[60]  J. Keeffe,et al.  Associations between glaucomatous visual field loss and participation in activities of daily living , 2003, Clinical & experimental ophthalmology.

[61]  D. Melzer,et al.  The predictive validity for mortality of the index of mobility-related limitation--results from the EPESE study. , 2003, Age and ageing.

[62]  B. Munoz,et al.  Association of Visual Field Loss and Mobility Performance in Older Adults: Salisbury Eye Evaluation Study , 2004, Optometry and vision science : official publication of the American Academy of Optometry.

[63]  Karen Bandeen-Roche,et al.  Divided visual attention as a predictor of bumping while walking: the Salisbury Eye Evaluation. , 2004, Investigative ophthalmology & visual science.

[64]  Cynthia Owsley,et al.  Mobility function in older veterans improves after blind rehabilitation. , 2004, Journal of rehabilitation research and development.

[65]  Gang Luo,et al.  Evaluation of a prototype Minified Augmented‐View device for patients with impaired night vision * , 2004, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[66]  J. J. Neve,et al.  Improved mobility and independence of night-blind people using night-vision goggles. , 2004, Investigative ophthalmology & visual science.

[67]  R. Klein,et al.  Causes and prevalence of visual impairment among adults in the United States. , 2004, Archives of ophthalmology.

[68]  Timothy McMahon,et al.  Use of prisms for navigation and driving in hemianopic patients , 2005, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[69]  J. Duysens,et al.  Advancing age progressively affects obstacle avoidance skills in the elderly. , 2005, Human movement science.

[70]  Karen Bandeen-Roche,et al.  Measures of visual function and percentage of preferred walking speed in older adults: the Salisbury Eye Evaluation Project. , 2006, Investigative ophthalmology & visual science.

[71]  J. Jonas,et al.  Prevalence of visual impairment among adults in China: the Beijing Eye Study. , 2006, American journal of ophthalmology.

[72]  Jan E Lovie-Kitchin,et al.  Measuring mobility performance: experience gained in designing a mobility course , 2006, Clinical & experimental optometry.

[73]  Gang Luo,et al.  Use of an augmented-vision device for visual search by patients with tunnel vision. , 2006, Investigative ophthalmology & visual science.

[74]  R. Klein,et al.  Age-related eye disease, visual impairment, and survival: the Beaver Dam Eye Study. , 2005, Archives of ophthalmology.

[75]  U. Schiefer,et al.  Quantification of stato-kinetic dissociation by semi-automated perimetry , 2006, Vision Research.

[76]  J E Keeffe,et al.  The economic impact and cost of visual impairment in Australia , 2005, British Journal of Ophthalmology.

[77]  Hao Lei,et al.  What is the minimum field of view required for efficient navigation? , 2007, Vision Research.

[78]  ARIFS ARom,et al.  THE VOLUME VISUAL FIELD: A BASIS FOR FUNCTIONAL PERIMETRY , 2008 .

[79]  Eli Peli,et al.  Community-based trial of a peripheral prism visual field expansion device for hemianopia. , 2008, Archives of ophthalmology.

[80]  Visual Field Loss and Risk of Fractures in Older Women , 2009, Journal of the American Geriatrics Society.

[81]  E. Peli,et al.  Clinical and Laboratory Evaluation of Peripheral Prism Glasses for Hemianopia , 2009, Optometry and vision science : official publication of the American Academy of Optometry.

[82]  Gang Luo,et al.  Collision judgment when using an augmented-vision head-mounted display device. , 2009, Investigative ophthalmology & visual science.

[83]  Gianni Virgili,et al.  Orientation and mobility training for adults with low vision. , 2010, The Cochrane database of systematic reviews.

[84]  Eli Peli,et al.  Extended wearing trial of Trifield lens device for ‘tunnel vision’ , 2010, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[85]  G. Berdeaux,et al.  Evaluation of Non-Medical Costs Associated with Visual Impairment in Four European Countries , 2012, PharmacoEconomics.