Face recognition in age related macular degeneration: perceived disability, measured disability, and performance with a bioptic device

Aims: (1) To explore the relation between performance on tasks of familiar face recognition (FFR) and face expression difference discrimination (FED) with both perceived disability in face recognition and clinical measures of visual function in subjects with age related macular degeneration (AMD). (2) To quantify the gain in performance for face recognition tasks when subjects use a bioptic telescopic low vision device. Methods: 30 subjects with AMD (age range 66–90 years; visual acuity 0.4–1.4 logMAR) were recruited for the study. Perceived (self rated) disability in face recognition was assessed by an eight item questionnaire covering a range of issues relating to face recognition. Visual functions measured were distance visual acuity (ETDRS logMAR charts), continuous text reading acuity (MNRead charts), contrast sensitivity (Pelli-Robson chart), and colour vision (large panel D-15). In the FFR task, images of famous people had to be identified. FED was assessed by a forced choice test where subjects had to decide which one of four images showed a different facial expression. These tasks were repeated with subjects using a bioptic device. Results: Overall perceived disability in face recognition did not correlate with performance on either task, although a specific item on difficulty recognising familiar faces did correlate with FFR (r = 0.49, p<0.05). FFR performance was most closely related to distance acuity (r = −0.69, p<0.001), while FED performance was most closely related to continuous text reading acuity (r = −0.79, p<0.001). In multiple regression, neither contrast sensitivity nor colour vision significantly increased the explained variance. When using a bioptic telescope, FFR performance improved in 86% of subjects (median gain = 49%; p<0.001), while FED performance increased in 79% of subjects (median gain = 50%; p<0.01). Conclusion: Distance and reading visual acuity are closely associated with measured task performance in FFR and FED. A bioptic low vision device can offer a significant improvement in performance for face recognition tasks, and may be useful in reducing the handicap associated with this disability. There is, however, little evidence for a correlation between self rated difficulty in face recognition and measured performance for either task. Further work is needed to explore the complex relation between the perception of disability and measured performance.

[1]  S. Haymes,et al.  Relationship between vision impairment and ability to perform activities of daily living , 2002, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[2]  A W Johnston,et al.  The development of the Melbourne low-vision ADL index: a measure of vision disability. , 2001, Investigative ophthalmology & visual science.

[3]  D. Henson,et al.  Randomised controlled trial of an integrated versus an optometric low vision rehabilitation service for patients with age‐related macular degeneration: study design and methodology , 2001, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[4]  D. Levin.  Race as a visual feature: using visual search and perceptual discrimination tasks to understand face categories and the cross-race recognition deficit. , 2000, Journal of experimental psychology. General.

[5]  H T Kukkonen,et al.  The effect of contrast and size scaling on face perception in foveal and extrafoveal vision. , 2000, Investigative ophthalmology & visual science.

[6]  K L Petre,et al.  Visual function and subjective quality of life compared in subjects with acquired macular disease. , 2000, Investigative ophthalmology & visual science.

[7]  J. Lowe,et al.  Distance Telescopes: A Survey of User Success , 2000, Optometry and vision science : official publication of the American Academy of Optometry.

[8]  U Chakravarthy,et al.  Macular degeneration: do conventional measurements of impaired visual function equate with visual disability? , 2000, The British journal of ophthalmology.

[9]  C. Mangione,et al.  Influence of age-related maculopathy on visual functioning and health-related quality of life. , 1999, American journal of ophthalmology.

[10]  K Bandeen-Roche,et al.  Characteristics of discrepancies between self-reported visual function and measured reading speed. Salisbury Eye Evaluation Project Team. , 1999, Investigative ophthalmology & visual science.

[11]  C Owsley,et al.  Identifying the content area for the 51-item National Eye Institute Visual Function Questionnaire: results from focus groups with visually impaired persons. , 1998, Archives of ophthalmology.

[12]  W. Feuer,et al.  Visual function and quality of life among patients with glaucoma. , 1997, Archives of ophthalmology.

[13]  J. G. Strong,et al.  Demographic characteristics of the vision-disabled elderly. , 1997, Investigative ophthalmology & visual science.

[14]  Gale R. Watson,et al.  National Survey of the Impact of Low Vision Device Use among Veterans , 1997, Optometry and vision science : official publication of the American Academy of Optometry.

[15]  R. Wormald,et al.  Is the incidence of registrable age-related macular degeneration increasing? , 1996, The British journal of ophthalmology.

[16]  G E Legge,et al.  Color improves object recognition in normal and low vision. , 1993, Journal of experimental psychology. Human perception and performance.

[17]  D. Madden,et al.  Use of spectacle mounted telescope systems by the visually impaired. , 1993, Journal of the American Optometric Association.

[18]  S J Leat,et al.  Reading performance with low vision aids: relationship with contrast sensitivity , 1993, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[19]  E F Cook,et al.  Development of the Activities of Daily Vision Scale: A Measure of Visual Functional Status , 1992, Medical care.

[20]  J. Stelmack,et al.  Preliminary Examination of the Reliability and Relation to Clinical State of a Measure of Low Vision Patient Functional Status , 1991, Optometry and vision science : official publication of the American Academy of Optometry.

[21]  E. Peli,et al.  Image enhancement for the visually impaired. Simulations and experimental results. , 1991, Investigative ophthalmology & visual science.

[22]  I L Bailey,et al.  Face recognition in age-related maculopathy. , 1991, Investigative ophthalmology & visual science.

[23]  D. Whitaker,et al.  Differences in the legibility of letters at contrast threshold using the Pelli‐Robson chart , 1990, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[24]  G. Lennerstrand,et al.  Contrast sensitivity in macular degeneration and the relation to subjective visual impairment , 1989, Acta ophthalmologica.

[25]  M G Maguire,et al.  Assessment of visual function in patients with age-related macular degeneration and low visual acuity. , 1988, Archives of ophthalmology.

[26]  C. Owsley,et al.  Contrast sensitivity, acuity, and the perception of 'real-world' targets. , 1987, The British journal of ophthalmology.

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

[28]  M G Maguire,et al.  Functional vision in patients with neovascular maculopathy and poor visual acuity. , 1986, Archives of ophthalmology.

[29]  I. Bailey,et al.  Visual Factors and Orientation‐Mobility Performance , 1982, American journal of optometry and physiological optics.

[30]  R. Sekuler,et al.  Aging and low-contrast vision: face perception. , 1981, Investigative ophthalmology & visual science.

[31]  G S Rubin,et al.  The association of multiple visual impairments with self-reported visual disability: SEE project. , 2001, Investigative ophthalmology & visual science.

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

[33]  D. Madden,et al.  The Ocutech Vision Enhancing System (VES): utilization and preference study. , 1991, Journal of the American Optometric Association.

[34]  M. Bullimore,et al.  Improving the Reliability of the Pelli-Robson Contrast Sensitivity Test , 1991, Noninvasive Assessment of the Visual System.

[35]  David B Elliott,et al.  Comparing clinical tests of visual function in cataract with the patient's perceived visual disability , 1990, Eye.

[36]  Gs Rubin,et al.  Does Contrast Sensitivity Predict face Recognition Performance in Low-Vision Observers? , 1990, Noninvasive Assessment of the Visual System.

[37]  P E King-Smith,et al.  A quantitative scoring technique for panel tests of color vision. , 1988, Investigative ophthalmology & visual science.

[38]  A. Adelstein.  Studies on medical and population subjects. , 1976 .