Vision improvement in pilots with presbyopia following perceptual learning

&NA; Israeli Air Force (IAF) pilots continue flying combat missions after the symptoms of natural near‐vision deterioration, termed presbyopia, begin to be noticeable. Because modern pilots rely on the displays of the aircraft control and performance instruments, near visual acuity (VA) is essential in the cockpit. We aimed to apply a method previously shown to improve visual performance of presbyopes, and test whether presbyopic IAF pilots can overcome the limitation imposed by presbyopia. Participants were selected by the IAF aeromedical unit as having at least initial presbyopia and trained using a structured personalized perceptual learning method (GlassesOff application), based on detecting briefly presented low‐contrast Gabor stimuli, under the conditions of spatial and temporal constraints, from a distance of 40 cm. Our results show that despite their initial visual advantage over age‐matched peers, training resulted in robust improvements in various basic visual functions, including static and temporal VA, stereoacuity, spatial crowding, contrast sensitivity and contrast discrimination. Moreover, improvements generalized to higher‐level tasks, such as sentence reading and aerial photography interpretation (specifically designed to reflect IAF pilots' expertise in analyzing noisy low‐contrast input). In concert with earlier suggestions, gains in visual processing speed are plausible to account, at least partially, for the observed training‐induced improvements.

[1]  D. Glaser,et al.  Initial performance, learning and observer variability for hyperacuity tasks , 1993, Vision Research.

[2]  Uri Polat,et al.  Gains following perceptual learning are closely linked to the initial visual acuity , 2016, Scientific Reports.

[3]  R E Miller,et al.  Prescribing spectacles for aviators: USAF experience. , 1992, Aviation, space, and environmental medicine.

[4]  Uri Polat,et al.  The Effects of Perceptual Learning on Visual Processing Functions in Professional Baseball Players: 3171 Board #236 June 3, 2: 00 PM - 3: 30 PM. , 2016, Medicine and science in sports and exercise.

[5]  U. Tulunay-Keesey,et al.  Threshold and suprathreshold spatiotemporal response throughout adulthood. , 1988, Journal of the Optical Society of America. A, Optics and image science.

[6]  V. Ramachandran,et al.  Learning-like phenomena in stereopsis , 1976, Nature.

[7]  R K Jones,et al.  Why two eyes are better than one: the two views of binocular vision. , 1981, Journal of experimental psychology. Human perception and performance.

[8]  Uri Polat,et al.  Learning to be fast: Gain accuracy with speed , 2012, Vision Research.

[9]  Roger W Li,et al.  Prolonged Perceptual Learning of Positional Acuity in Adult Amblyopia: Perceptual Template Retuning Dynamics , 2008, The Journal of Neuroscience.

[10]  Zoe Kourtzi,et al.  Flexible learning of natural statistics in the human brain. , 2009, Journal of neurophysiology.

[11]  M. Corbetta,et al.  Learning sculpts the spontaneous activity of the resting human brain , 2009, Proceedings of the National Academy of Sciences.

[12]  Jane F. Koretz,et al.  Accommodation and presbyopia in the human eye—aging of the anterior segment , 1989, Vision Research.

[13]  Uri Polat,et al.  Crowding is proportional to visual acuity in young and aging eyes. , 2015, Journal of vision.

[14]  Gerald Westheimer,et al.  Can perceptual learning compensate for optical image blur? , 2014, Vision Research.

[15]  Gianluca Campana,et al.  Reducing Crowding by Weakening Inhibitory Lateral Interactions in the Periphery with Perceptual Learning , 2011, PloS one.

[16]  Roger Ratcliff,et al.  Dissociable Perceptual-learning Mechanisms Revealed by Diffusion-model Analysis , 2022 .

[17]  Paul V. McGraw,et al.  A Weber-like law for perceptual learning , 2013, Scientific Reports.

[18]  Uri Polat.  Improving Abnormal Spatial Vision in Adults with Amblyopia , 2005 .

[19]  Leslie G. Ungerleider,et al.  The acquisition of skilled motor performance: fast and slow experience-driven changes in primary motor cortex. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[20]  Ron D. Hays,et al.  Associations of Presbyopia With Vision-Targeted Health-Related Quality of Life , 2003 .

[21]  Lihua He,et al.  Functional degradation of visual cortical cells in old cats , 2006, Neurobiology of Aging.

[22]  Roger W. Li,et al.  Video-Game Play Induces Plasticity in the Visual System of Adults with Amblyopia , 2011, PLoS biology.

[23]  Philipp Sterzer,et al.  Training improves visual processing speed and generalizes to untrained functions , 2014, Scientific Reports.

[24]  Takeo Watanabe,et al.  Accounting for speed-accuracy tradeoff in visual perceptual learning , 2010 .

[25]  A J O'Toole,et al.  Learning to See Random-Dot Stereograms , 1992, Perception.

[26]  Uri Polat,et al.  Making perceptual learning practical to improve visual functions , 2009, Vision Research.

[27]  V B Nakagawara,et al.  Monovision contact lens use in the aviation environment: a report of a contact lens-related aircraft accident. , 2000, Optometry.

[28]  Pengjing Xu,et al.  Perceptual learning improves contrast sensitivity and visual acuity in adults with anisometropic amblyopia , 2006, Vision Research.

[29]  Uri Polat,et al.  Training the brain to overcome the effect of aging on the human eye , 2012, Scientific Reports.

[30]  B. Brown,et al.  Age-Related Changes in Contrast Sensitivity in Central and Peripheral Retina , 1988, Perception.

[31]  W Skrandies,et al.  Learning to see 3-D: psychophysics and brain electrical activity. , 1999, Neuroreport.

[32]  Uri Polat,et al.  Restoration of underdeveloped cortical functions: evidence from treatment of adult amblyopia. , 2008, Restorative neurology and neuroscience.

[33]  Yifeng Zhou,et al.  Age-related decline of contrast sensitivity for second-order stimuli: earlier onset, but slower progression, than for first-order stimuli. , 2009, Journal of vision.

[34]  U. Polat,et al.  Lateral interactions between spatial channels: Suppression and facilitation revealed by lateral masking experiments , 1993, Vision Research.

[35]  Uri Polat,et al.  Training on spatiotemporal masking improves crowded and uncrowded visual acuity. , 2015, Journal of vision.

[36]  C. Gilbert,et al.  The Neural Basis of Perceptual Learning , 2001, Neuron.

[37]  David Whitaker,et al.  Neural contribution to spatiotemporal contrast sensitivity decline in healthy ageing eyes , 1990, Vision Research.

[38]  D. Melmoth,et al.  Eye-hand coordination skills in children with and without amblyopia. , 2011, Investigative ophthalmology & visual science.

[39]  O Braddick,et al.  Orientation-Specific Learning in Stereopsis , 1973, Perception.

[40]  J E Sheedy,et al.  Binocular vs. Monocular Task Performance , 1986, American journal of optometry and physiological optics.

[41]  B. Julesz.  Foundations of Cyclopean Perception , 1971 .

[42]  Susana T. L. Chung,et al.  Spatial-frequency and contrast properties of crowding , 2001, Vision Research.

[43]  Nakagawara,et al.  Monovision contact lens use in the aviation environment: a report of a contact lens-related aircraft accident(1) , 2000, American journal of ophthalmology.

[44]  D. Tan,et al.  Efficacy of neural vision therapy to enhance contrast sensitivity function and visual acuity in low myopia , 2008, Journal of Cataract & Refractive Surgery.

[45]  C. Owsley.  Aging and vision , 2011, Vision Research.

[46]  G. Westheimer,et al.  Target crowding in foveal and peripheral stereoacuity. , 1988, American journal of optometry and physiological optics.

[47]  Paul T. Sowden,et al.  Perceptual Learning of Stereoacuity , 1996, Perception.

[48]  Dennis M Levi,et al.  Suppressive and facilitatory spatial interactions in foveal vision: foveal crowding is simple contrast masking. , 2002, Journal of vision.

[49]  Andrew B Watson,et al.  Blur clarified: a review and synthesis of blur discrimination. , 2011, Journal of vision.

[50]  Michael Belkin,et al.  Improving vision in adult amblyopia by perceptual learning. , 2004, Proceedings of the National Academy of Sciences of the United States of America.

[51]  Allison M McKendrick,et al.  Aging effects on collinear facilitation. , 2012, Journal of vision.

[52]  D. Sagi.  Perceptual learning in Vision Research , 2011, Vision Research.

[53]  D. Levi.  Crowding—An essential bottleneck for object recognition: A mini-review , 2008, Vision Research.

[54]  A. Leventhal,et al.  Degradation of stimulus selectivity of visual cortical cells in senescent rhesus monkeys , 2000, Nature Neuroscience.

[55]  David G Newman,et al.  An overview of spatial disorientation as a factor in aviation accidents and incidents , 2007 .

[56]  C S Green,et al.  Action-Video-Game Experience Alters the Spatial Resolution of Vision , 2007, Psychological science.

[57]  Shahina Pardhan,et al.  The Repeatability of MNREAD Acuity Charts and Variability at Different Test Distances , 2006, Optometry and vision science : official publication of the American Academy of Optometry.

[58]  G. Westheimer,et al.  Effects of practice and the separation of test targets on foveal and peripheral stereoacuity , 1983, Vision Research.

[59]  Uri Polat,et al.  Uncovering foveal crowding? , 2014, Scientific Reports.

[60]  Uri Polat,et al.  Treatment of children with amblyopia by perceptual learning , 2009, Vision Research.

[61]  R. Sekuler,et al.  Contrast sensitivity throughout adulthood , 1982, Vision Research.

[62]  Gordon E Legge,et al.  Does print size matter for reading? A review of findings from vision science and typography. , 2011, Journal of vision.

[63]  D. Pelli,et al.  Crowding is unlike ordinary masking: distinguishing feature integration from detection. , 2004, Journal of vision.

[64]  S. Hochstein,et al.  View from the Top Hierarchies and Reverse Hierarchies in the Visual System , 2002, Neuron.

[65]  I. Rentschler,et al.  Contrast thresholds for identification of numeric characters in direct and eccentric view , 1991, Perception & psychophysics.

[66]  C. Owsley,et al.  Aging, senile miosis and spatial contrast sensitivity at low luminance , 1988, Vision Research.

[67]  D. Levi,et al.  Visual crowding: a fundamental limit on conscious perception and object recognition , 2011, Trends in Cognitive Sciences.

[68]  Guangxing Li,et al.  Declined contrast sensitivity of neurons along the visual pathway in aging cats , 2014, Front. Aging Neurosci..

[69]  George J. Andersen,et al.  Optimization of perceptual learning: Effects of task difficulty and external noise in older adults , 2014, Vision Research.

[70]  Yuanye Ma,et al.  Functional degradation of the primary visual cortex during early senescence in rhesus monkeys. , 2013, Cerebral cortex.

[71]  Michael Dorr,et al.  Visual Psychophysics and Physiological Optics Rapid and Reliable Assessment of the Contrast Sensitivity Function on an iPad , 2013 .