Eyelander at CVRS London 2023

Last week I attended the 18th Biennial Child Vision Research Society meeting at UCL Great Ormond Street Institute of Child Health. The meeting included a symposium in honour of the late Oliver Braddick, co-founder of the UCL/Oxford Visual Development Unit together with Janette Atkinson who gave an impressive overview of the unit’s pioneering work on infant vision over the decades as part of the session.

Amongst the many other highlights of the meeting, Cathy Williams (University of Bristol), presented evidence for sub-types of Cerebral Visual Impairment (CVI) in children. It has become apparent recently that a surprisingly high proportion of children in main stream classrooms may have such brain based visual problems.

My own talk about the Eyelander game was the last presentation of the conference! But everyone stayed right to the end and seemed to really enjoy it! Eyelander is a gamified version of compensatory visual search training for children with loss of vision on one side (hemianopia) . Selective loss of vision to the left or right might occur following brain injury or neurosurgery, but may also be found in many children with CVI (see above).

I really enjoyed the CVRS meeting. It was great to meet so many new people. In fact, it was one of the friendliest and most enjoyable meetings I’ve ever been to, so I will be sure to go again in 2 years time!

Eyelander game at VIEW conference

Recently I attended the VIEW conference for Visual impairment (VI) specialist teachers and professionals in Birmingham, to raising awareness of our Eyelander online game for children with partial visual field loss (Hemianopia).

Eyelander is based on visual search training programmes that have been shown to be effective in improving functional visual abilities in adults that suffer from Homonymous visual field loss following stroke. In the game you have to search for coloured shapes amongst “distractor” shapes, with varying levels of task difficult as the game progresses. As you complete more searches your character (the “Eyelander”) make progress in escaping a volcanic desert island.

The game is available to play via a web browser, either on a computer with a mouse / laptop or a touch screen device. Its efficacy was validated via a published small scale trial in a group of children and young people with well defined hemianopia, suggesting playing the game every day over a period of 4 to 6 weeks can lead to improved visual abilities.

There was lots of interest in the game from VI teachers, who feel that partial visual field loss and problems seeing on one side is very common in the children they work with. Estimates for number of children with some form of brain based visual impairment (also known as Cerebral Visual Impairment or CVI) and many of these may have visual field problems. Given this we are keen for more parents, children, teachers and others working with children with VI to know about Eyelander and to give it a go.

So visit www.eyelander.co.uk and register to play!

Hemi-disconnection project at Great Ormond Street Hospital

This week I have been at Great Ormond Street Hospital London setting up some tasks on an Eyelink Duo eye tracker for a project led by Dr Luis Lacerda and Prof. Chris Clark with Vision Specialist Clinical Scientist Sian Hanley.

The project will examine children’s recovery of visual function following Hemisphere disconnection surgery (which can be used to treat severe epilepsy). Luis’ team will evaluate the effectiveness of our Eyelander game for training visual search ability in these children as well as UCL’s Read Right programme, developed by my old colleague and collaborator Prof. Alex Leff.

It’s been great to visit and a privilege to be involved in such an exciting project with such an outstanding team of researchers and clinicians. Feel free to get in touch with Luis if you would like to know more about the project.

Eyelander Goes Mobile

The Eyelander game for children with visual field loss is now compatible for use on mobile devices such as phones and tablets!

The game is based on visual search training that has been shown to be effective in improving functional visual abilities in adults with homonymous hemianopia. Our recent evaluation trial showed Eyelander delivered similar magnitude of improvement in functional visual abilities in children and young adults as the more boring adult training programmes. You can play the game and sign up for research to give us feedback on the game via the Eyelander website http://www.eyelander.co.uk. It is free to play and is designed to be colourful, fun and engaging for children. Players search for shapes on the screen which help their character to escape from a mysterious island.

We have been taking a step by step approach to making the game more widely available as we build the evidence base for its effectiveness, but we decided now was the time to make it more widely available for tablets and phones. It actually makes the game more fun to play using a touch screen rather than a mouse and cursor so I am really pleased with the results.

 

 

 

 

 

The game was developed in collaboration with The WESC Foundation Exeter, the School of Computer Science University of Lincoln and Mutant Labs Ltd Plymouth. See here for previous blog posts on the game development and evaluation: Eyelander game evaluation and Parkinsons and Spatial Memory studies published “EyeLander” game for children with VI now available! “Game-ifying” visual search training for children

Eyelander game evaluation and Parkinsons and Spatial Memory studies published

Research in patients both young and old can be difficult, time consuming and stressful to carry out (e.g. due to the ethical approval process, patient recruitment and practical difficulties in testing patients with physical disabilities etc). Yet the importance and potential benefits to patients themselves of such research far out weighs the difficulty entailed in conducting it.

Two of my recently published papers reflect the outcome of patient based projects. Both studies use tasks which require viewers to search through items on a screen using saccadic eye movements. The first addressed the issue of working memory and oculomotor control in Parkinsons disease, a topic I have been researching since the late 1990s. Whilst the second reports the clinical trial evaluating the effectiveness of the Eyelander video game for children who have had neurological injury leading to partial visual field loss (hemianopia).

In the first study, published in the April 2019 edition of the Journal of Cognitive Neuroscience we recorded eye movements while participants performed a version of the CANTAB Spatial Working Memory task which requires patients to search through boxes on a computer screen to find hidden tokens. I first had the idea to do this study whilst watching patients performing this task on a touch screen when I was a post-doctoral research fellow at Charing Cross Hospital, London. I could see that patients were using eye movements a lot in this token “foraging” task, but at the time we didnt have the technology to track their eye movements properly. It was only later that suitable eye tracking equipment and software became available to carry out the research. Amongst other findings the paper shows that people with Parkinsons don’t use eye movements to plan ahead or look back at locations they’ve already searched as effectively as controls, most likely due to an imbalance of the neurotransmitter dopamine in the prefrontal cerebral cortex.

 

The second paper, published in the December 2018 edition of Journal of Visual Impairment and Blindness describes the evaluation of our visual search  game for children with partial visual loss following brain injury affecting the visual parts of the cerebral cortex. The results showed children were able to play the game at home unsupervised and that it had a positive effect on parallel measures of functional visual ability which was similar in magnitude to effects reported for visual search training in adult with partial visual loss following stroke. The Eyelander game is now available for anyone to play online, so please take a look. We are also starting a collaborative project with Great Ormond Street Hospital to evaluate its effectiveness for treating visual field loss following neurosurgical procedures in children.