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Examples of the simulations of the three visual impairments in the VR platform: (a) severe age-related macular degeneration, (b) severe diabetic retinopathy, and (c) severe glaucoma.
Context in source publication
Context 1
... VR, we simulated age-related macular degeneration (AMD), diabetic retinopathy (DR), and glaucoma since they represent the fastest-growing and leading causes of VI among people of working age in recent times (Fig. 1). The initial symptoms of AMD often consist of distorted vision and visual loss in the center of the visual field that progresses slowly leading to a complete loss of central vision. 24 Patients with AMD often have increasing difficulty reading and recognizing objects and faces; spatial orientation, however, is preserved through the ...
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Citations
... ETAs are often complex and even counter-intuitive, such that their use requires a significant amount of training [18]. To address these problems, there is an immediate need for a platform that can: i) support the development, testing, and refinement out of the prototype stage of ETAs, targeted to end-users; and ii) train persons with VIs to use ETAs within realistic scenarios, while limiting their risk of injury in the process [22][23][24]. ...
Visual impairment represents a significant health and economic burden affecting 596 million globally. The incidence of visual impairment is expected to double by 2050 as our population ages. Independent navigation is challenging for persons with visual impairment, as they often rely on non-visual sensory signals to find the optimal route. In this context, electronic travel aids are promising solutions that can be used for obstacle detection and/or route guidance. However, electronic travel aids have limitations such as low uptake and limited training that restrict their widespread use. Here, we present a virtual reality platform for testing, refining, and training with electronic travel aids. We demonstrate the viability on an electronic travel aid developed in-house, consist of a wearable haptic feedback device. We designed an experiment in which participants donned the electronic travel aid and performed a virtual task while experiencing a simulation of three different visual impairments: age-related macular degeneration, diabetic retinopathy, and glaucoma. Our experiments indicate that our electronic travel aid significantly improves the completion time for all the three visual impairments and reduces the number of collisions for diabetic retinopathy and glaucoma. Overall, the combination of virtual reality and electronic travel aid may have a beneficial role on mobility rehabilitation of persons with visual impairment, by allowing early-phase testing of electronic travel aid prototypes in safe, realistic, and controllable settings.
... Several researchers have designed virtual/augmented reality (VR/AR) systems for training persons with VI in the navigation of unknown environment [17][18][19][20] and in the proper use of ETAs. [21][22][23][24][25] By creating customized visual and auditory cues, VR/AR offers the unique possibility to train and assist users with a specific task in virtual environments, which are safe, controllable, realistic, and engaging. In fact, VR/AR improve the training process by offering virtual settings in which real stimuli are perceived through multi-sensory feedback modalities. ...
Background
Visual disability is a growing problem for many middle-aged and older adults. Conventional mobility aids, such as white canes and guide dogs, have notable limitations that have led to increasing interest in electronic travel aids (ETAs). Despite remarkable progress, current ETAs lack empirical evidence and realistic testing environments and often focus on the substitution or augmentation of a single sense.
Objective
This study aims to (1) establish a novel virtual reality (VR) environment to test the efficacy of ETAs in complex urban environments for a simulated visual impairment (VI) and (2) evaluate the impact of haptic and audio feedback, individually and combined, on navigation performance, movement behavior, and perception. Through this study, we aim to address gaps to advance the pragmatic development of assistive technologies (ATs) for persons with VI.
Methods
The VR platform was designed to resemble a subway station environment with the most common challenges faced by persons with VI during navigation. This environment was used to test our multisensory, AT-integrated VR platform among 72 healthy participants performing an obstacle avoidance task while experiencing symptoms of VI. Each participant performed the task 4 times: once with haptic feedback, once with audio feedback, once with both feedback types, and once without any feedback. Data analysis encompassed metrics such as completion time, head and body orientation, and trajectory length and smoothness. To evaluate the effectiveness and interaction of the 2 feedback modalities, we conducted a 2-way repeated measures ANOVA on continuous metrics and a Scheirer-Ray-Hare test on discrete ones. We also conducted a descriptive statistical analysis of participants’ answers to a questionnaire, assessing their experience and preference for feedback modalities.
Results
Results from our study showed that haptic feedback significantly reduced collisions (P=.05) and the variability of the pitch angle of the head (P=.02). Audio feedback improved trajectory smoothness (P=.006) and mitigated the increase in the trajectory length from haptic feedback alone (P=.04). Participants reported a high level of engagement during the experiment (52/72, 72%) and found it interesting (42/72, 58%). However, when it came to feedback preferences, less than half of the participants (29/72, 40%) favored combined feedback modalities. This indicates that a majority preferred dedicated single modalities over combined ones.
Conclusions
AT is crucial for individuals with VI; however, it often lacks user-centered design principles. Research should prioritize consumer-oriented methodologies, testing devices in a staged manner with progression toward more realistic, ecologically valid settings to ensure safety. Our multisensory, AT-integrated VR system takes a holistic approach, offering a first step toward enhancing users’ spatial awareness, promoting safer mobility, and holds potential for applications in medical treatment, training, and rehabilitation. Technological advancements can further refine such devices, significantly improving independence and quality of life for those with VI.
Blind or low-vision (BLV) individuals often have reduced independent mobility, yet new aids fails in increasing it, are not adopted enough, or both. A major cause is a severe deficiency in how mobility aids are assessed in the field: there are no established methods or measures and those used often have poor relevancy, insight affordances, and reproducibility; probing how actual BLV participants regard a proposed aid and how they compare to current aids is rare; and crucially, tests feature too few BLV participants. In this work two tools are introduced to alleviate this: a portable, large-scale-exploration, virtual reality (VR) system; and a comprehensive, aid-agnostic questionnaire focused on BLV mobility. The questionnaire has been validated once with eight orientation and mobility experts and six BLV respondents. Further, both it and the VR system have been applied in aid assessment with 19 BLV participants in a separate study. The VR system is to our knowledge the first in the field designed for portable evaluation, helping considerably in recruiting adequate numbers of BLV participants, for instance by allowing for testing in participants’ homes; while also supporting reproducible and motivated tests and analyses. The questionnaire provides a systematic method to investigate respondents’ views of numerous important facets of a proposed mobility aid, and how they relate to other aids. These tools should assist in achieving a widely adopted aid that meaningfully improves its users’ mobility.
