Supervised and unsupervised rehabilitation of visual field defect: cohort investigation of eye movement training at a clinical setting and at home

Lesions along the visual pathways can lead to areas of blindness, which can extend to an entire hemifield (hemianopia). Hemianopic patients often have abnormal eye-movements which hampers their interaction with their immediate surrounds, adversely affecting their quality of life. Compensatory rehabilitation techniques are aimed at improving eye-movement efficacy enabling patients to make better use of their sighted field to compensate for the sight loss. NeuroEyeCoach (NEC) is a compensatory vision therapy that can be accessed at home and is effective in improving visual search performance and reducing perceived disability. We have compared objective and subjective assessments of visual function before and after vision rehabilitation in a cohort of patients that accessed NEC at home (N=95) and a group of patients that completed the training under clinical supervision in a rehabilitation clinic (N=31). Use of NEC led to improvements in both objective measures of visual function such as reduced visual search times, lower search errors, and faster completion of a cancellation task as well as reduced subjective reports of disability. The objective measures showed a larger improvement in those undergoing rehabilitation in the clinic settings compared to the home cohort, nevertheless, there was no cohort x training interaction for perceived improvements in subjective reports of disability. This indicates no significant differences on the effect of training on activities of daily living between the groups. The findings demonstrate that compensatory eye movement training is an effective tool for rehabilitation of vision loss when used in clinical settings or accessed remotely from home.