Mobility-Related Gaze Training in Individuals With Glaucoma: A Proof-of-Concept Study

PURPOSE: Older adults with glaucoma show inappropriate gaze strategies during routine mobility tasks. Furthermore, glaucoma is a risk factor for falling and colliding with objects when walking. However, effective interventions to rectify these strategies and prevent these adverse events are scarce. We designed a gaze training program with the goal of providing proof-of-concept that we could modify mobility-related gaze behavior in this population. METHODS: A total of 13 individuals with moderate glaucoma participated in this study. We taught participants general and task-specific gaze strategies over two 1-hour sessions. To determine the efficacy of this gaze training program, participants performed walking tasks that required accurate foot placement onto targets and circumventing obstacles before and after training. We used a mobile eye tracker to quantify gaze and a motion-capture system to quantify body movement. RESULTS: After training, we found changes in the timing between gaze shifts away from targets relative to stepping on them (P < 0.05). In the obstacle negotiation task, we found a greater range of gaze shifts early in walking trials and changes in the timing between gaze shifts away from obstacles after training (P < 0.05), each suggesting better route planning. A posttraining reduction in foot-placement error and obstacle collisions accompanied these changes (P < 0.05). CONCLUSIONS: Our results demonstrated that it is possible to modify mobility-related gaze behavior and mobility performance in older adults with glaucoma. TRANSLATIONAL RELEVANCE: This study provides proof-of-concept for a gaze training program for glaucoma. A larger, randomized controlled trial is warranted.