Application of Spatial Cues and Optical Distortions as Augmentations during Virtual Reality (VR) Gaming: The Multifaceted Effects of Assistance for Eccentric Viewing Training

The present study investigates the effects of peripheral spatial cues and optically distorting augmentations over eccentric vision mechanisms in normally sighted participants with simulated scotoma. Five different augmentations were tested inside a virtual reality (VR)-gaming environment. Three were monocular spatial cues, and two were binocular optical distortions. Each was divided into three conditions: baseline with normal viewing, augmentation with one of the assistance methods positioned around the scotoma, and one with only the simulated central scotoma. The study found that the gaming scenario induced eccentric viewing for the cued augmentation groups, even when the peripheral assistance was removed, while for the optical distortions group, the eccentric behavior disappeared after the augmentation removal. Additionally, an upwards directionality of gaze relative to target during regular gaming was found. The bias was maintained and implemented during and after the cued augmentations but not after the distorted ones. The results suggest that monocular peripheral cues could be better candidates for implementing eccentric viewing training in patients. At the same time, it showed that optical distortions might disrupt such behavior. Such results are noteworthy since distortions such as zoom are known to help patients with macular degeneration see targets of interest.