A reconfigurable real-time morphological system for augmented vision

There is a significant number of visually impaired individuals who suffer sensitivity loss to high spatial frequencies, for whom current optical devices are limited in degree of visual aid and practical application. Digital image and video processing offers a variety of effective visual enhancement methods that can be utilised to obtain a practical augmented vision head-mounted display device. The high spatial frequencies of an image can be extracted by edge detection techniques and overlaid on top of the original image to improve visual perception among the visually impaired. Augmented visual aid devices require highly user-customisable algorithm designs for subjective configuration per task, where current digital image processing visual aids offer very little user-configurable options. This paper presents a highly user-reconfigurable morphological edge enhancement system on field-programmable gate array, where the morphological, internal and external edge gradients can be selected from the presented architecture with specified edge thickness and magnitude. In addition, the morphology architecture supports reconfigurable shape structuring elements and configurable morphological operations. The proposed morphology-based visual enhancement system introduces a high degree of user flexibility in addition to meeting real-time constraints capable of obtaining 93 fps for high-definition image resolution

The effect of magnification and contrast on reading performance in different types of simulated low vision

Low vision therapy, such as magnifiers or contrast enhancement, is widely used. Scientific evidence proving its efficacy is scarce however. The objective of this study was to investigate whether the benefits of magnification and contrast enhancement depended on the origin of low vision. For this purpose we measured reading speed with artificially induced low vision in 12 healthy subjects in conditions of a simulated central scotoma, blurred vision and oscillopsia. Texts were either blurred, set in motion or blanked at the gaze position by using eye tracking and gaze contingent display. The simulated visual impairment was calibrated such that all types of low vision caused equal reading impairment. We then tested the effect of magnification and contrast enhancement among the different types of low vision. We found that reading speed improved with increasing magnification and with higher contrast in all conditions. The effect of magnification was significantly different in the three low vision conditions: The gain from magnification was highest in simulated blur and least in central scotoma. Magnification eventually led to near normal reading speed in all conditions. High contrast was less effective than high magnification and the effect of contrast enhancement was similar in all low vision conditions. From these results we conclude that the type of low vision determines the benefit that can be expected from magnification. Contrast enhancement leads to similar improved reading speed in all low vision types. We provide evidence that supports the use of low vision aids

Ability of head-mounted display technology to improve mobility in people with low vision: a systematic review

Purpose: The purpose of this study was to undertake a systematic literature review on how vision enhancements, implemented using head-mounted displays (HMDs), can improve mobility, orientation, and associated aspects of visual function in people with low vision. Methods: The databases Medline, Chinl, Scopus, and Web of Science were searched for potentially relevant studies. Publications from all years until November 2018 were identified based on predefined inclusion and exclusion criteria. The data were tabulated and synthesized to produce a systematic review. Results: The search identified 28 relevant papers describing the performance of vision enhancement techniques on mobility and associated visual tasks. Simplifying visual scenes improved obstacle detection and object recognition but decreased walking speed. Minification techniques increased the size of the visual field by 3 to 5 times and improved visual search performance. However, the impact of minification on mobility has not been studied extensively. Clinical trials with commercially available devices recorded poor results relative to conventional aids. Conclusions: The effects of current vision enhancements using HMDs are mixed. They appear to reduce mobility efficiency but improved obstacle detection and object recognition. The review highlights the lack of controlled studies with robust study designs. To support the evidence base, well-designed trials with larger sample sizes that represent different types of impairments and real-life scenarios are required. Future work should focus on identifying the needs of people with different types of vision impairment and providing targeted enhancements. Translational Relevance: This literature review examines the evidence regarding the ability of HMD technology to improve mobility in people with sight loss

Head-mounted displays and dynamic text presentation to aid reading in macular disease

The majority of individuals living with significant sight loss have residual vision which can be enhanced using low vision aids. Smart glasses and smartphone-based headsets, both increasing in prevalence, are proposed as a low vision aid platform. Three novel tests for measuring the visibility of displays to partially sighted users are described, along with a questionnaire for assessing subjective preference. Most individuals tested, save those with the weakest vision, were able to see and read from both a smart glasses screen and a smartphone screen mounted in a headset. The scheme for biomimetic scrolling, a text presentation strategy which translates natural eye movement into text movement, is described. It is found to enable the normally sighted to read at a rate five times that of continuous scrolling and is faster than rapid serial visual presentation for individuals with macular disease. With text presentation on the smart glasses optimised to the user, individuals with macular disease read on average 65% faster than when using their habitual optical aid. It is concluded that this aid demonstrates clear benefit over the commonly used devices and is thus recommended for further development towards widespread availability

Are wearable electronic vision enhancement systems (wEVES) beneficial for people with age-related macular degeneration? A scoping review

INTRODUCTION: Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment in the United Kingdom. It has a wide-ranging detrimental impact on daily living, including impairment of functional ability and quality of life. Assistive technology designed to overcome this impairment includes wearable electronic vision enhancement systems (wEVES). This scoping review assesses the usefulness of these systems for people with AMD. METHODS: Four databases (Cumulative Index to Nursing and Allied Health Literature, PubMed, Web of Science and Cochrane CENTRAL) were searched to identify papers that investigated image enhancement with a head-mounted electronic device on a sample population that included people with AMD. RESULTS: Thirty-two papers were included: 18 studied the clinical and functional benefits of wEVES, 11 investigated use and usability and 3 discussed sickness and adverse effects. CONCLUSIONS: Wearable electronic vision enhancement systems provide hands-free magnification and image enhancement producing significant improvements in acuity, contrast sensitivity and aspects of laboratory-simulated daily activity. Adverse effects were infrequent, minor and spontaneously resolved with the removal of the device. However, when symptoms arose, they sometimes persisted with continued device usage. There are multi-factorial influences and a diversity of user opinions on promotors to successful device use. These factors are not exclusively driven by visual improvement and incorporate other issues including device weight, ease of use and inconspicuous design. There is insufficient evidence of any cost-benefit analysis for wEVES. However, it has been shown that a user's decision to make a purchase evolves over time, with their estimates of cost falling below the retail price of the devices. Additional research is needed to understand the specific and distinct benefits of wEVES for people with AMD. Further patient-centred research should assess the benefits of wEVES in user-led activities when directly compared with alternative coping strategies, allowing professionals and users to make better prescribing and purchasing decisions

A Systematic Review of Extended Reality (XR) for Understanding and Augmenting Vision Loss

Over the past decade, extended reality (XR) has emerged as an assistive technology not only to augment residual vision of people losing their sight but also to study the rudimentary vision restored to blind people by a visual neuroprosthesis. To make the best use of these emerging technologies, it is valuable and timely to understand the state of this research and identify any shortcomings that are present. Here we present a systematic literature review of 227 publications from 106 different venues assessing the potential of XR technology to further visual accessibility. In contrast to other reviews, we sample studies from multiple scientific disciplines, focus on augmentation of a person's residual vision, and require studies to feature a quantitative evaluation with appropriate end users. We summarize prominent findings from different XR research areas, show how the landscape has changed over the last decade, and identify scientific gaps in the literature. Specifically, we highlight the need for real-world validation, the broadening of end-user participation, and a more nuanced understanding of the suitability and usability of different XR-based accessibility aids. By broadening end-user participation to early stages of the design process and shifting the focus from behavioral performance to qualitative assessments of usability, future research has the potential to develop XR technologies that may not only allow for studying vision loss, but also enable novel visual accessibility aids with the potential to impact the lives of millions of people living with vision loss

Improving face perception and quality of life in age-related macular degeneration

The ability to see faces is essential for successful social interactions and good quality of life. Age-related macular degeneration (AMD) is a progressive eye condition that damages central vision required to see faces clearly. This thesis aims to investigate potential means to improve quality of life in AMD, via a two-pronged approach. The first prong examines the importance of face recognition difficulties, using a qualitative study of the effects of poor face perception in AMD on social interactions and quality of life. Previous studies of the impact of AMD on quality of life have focussed on domains including reading, driving, and self-care. Paper 1 of the thesis presents the first in-depth study of the quality-of-life impacts arising specifically from poor face perception. Results showed that, across all levels of vision loss (still driving through legally blind), AMD patients experience everyday problems with recognising who people are (face identity) and their emotions (facial expressions). These result in difficulties in social interactions, fear of offending others (e.g., appearing to ignore them deliberately), misinterpreting how others are feeling, and missing out in social situations. Patients also reported others did not understand their vision loss, and worried about appearing a fraud. These outcomes often contributed to social withdrawal and reduced confidence and quality of life. Paper 1 uses the study findings to develop new community resources (Faces and Social Life in AMD information sheet, conversation-starter, brochure for low-vision clinics), intended to improve patient and community understanding of how AMD affects face perception, and to provide practical tips for improving social interactions. The second prong focusses on improving face perception in AMD patients via image enhancement. The broad idea here is that, potentially, face images can be displayed to patients on screens or smart glasses after being digitally altered in ways that make them easier for patients to see and interpret. The specific image enhancement tested here is caricaturing, which involved exaggerating the shape information in the face image away from the average face (for face identity) or a neutral expression (for face expression). Paper 2 demonstrates that caricaturing can improve perception of identity in AMD; this benefit was observed for all eyes tested with mild vision loss, and half of eyes tested with moderate-to-severe vision loss. Paper 3 demonstrated that caricaturing can improve perception of facial expression in AMD, particularly for low-intensity expressions that are poorly recognised in their natural form, again across a wide range of vision loss. Overall, this thesis demonstrates that poor face perception in AMD is an important contributor to patients’ reduced quality of life. With the aim of enhancing quality of life, I have developed resources to improve community understanding, plus demonstrated that caricaturing provides a useful image enhancement method in AMD. Future research should focus on: further evaluation of the helpfulness of the community resources (to patients, carers and orthoptists); testing whether combining image enhancement methods (e.g., caricaturing plus contrast manipulations) can further improve face perception; and engineering advances needed to implement accurate caricaturing for patients in real-time

Narrow-Band Imaging in Digestive Endoscopy

The application of opto-electronics in video-endoscopes improves the accuracy in diagnosis, through image processing and digital technology. Narrow Band Imaging (NBI), consists of using interference filters for the illumination of the target in narrowed blue and green bands of the spectrum. NBI is combined with magnifying endoscopy using an objective macro or an optical zoom. The NBI technique developed by Olympus Medical Systems is now available in the most recent models of video-endoscopes that use the non-sequential system of illumination (Lucera Spectrum) or the sequential R/G/B system of illumination (Exera II). The major contribution of the technique is in the characterization (analysis after detection) of the flat and superficial neoplastic areas of the digestive mucosa, with a specific application to the identification of intestinal metaplasia and early neoplastic changes in the Barrett's esophagus. The technique also proves helpful for the assessment of the vascular pattern in chronic inflammatory disorders of the digestive mucosa

Evaluation and optimization of central vision compensation techniques

Non-costly, non-invasive, safe, and reliable electronic vision enhancement systems (EVES) and their methods have presented a huge medical and industrial demand in the early 21st century. Two unique, vision compensation and enhancement algorithms are reviewed and compared, qualitatively optimizing the view of a restricted (or truncated) image. The first is described as the convex or fish-eye technique, and the second is the cartoon superimposition or Peli technique (after the leading author for this research). The novelty in this dissertation is in presenting and analyzing both of these with a comparison to a novel technique, motivated by characterization of quality vision parameters (or the distribution of photoreceptors in the eye), in an attempt to account for and compensate reported viewing difficulties and low image quality measures associated with these two existing methods.;This partial cartoon technique is based on introducing the invisible image to the immediate left and right of the truncated image as a superimposed cartoon into respective sides of the truncated image, yet only on a partial basis as not to distract the central view of the image. It is generated and evaluated using MatlabRTM to warp sample grayscale images according to predefined parameters such as warping method, cartoon and other warping parameters, different grayscale values, as well as comparing both the static and movie modes. Warped images are quantitatively compared by evaluating the Root-Mean-Square Error (RMSE) and the Universal Image Quality Index (UIQI), both representing image distortion and quality measures of warped, as compared to original images for five different scenes; landscape, close-up, obstacle, text, and home (or low-illumination) views. Remapped images are also evaluated through surveys performed on 115 subjects, where improvement is assessed using measures of image detail and distortion.;It is finally concluded that the presented partial cartoon method exhibits superior image quality for all objective measures, as well as for a majority of subjective distortion measures. Justification is provided as to why the technique does not offer superior subjective detail measures. Further improvement is suggested, as well as additional techniques and research