Explorative Saccade Training in Children with Homonymous Hemianopia

Background/Purpose: In adult patients with homonymous hemianopia, computer-based saccade training can lead to significant improvements of visual search.¹ Here, we developed and tested a child-adapted training program.

Methods: Twenty-two children and adolescents (age range: 6–19 years, median: 11 years) with homonymous visual field defects (19 hemianopias, 3 quadrant anopias; 5 since birth, 17 acquired during childhood) trained at home with a child-adapted PC-based explorative saccade training program over 6 weeks for 5 days/week and 15 minutes/day. Visual search tasks (PC-based and real-world) were measured before, immediately after, and 6 weeks after the training. Changes in search strategies were monitored by eye tracking.

Results: Significantly shorter search times (until the targets were found) were measured immediately after training as well as 6 weeks later. The search strategies changed, with a relative increase of saccades toward the blind hemifields. No changes were observed for basal search parameters (frequency of saccades [per minute], duration of fixation).

Conclusion: A child-adapted explorative saccade training leads to significant and lasting improvements of visual search in hemianopic children. These improvements go along with changes in search strategy, consisting of relatively more saccades directed toward the blind hemifields.

• Reference

• 1 Roth T, Sokolov AN, Messias A, Roth P, Weller M, Trauzettel-Klosinski S.. Comparing explorative saccade and flicker training in hemianopia: a randomized controlled study. Neurology 2009; 27; 72 (04) 324-331