Visual training of cerebral blindness patients gradually enlarges the visual field.

BACKGROUND: Multiple studies on recovery of hemianopsia after cerebrovascular accident report visual-field enlargements after stimulation of the visual-field border area. These enlargements are made evident by the difference between pre- and post-training measurements of the visual field. Until now, it was not known how the visual-field enlargement develops. AIM: To study how the enlargement develops as a function of time.
METHODS: 11 subjects were trained by stimulating the border area of their visual-field defect using a Goldmann perimeter. The visual-field border location was assessed using dynamic Goldmann perimetry before, after and during training (after each 10th training session). To monitor eye fixation, a video-based eye-tracker was used during each complete perimetry session.
RESULTS: It was found that visual-field enlargement during training is actually a gradual shift of the visual-field border, which was independent of the type of stimulus-set used during training. The shift could be observed while eye fixation was accurate.
CONCLUSION: Visual-detection training leads to a decrease in detection thresholds in the affected visual-field areas and to visual-field enlargement. Training effects can be generalised to important daily-life activities like reading.