Tweaking Monitor Settings May Ease Computer Use in Patients With Glaucoma

By David Douglas

March 29, 2021

NEW YORK (Reuters Health) - Enhancement of the graphical interface appears to improve visual comfort during computer use in patients with glaucoma and perhaps the elderly in general, according to an exploratory study by researchers in France.

Dr. Quentin Lenoble told Reuters Health by email that this is the beginning of a new research project, the main idea being "that we could increase the performance of the patients if they better know their own visual deficit," and if they have a clear idea about how to compensate in part for their loss of vision when using computers and tablets at home.

To help gauge what modifications might be of most use, Dr. Lenoble and colleagues at the University of Lille the researchers gathered 30 screenshots of typical web pages from the Internet. These covered items such as weather, recipes and maps.

In addition to the basic screenshot, the team used gradual modulation of contrast, luminance and color to produce low, medium and high degrees of enhancement of the original image. For example, the high-enhancement image was "radically different from the original and accentuated contrast, luminance, and color perceptions in a way that contours and lines were more detectable."

To determine which alterations might be the most efficacious the researchers recruited 16 patients with primary open-angle glaucoma (mean age, 63). They also enrolled 17 age-matched controls and a further 16 young controls (mean age, 23). The frequency of computer and smartphone use was similar across groups.

The participants were tested binocularly wearing their usual correction. They were seated in a dimly lit room and viewed the prepared images on a 15.6-inch screen with a resolution of 1920 x 1080 pixels. They were asked to select the most readable and comfortably viewed image among the original scene and the three enhanced versions.

Contrast sensitivity, which "was critical to explain the main variations of the data," was significantly lower in glaucoma patients than in the two control group, the researchers report in Ophthalmology Glaucoma.

There were significant correlations across all participants between contrast sensitivity and global enhancement preference as well as between contrast sensitivity and exploration velocity. Glaucoma patients showed significantly longer oculomotor behavior in exploring the screenshots.

Individual variable analysis demonstrated that while young controls mostly selected original computer scenes, age-matched controls and glaucoma patients preferred enhanced stimuli. The absence of a significant difference between glaucoma patients and age-matched patients suggests that "enhancement could generally benefit elderly people, with or without visual impairment."

No differences in enhancement preferences were found among early, moderate and severe glaucoma. "Further investigations with larger cohorts of various glaucoma stages could statistically validate the correlation between the degree of enhancement needed and the severity of visual impairment," the researchers write.

Their findings, they add, "underline the importance of including information technology questions in visual-related quality-of-life questionnaires."

SOURCE: Ophthalmology Glaucoma, online February 6, 2021.