Glaucoma and Computer Use Do Contrast and Color Enhancements Improve Visual Comfort in Patients?

Purpose: To estimate the impact of glaucoma on computer use and to assess specific adaptations of the graphical interface to this form of visual impairment. Design: Prospective, experimental cohort study. Participants: Forty-nine participants were recruited: 16 patients with primary open-angle glaucoma (mean +/- SD, 62.7 +/- 5.6 years of age), 17 age-matched participants (mean +/- SD, 59.1 +/- 8.3 years of age), and 16 young control participants (mean +/- SD, 23.3 +/- 2.1 years of age). Methods: An ophthalmologic examination before the study evaluated the level of visual loss (mean deviation), visual acuity (logarithm of the minimum angle of resolution units), and contrast sensitivity (CS) of the primary open-angle glaucoma patients. Each participant underwent the following measurements: an information technology (IT) experience questionnaire, a preference task monitored by eye tracking, and a feedback session. The experimental task was based on ecological computer scenes with 3 enhancement levels (low, medium, and high), determined by gradual modulation of contrast, luminance, and color. Participants were asked to select the most readable and comfortable stimulus among 4 images displayed on the screen: the original computer scene and 3 enhanced versions. Main Outcome Measures: Clinical, oculomotor, and subjective data were computed together in a multivariate model by using a principal component analysis (PCA). Results: The PCA revealed 3 principal components accounting for 72% of the total variance of the data and showed a greater need for enhanced computer scenes in glaucoma patients, an equal preference for low and medium enhancement within the 3 groups, and significantly longer oculomotor behavior in the patient groups. Subjective reports of difficulty using IT because of vision were correlated with visual impairment and high enhancement preference. Contrast sensitivity was critical to explaining the main variations of the data. A reduced CS had a significant effect on the preference for enhanced computer scenes (r = -0.43; P < 0.002) and a less effective exploration velocity (r = 0.43; P < 0.002). Conclusions: Glaucoma alters the global exploration of computer scenes. High enhancement of the graphical interface could improve visual comfort during computer use. Subjective patients' reports underline the importance of including IT questions in visual-related quality-of-life questionnaires. (C) 2021 by the American Academy of Ophthalmology