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Purpose: This article describes and analyses the journey with technology of a woman with deafblindness, from her first experiences with communication assistive devices (CADs) until the setup of her homemade CAD. More specifically, it describes the homemade CAD setup, reports on her journey with technology until the setup, and examines the setup process and its outcomes in terms of user innovation and changes in life domains., Materials and Methods: This is a case study report derived from a previous assessment study. It was documented on the basis of meetings, operation sessions, literature searches, clinicians' memories as well as observations, impressions, stories and interviews from previous field visits. Analyses were performed based on von Hippel's description of the user innovation process and the Activities and Participation domains of the International Classification of Functioning, Disability and Health (ICF). The participant in this case study was a female client of a deafblindness rehabilitation program in the Montreal region, living with type 1 Usher syndrome., Results and Conclusions: The homemade CAD setup was based on an electronic braille notetaker connected to an iPhone via Bluetooth. The software included the iOS operating system, the VoiceOver screen reader and a text editing application, all running on the iPhone. The examination of the participant's journey found the presence of the four characteristics of the user innovator proposed by von Hippel. It appears that the participant's life has been positively impacted by the use of her homemade CAD on the nine "Activities and Participation" domains of the ICF.Implications for RehabilitationA CAD may make it easier to achieve some rehabilitation goals with respect to social participation.A person with deafblindness who becomes more autonomous with communications requires less support from rehabilitation professionals.An iPhone-based CAD provides access to a normalizing life and results in better self-esteem, among other things.Lead users facilitate future professional interventions in the field by providing positive experiences and successes that make the general public aware of the situation of persons using special technologies.

Locomotor adaptations, as required for community walking, rely heavily on the sense of vision. Little is known, however, about gaze behavior during pedestrian interactions while ambulating in the community. Our objective was to characterize gaze behavior while walking in a community environment and interacting with pedestrians of different locations and directions. Twelve healthy young individuals were assessed as they walked in a shopping mall from a pre-set location to a goal located 20 m ahead. Eye movements were recorded with a binocular eye-tracker and temporal distance factors were assessed using wearable sensors from a full-body motion capture system. Participants exhibited more numerous and longer gaze episodes on pedestrians (GEP) that were walking in the same direction as themselves vs. those that were in the opposite direction. The relative durations of GEPs, however, showed no significant differences between pedestrians walking in the same vs. opposite direction. Longer durations of GEPs were also observed for centrally located pedestrians compared to those located on either side, but this was the case only for pedestrians that were walking in the same direction as participants. In addition, pedestrians in the centre, and even more so those on the right, were fixated at farther distances compared to those on the left. Results indicate that healthy young individuals modulate their gaze behavior as a function of the location and direction of pedestrians when ambulating in a community environment. The observed modulation is interpreted as being caused by an interplay between collision risk, pedestrian visibility, presence of leaders and social conventions (right-sided circulation). Present results also establish baseline measures for the quantification of defective visuomotor strategies in individuals with mobility disorders., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Visually impaired people may be allowed to drive if they wear bioptic telescopes. Bioptic driving safety is debatable, especially given that the telescopes are seldom used by most bioptic drivers. This preliminary study examined bioptic safety based on critical events that occurred in naturalistic daily driving., Methods: Daily driving activities were recorded using in-car video recorders in 20 bioptic drivers (median age 55, visual acuity, 20/60-160) and 19 control subjects (median age 74) for two to eight weeks. In a secondary analysis, these subjects were compared with 44 cognitively impaired drivers with normal vision (median age 75)., Results: In 292 hours of driving by bioptic drivers and 169 hours by control drivers, seven bioptic drivers and three control drivers had eight and four near-collisions, respectively. Near-collision survival times were not significantly different between the two groups (hazard ratio [HR] = 1.93, P = 0.591) according to Cox hazards regression. Even without compensation for bioptic drivers' longer driving exposure, their odds ratio (OR) was not statistically significant (OR = 2.88, P = 0.18). When including cognitively impaired drivers with normal vision, cognition was a significant predictor of near collisions (HR = 3.86, P = 0.036), but vision loss was not (HR = 0.47, P = 0.317)., Conclusions: This preliminary study failed to find any evidence suggesting that bioptic drivers were more prone to near-collision than healthy drivers. Vision might be a less-significant factor than cognition., Translational Relevance: Given that bioptic drivers use the telescope for less than 2% of the driving time, this study suggests that driving safety might not be substantially affected even when visual acuity is in the low vision range., Competing Interests: Disclosure: M. Moharrer, None; S. Wang, None; B.E. Dougherty, None; W. Cybis, None; B.R. Ott, None; J.D. Davis, None; G. Luo, None, (Copyright 2020 The Authors.)

Purpose: The purpose of this study was to investigate the telescope use behaviors in natural daily driving of people with reduced visual acuity licensed to drive with a bioptic (a small spectacle-mounted telescope)., Methods: A large dataset (477 hours) of naturalistic driving was collected from 19 bioptic drivers (visual acuity 20/60 to 20/160 without the telescope). To reduce the data volume, a multiloss 50-layer deep residual neural network (ResNet-50) was used to detect potential bioptic telescope use events. Then, a total of 120 hours of selected video clips were reviewed and annotated in detail., Results: The frequency of looking through their telescopes ranged from 4 to 308 times per hour (median: 27, interquartile range [IQR], 19-75), with each bioptic use lasting median 1.4 seconds (IQR, 1.2-1.8). Thus, participants spent only 1.6% (IQR, 0.7%-3.5%) driving time with their telescopes aiding their vision. Bioptic telescopes were used most often for checking the road ahead (84.8%), followed by looking at traffic lights (5.3%), and reading road signs (4.6%)., Conclusions: In daily driving, the bioptic drivers mostly (>98% of driving time) drove under low visual acuity conditions. The bioptic telescope was mainly used for observing road and traffic conditions in the distance for situational awareness. Only a small portion of usage was for road sign reading., Translational Relevance: This study provides new insights into how the vision rehabilitation device-bioptic telescopes are used in daily driving. The findings may be helpful for designing bioptic driving training programs., Competing Interests: Disclosure: S. Wang, None; M. Moharrer, None; V. Baliutaviciute, None; B.E. Dougherty, None; W. Cybis, None; A.R. Bowers, None; G. Luo, None, (Copyright 2020 The Authors.)

Objective: The purpose of this study was to develop a French Canadian questionnaire for the detection of Charles Bonnet syndrome that allows for (i) valid screening and (ii) the examination of different dimensions of the client's visual hallucinations in order to better assess the resulting needs., Method: Questionnaire development was guided by interviews with visually impaired individuals experiencing visual hallucinations, as well as supported by scientific literature and expert experience. A clinical study involving 76 individuals with low vision was conducted to determine the sensitivity and specificity of the instrument according to criterion validation., Results: Of the 54 closed-ended questions, a subset of 11 revealed a sensitivity of 1.00 and a specificity of 0.77. Two additional questions showed high discriminating potential. Improvements to the wording and structure of some questions aiming at needs assessment were identified and applied. The improved version consists of 55 questions grouped in 8 dimensions: (1) Screening; (2) Characteristics of hallucinations; (3) Psychological impact; (4) Psychopathological origin; (5) Coping strategies; (6) Context of appearance of hallucinations; (7) Time-related matters; (8) Psychosocial support. The screening is operationalized through an algorithm applied to the set of 13 questions., Conclusion: The questionnaire will be a valuable aid in screening for Charles Bonnet syndrome among the low vision clientele. However, the screening will need to be supplemented by a focused low vision interdisciplinary assessment including a visual examination and a clinical interview with a psychologist., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)