Vision, Volume 8, Issue 2 (June 2024) – 23 articles

The purpose was to define the threshold of normal visual acuity (VA), mean monocular and binocular VA, and interocular difference in the uniform cohort of healthy four-year-old children. All the children were recruited from the Croatian National Registry of Early Amblyopia Detection database. LEA Symbols^® inline optotypes were used for VA testing at near and distance, binocularly and monocularly. The pass cut-off level was set to ≤0.1 logMAR. The final sample consisted of 58,712 four-year-old children. In total, 83.78% of the children had unremarkable results, and 16.22% of the children were referred to examination. Of those, 92% of the children were referred due to binocular, and 8% of the children due to monocular causes. The children referred due to binocular causes demonstrated a VA of 0.3 ± 0.24, while the children referred due to monocular causes 0.6 ± 0.21. The ROC curve analysis defined the uniform cut-off value for a normative VA of 0.78. We analyzed the largest uniform cohort of 58,712 children, and have determined normative data for binocular and monocular VA tested with gold standard logMAR chart in four-year-old children. The results presented here established no reasoning to further utilize historical protocols in testing VA in preschool children aged ≥ 4 years. Full article

The university population has high visual demands. It is therefore important to assess the prevalence of symptoms in these subjects, which may affect their academic performance. In this cross-sectional study, a randomized sample of 252 subjects from a university answered the Convergence Insufficiency Symptom Survey (CISS) questionnaire. In addition, questions were asked about blurred vision during and after near tasks, the number of hours per day spent in near vision, and whether or not they wore glasses. Furthermore, 110 subjects underwent an eye exam, including a refraction and accommodation assessment. The mean age of the subjects was 28.79 ± 11.36 years, 62.3% reported wearing glasses, and on average 7.20 ± 2.92 hours/day was spent in near vision. The mean of the CISS score was 18.69 ± 9.96, and according to its criteria, 38% of the subjects were symptomatic. Some symptoms were significantly (p < 0.05) more frequent in subjects wearing glasses. Accommodative dysfunctions were present in 30.9% of the subjects, the most common being insufficiency of accommodation. We emphasise the importance of assessing symptomatology during the clinical examination in this group of subjects, as they spend many hours a day in near vision, as well as assessing accommodation, binocular vision, and the ergonomic work environment, which may be at the origin of the symptoms, in addition to the need to wear glasses. Full article

This review critically examines the contributions of pupillometry to memory research, primarily focusing on its enhancement of our understanding of memory encoding and retrieval mechanisms mainly investigated with the recognition memory paradigm. The evidence supports a close link between pupil response and memory formation, notably influenced by the type of novelty detected. This proposal reconciles inconsistencies in the literature regarding pupil response patterns that may predict successful memory formation, and highlights important implications for encoding mechanisms. The review also discusses the pupil old/new effect and its significance in the context of recollection and in reflecting brain signals related to familiarity or novelty detection. Additionally, the capacity of pupil response to serve as a true memory signal and to distinguish between true and false memories is evaluated. The evidence provides insights into the nature of false memories and offers a novel understanding of the cognitive mechanisms involved in memory distortions. When integrated with rigorous experimental design, pupillometry can significantly refine theoretical models of memory encoding and retrieval. Furthermore, combining pupillometry with neuroimaging and pharmacological interventions is identified as a promising direction for future research. Full article

It is debated whether emotional processing and response depend on semantic identification or are preferentially tied to specific information in natural scenes, such as global features or local details. The present study aimed to further examine the relationship between scene understanding and affective response while manipulating visual content. To this end, we presented affective and neutral natural scenes which were progressively band-filtered to contain global features (low spatial frequencies) or local details (high spatial frequencies) and assessed both affective response and scene understanding. We observed that, if scene content was correctly reported, subjective ratings of arousal and valence were modulated by the affective content of the scene, and this modulation was similar across spatial frequency bands. On the other hand, no affective modulation of subjective ratings was observed if picture content was not correctly reported. The present results indicate that subjective affective response requires content understanding, and it is not tied to a specific spatial frequency range. Full article

The ability to make on-field, split-second decisions is critical for National Football League (NFL) game officials. Multiple principles in visual function are critical for accuracy and precision of these play calls, including foveation time and unobstructed line of sight, static visual acuity, dynamic visual acuity, vestibulo-ocular reflex, and sufficient visual field. Prior research has shown that a standardized curriculum in these neuro-ophthalmic principles have demonstrated validity and self-rated improvements in understanding, confidence, and likelihood of future utilization by NFL game officials to maximize visual performance during officiating. Virtual reality technology may also be able to help optimize understandings of specific neuro-ophthalmic principles and simulate real-life gameplay. Personal communication between authors and NFL officials and leadership have indicated that there is high interest in 3D virtual on-field training for NFL officiating. In this manuscript, we review the current and past research in this space regarding a neuro-ophthalmic curriculum for NFL officials. We then provide an overview our current visualization engineering process in taking real-life NFL gameplay 2D data and creating 3D environments for virtual reality gameplay training for football officials to practice plays that highlight neuro-ophthalmic principles. We then review in-depth the physiology behind these principles and discuss strategies to implement these principles into virtual reality for football officiating. Full article

The measurement of corneal sensation allows clinicians to assess the status of corneal innervation and serves as a crucial indicator of corneal disease and eye health. Many devices are available to assess corneal sensation, including the Cochet–Bonnet aesthesiometer, the Belmonte Aesthesiometer, the Swiss Liquid Jet Aesthesiometer, and the newly introduced Corneal Esthesiometer Brill. Increasing the clinical use of in vivo confocal microscopy and optical coherence tomography will allow for greater insight into the diagnosis, classification, and monitoring of ocular surface diseases such as neurotrophic keratopathy; however, formal esthesiometric measurement remains necessary to assess the functional status of corneal nerves. These aesthesiometers vary widely in their mode of corneal stimulus generation and their relative accessibility, precision, and ease of clinical use. The development of future devices to optimize these characteristics, as well as further comparative studies between device types should enable more accurate and precise diagnosis and treatment of corneal innervation deficits. The purpose of this narrative review is to describe the advancements in the use of aesthesiometers since their introduction to clinical practice, compare currently available devices for assessing corneal innervation and their relative limitations, and discuss how the assessment of corneal innervation is crucial to understanding and treating pathologies of the ocular surface. Full article

Traditional neuroimaging methods have identified alterations in brain activity patterns following mild traumatic brain injury (mTBI), particularly during rest, complex tasks, and normal vision. However, studies using graph theory to examine brain network changes in mTBI have produced varied results, influenced by the specific networks and task demands analyzed. In our study, we employed functional MRI to observe 17 mTBI patients and 54 healthy individuals as they viewed a simple, non-narrative underwater film, simulating everyday visual tasks. This approach revealed significant mTBI-related changes in network connectivity, efficiency, and organization. Specifically, the mTBI group exhibited higher overall connectivity and local network specialization, suggesting enhanced information integration without overwhelming the brain’s processing capabilities. Conversely, these patients showed reduced network segregation, indicating a less compartmentalized brain function compared to healthy controls. These patterns were consistent across various visual cortex subnetworks, except in primary visual areas. Our findings highlight the potential of using naturalistic stimuli in graph-based neuroimaging to understand brain network alterations in mTBI and possibly other conditions affecting brain integration. Full article

Research has suggested that near future events are typically viewed from a first-person (an own-eyes, also known as field) perspective while distant future events are typically viewed from a third-person (an observer) perspective. We investigated whether these distinct mental perspectives would be accompanied by distinct eye movement activities. We invited participants to imagine near and distant future events while their eye movements (i.e., scan path) were recorded by eye-tracking glasses. Analysis demonstrated fewer but longer fixations for near future thinking than for distant future thinking. Analysis also demonstrated more “field” mental visual perspective responses for near than for distant future thinking. The long fixations during near future thinking may mirror a mental visual exploration involving processing of a more complex visual representation compared with distant future thinking. By demonstrating how near future thinking triggers both “field” responses and long fixations, our study demonstrates how the temporality of future thinking triggers both distinct mental imagery and eye movement patterns. Full article

Neurofibromatosis type 1 (NF1) is an inherited autosomal dominant disorder primarily affecting children and adolescents characterized by multisystemic clinical manifestations. Mutations in neurofibromin, the protein encoded by the Nf1 tumor suppressor gene, result in dysregulation of the RAS/MAPK pathway leading to uncontrolled cell growth and migration. Neurofibromin is highly expressed in several cell lineages including melanocytes, glial cells, neurons, and Schwann cells. Individuals with NF1 possess a genetic predisposition to central nervous system neoplasms, particularly gliomas affecting the visual pathway, known as optic pathway gliomas (OPGs). While OPGs are typically asymptomatic and benign, they can induce visual impairment in some patients. This review provides insight into the spectrum and visual outcomes of NF1, current diagnostic techniques and therapeutic interventions, and explores the influence of NF1-OPGS on visual abnormalities. We focus on recent advancements in preclinical animal models to elucidate the underlying mechanisms of NF1 pathology and therapies targeting NF1-OPGs. Overall, our review highlights the involvement of retinal ganglion cell dysfunction and degeneration in NF1 disease, and the need for further research to transform scientific laboratory discoveries to improved patient outcomes. Full article

This study aimed to determine the pars plana length in postmortem human eyes using advanced morphometric techniques and correlate demographics to ocular metrics such as age, sex, ethnicity, and axial length. Between February and July 2005, we conducted a cross-sectional observational study on 46 human cadaver eyes deemed unsuitable for transplant by the SBO Eye Bank. The morphometric analysis was performed on projected images using a surgical microscope and a video-microscopy system with a 20.5:1 correction factor. The pars plana length was measured three times per quadrant, with the final value being the mean of these measurements. Of the 46 eyes collected, 9 were unsuitable for the study due to technical constraints in conducting intraocular measurements. Overall, the average axial length was 25.20 mm. The average pars plana length was 3.8 mm in all quadrants, with no measurements below 2.8 mm or above 4.9 mm. There were no statistically significant variations across quadrants or with age, sex, axial length, or laterality. Accurately defining the pars plana dimensions is crucial for safely accessing the posterior segment of the eye and minimizing complications during intraocular procedures, such as intravitreal injections and vitreoretinal surgeries. Full article

The question of whether the early visual cortex (EVC) is involved in visual mental imagery remains a topic of debate. In this paper, I propose that the inconsistency in findings can be explained by the unique challenges associated with investigating EVC activity during imagery. During perception, the EVC processes low-level features, which means that activity is highly sensitive to variation in visual details. If the EVC has the same role during visual mental imagery, any change in the visual details of the mental image would lead to corresponding changes in EVC activity. Within this context, the question should not be whether the EVC is ‘active’ during imagery but how its activity relates to specific imagery properties. Studies using methods that are sensitive to variation in low-level features reveal that imagery can recruit the EVC in similar ways as perception. However, not all mental images contain a high level of visual details. Therefore, I end by considering a more nuanced view, which states that imagery can recruit the EVC, but that does not mean that it always does so. Full article

The pulsed- and steady-pedestal paradigms were designed to track increment thresholds (ΔC) as a function of pedestal contrast (C) for the parvocellular (P) and magnocellular (M) systems, respectively. These paradigms produce contrasting results: linear relationships between ΔC and C are observed in the pulsed-pedestal paradigm, indicative of the P system’s processing, while the steady-pedestal paradigm reveals nonlinear functions, characteristic of the M system’s response. However, we recently found the P model fits better than the M model for both paradigms, using Gabor stimuli biased towards the M or P systems based on their sensitivity to color and spatial frequency. Here, we used two-square pedestals under green vs. red light in the lower-left vs. upper-right visual fields to bias processing towards the M vs. P system, respectively. Based on our previous findings, we predicted the following: (1) steeper ΔC vs. C functions with the pulsed than the steady pedestal due to different task demands; (2) lower ΔCs in the upper-right vs. lower-left quadrant due to its bias towards P-system processing there; (3) no effect of color, since both paradigms track the P-system; and, most importantly (4) contrast gain should not be higher for the steady than for the pulsed pedestal. In general, our predictions were confirmed, replicating our previous findings and providing further evidence questioning the general validity of using the pulsed- and steady-pedestal paradigms to differentiate the P and M systems. Full article

Simulated (sim) racing is an emerging esport that has garnered much interest in recent years and has been a relatively under-researched field in terms of expertise and performance. When examining expertise, visual attention has been of particular interest to researchers, with eye tracking technology commonly used to assess visual attention. In this study, we examined the overt visual attention allocation of high- and low-skilled sim racers during a time trial task using Tobii 3 glasses. In the study, 104 participants were tested on one occasion, with 88 included in the analysis after exclusions. Participants were allocated to either group according to their fastest lap times. Independent t-tests were carried out with sidak corrections to test our hypotheses. Our results indicate that when eye tracking metrics were normalised to the lap time and corner sector time, there was a difference in the relative length of overt attention allocation (fixation behaviour) as lower-skilled racers had significantly greater total fixation durations in laps overall and across corner sectors when normalised (p = 0.013; p = 0.018). Interestingly, high- and low-skilled sim racers differed in where they allocated their attention during the task, with high-skilled sim racers allocating significantly less overt attention to the track relative to other areas of the display (p = 0.003). This would allow for higher-skilled racers to obtain relatively more information from heads-up display elements in-game, all whilst driving at faster speeds. This study provides evidence that high-skilled sim racers appear to need significantly less overt attention throughout a fast lap, and that high- and low-skilled sim racers differ in where they allocate their attention while racing. Full article

The outward migration of ommin pigment granules from the bases to the tips of the photoreceptors in response to light has been reported in the retina of several (mostly coastal) squid species. Following exposure to light and then dark conditions, we collected and processed retinal tissue from juvenile specimens of a deep-sea oegopsid squid, Gonatus onyx. We aimed to determine whether the ommin pigment returns to baseline, and to investigate the presence of glutamate neurotransmitter signaling under both dark and light conditions. We confirmed the presence of ommin granules but observed variability in the return of pigment to the basal layer in dark conditions, as well as changes in glutamate distribution. These findings provide support for the migration of retinal ommin pigment granules as a mechanism for regulating incoming light. Full article

Mild cognitive impairment (MCI) may progress to severe forms of dementia, so therapy is needed to maintain cognitive abilities. The neural circuitry for oculomotor control is closely linked to that which controls cognitive behavior. In this study, we tested whether training the oculomotor system with gaze-controlled video games could improve cognitive behavior in MCI patients. Patients played a simple game for 2–3 weeks while a control group played the same game using a mouse. Cognitive improvement was assessed using the MoCA screening test and CANTAB. We also measured eye pupil and vergence responses in an oddball paradigm. The results showed an increased score on the MoCA test specifically for the visuospatial domain and on the Rapid Visual Information Processing test of the CANTAB battery. Pupil responses also increased to target stimuli. Patients in the control group did not show significant improvements. This pilot study provides evidence for the potential cognitive benefits of gaze-controlled gaming in MCI patients. Full article

There are scarce data regarding the rate of the occurrence of primary open-angle glaucoma (POAG) and visible lamina cribrosa pores (LCPs) in the eyes of individuals with African ancestry; the potential impact of these features on disease burden remains unknown. We recruited subjects with POAG to the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Through regression models, we evaluated the association between the presence of LCPs and various phenotypic features. In a multivariable analysis of 1187 glaucomatous eyes, LCPs were found to be more likely to be present in eyes with cup-to-disc ratios (CDR) of ≥0.9 (adjusted risk ratio (aRR) 1.11, 95%CI: 1.04–1.19, p = 0.005), eyes with cylindrical-shaped (aRR 1.22, 95%CI: 1.11–1.33) and bean pot (aRR 1.24, 95%CI: 1.13–1.36) cups versus conical cups (p < 0.0001), moderate cup depth (aRR 1.24, 95%CI: 1.06–1.46) and deep cups (aRR 1.27, 95%CI: 1.07–1.50) compared to shallow cups (p = 0.01), and the nasalization of central retinal vessels (aRR 1.33, 95%CI: 1.23–1.44), p < 0.0001). Eyes with LCPs were more likely to have a higher degree of African ancestry (q0), determined by means of SNP analysis (aRR 0.96, 95%CI: 0.93–0.99, p = 0.005 for per 0.1 increase in q0). Our large cohort of POAG cases of people with African ancestry showed that LCPs may be an important risk factor in identifying severe disease, potentially warranting closer monitoring by physicians. Full article

The effects of social (eye gaze, pointing gestures) and symbolic (arrows) cues on observers’ attention are often studied by presenting such cues in isolation and at fixation. Here, we extend this work by embedding cues in natural scenes. Participants were presented with a single cue (Experiment 1) or a combination of cues (Experiment 2) embedded in natural scenes and were asked to ‘simply look at the images’ while their eye movements were recorded to assess the effects of the cues on (overt) attention. Single-gaze and pointing cues were fixated for longer than arrows but at the cost of shorter dwell times on the cued object. When presented together, gaze and pointing cues were fixated faster and for longer than simultaneously presented arrows. Attention to the cued object depended on the combination of cues and whether both cues were directed towards or away from the target object. Together, the findings confirm earlier observations that people attract attention more strongly than arrows but that arrows more strongly direct attention. Full article

The current understanding of clinical approaches and barriers in managing childhood myopia among Indian optometrists is limited. This research underscores the necessity and relevance of evidence-based practice guidelines by exploring their knowledge, attitude, and practice towards childhood myopia. A self-administered internet-based 26-item survey was circulated online among practicing optometrists in India. The questions assessed the demographics, knowledge, self-reported clinical practice behavior, barriers, source of information guiding their management, and extent of adult caregiver engagement for childhood myopia. Of 393 responses, a significant proportion of respondents (32.6–92.4%) were unaware of the ocular complications associated with high myopia, with less than half (46.5%) routinely performing ocular biometry in clinical practice. Despite the growing awareness of emerging myopia management options, the uptake remains generally poor, with single-vision distance full-correction spectacles (70.3%) being the most common mode of vision correction. Barriers to adopting optimal myopia care are medicolegal concerns, absence of clinical practice guidelines, and inadequate consultation time. Own clinical experience and original research articles were the primary sources of information supporting clinical practice. Most (>70%) respondents considered involving the adult caregiver in their child’s clinical decision-making process. While practitioners’ awareness and activity of newer myopia management strategies are improving, there is plenty of scope for its enhancement. The importance of evidence-based practice guidelines and continuing education on myopia control might help practitioners enhance their clinical decision-making skills. Full article

Purpose: To evaluate the immediate alterations in the thickness of the macular ganglion cell–inner plexiform layer (mGCIPL), peripapillary retinal nerve fiber layer (RNFL), inner retinal layer (IRL), and outer retinal layer (ORL) using spectral domain optical coherence tomography (SD-OCT) subsequent to strabismus surgery in pediatric patients diagnosed with horizontal esotropia. Methods: Twenty-eight eyes from twenty-one child patients who had undergone uncomplicated horizontal rectus muscle surgery due to strabismus were included. Measurements of RNFL, mGCL-IPL, IRL, and ORL using structural OCT were conducted both before the surgery and one month after the surgical procedure. Importantly, a control group comprising 14 healthy eyes, matched for age and significant refractive error (<3.00 diopters), was included in the current analysis. Results: Our analysis indicated no significant disparity before and after surgery in terms of best-corrected visual acuity (BCVA), RNFL, IRL, and ORL. Conversely, concerning the macular ganglion cell layer–inner plexiform layer analysis, a substantial increase in mGCL-IPL was observed following the surgical intervention. The mean mGCL-IPL measured 60.8 ± 9.2 μm at baseline and 66.1 ± 13.2 μm one month after the surgery (p = 0.026). Notably, comparison between the strabismus group at baseline and the healthy group revealed a significant reduction in mGCL-IPL in the strabismus group (60.8 ± 9.2) compared to the healthy control group (68.3 ± 7.2; p = 0.014). Conclusions: Following strabismus surgery, our observations pointed towards a thickening of the mGCL-IPL layer, which is likely attributable to transient local inflammation. Additionally, we identified a significant differentiation in the mGCL-IPL complex between the pediatric patient group with strabismus and the control group. Full article

Visual motion information plays an important role in the control of movements in sports. Skilled ball players are thought to acquire accurate visual information by using an effective visual search strategy with eye and head movements. However, differences in catching ability and gaze movements due to sports experience and expertise have not been clarified. Therefore, the purpose of this study was to determine the characteristics of gaze strategies based on eye and head movements during a ball-catching task in athlete and novice groups. Participants were softball and tennis players and college students who were not experienced in ball sports (novice). They performed a one-handed catching task using a tennis ball-shooting machine, which was placed at 9 m in front of the participants, and two conditions were set depending on the height of the ball trajectory (high and low conditions). Their head and eye velocities were detected using a gyroscope and electrooculography (EOG) during the task. Our results showed that the upward head velocity and the downward eye velocity were lower in the softball group than in the tennis and novice groups. When the head was pitched upward, the downward eye velocity was induced from the vestibulo-ocular reflex (VOR) during ball catching. Therefore, it is suggested that skilled ball players have relatively stable head and eye movements, which may lead to an effective gaze strategy. An advantage of the stationary gaze in the softball group could be to acquire visual information about the surroundings other than the ball. Full article

Background: Myopia management contact lenses have been shown to successfully decrease the rate of eye elongation in children by changing the peripheral refractive profile of the retina. Despite the efforts of the scientific community, the retinal response mechanism to defocus is still unknown. The purpose of this study was to evaluate the local electrophysiological response of the retina with a myopia control contact lens (CL) compared to a single-vision CL of the same material. Methods: The retinal electrical activity and peripheral refraction of 16 eyes (16 subjects, 27.5 ± 5.7 years, 13 females and 3 males) with myopia between −0.75 D and −6.00 D (astigmatism < 1.00 D) were assessed with two CLs (Filcon 5B): a single-vision (SV) CL and an extended-depth-of-focus (EDOF) CL used for myopia management. The peripheral refraction was assessed with an open-field WAM-5500 auto-refractometer/keratometer in four meridians separated by 45° at 2.50 m distance. The global-flash multifocal electroretinogram (gf-mfERG) was recorded with the Reti-port/scan21 (Roland Consult) using a stimulus of 61 hexagons. The implicit time (in milliseconds) and response density (RD, in nV/deg²) of the direct (DC) and induced (IC) components were used for comparison between lenses in physiological pupil conditions. Results: Although the EDOF decreased both the HCVA and the LCVA (one and two lines, respectively; p < 0.003), it still allowed a good VA. The EDOF lens induced a myopic shift in most retinal areas, with a higher and statistically significant effect on the nasal retina. No differences in the implicit times of the DC and IC components were observed between SV and EDOF. Compared with the SV, the EDOF lens showed a higher RD in the IC component in the foveal region (p = 0.032). In the remaining retinal areas, the EDOF evoked lower, non-statistically significant RD in both the DC and IC components. Conclusions: The EDOF myopia control CL enhanced the response of the inner layers of the fovea. This might suggest that, besides other mechanisms potentially involved, the central foveal retinal activity might be involved in the mechanism of myopia control with these lenses. Full article

This study elucidated the brain regions associated with the perception-driven suppression of mental imagery generation by comparing brain activation in a picture observation condition with that in a positive imagery generation condition. The assumption was that mental imagery generation would be suppressed in the former condition but not in the latter. The results show significant activation of the left posterior cingulate gyrus (PCgG) in the former condition compared to in the latter condition. This finding is generally consistent with a previous study showing that the left PCgG suppresses mental imagery generation. Furthermore, correlational analyses showed a significant correlation between the activation of the left PCgG and participants’ subjective richness ratings, which are a measure of the clarity of a presented picture. Increased activity in the PCgG makes it more difficult to generate mental imagery. As visual perceptual processing and visual imagery generation are in competition, the suppression of mental imagery generation leads to enhanced visual perceptual processing. In other words, the greater the suppression of mental imagery, the clearer the presented pictures are perceived. The significant correlation found is consistent with this idea. The current results and previous studies suggest that the left PCgG plays a role in suppressing the generation of mental imagery. Full article

We present a method for mapping multifocal Pupillary Response Fields in a short amount of time using a visual stimulus covering 40° of the visual angle divided into nine contiguous sectors simultaneously modulated in luminance at specific, incommensurate, temporal frequencies. We test this multifocal Pupillary Frequency Tagging (mPFT) approach with young healthy participants (N = 36) and show that the spectral power of the sustained pupillary response elicited by 45 s of fixation of this multipartite stimulus reflects the relative contribution of each sector/frequency to the overall pupillary response. We further analyze the phase lag for each temporal frequency as well as several global features related to pupil state. Test/retest performed on a subset of participants indicates good repeatability. We also investigate the existence of structural (RNFL)/functional (mPFT) relationships. We then summarize the results of clinical studies conducted with mPFT on patients with neuropathies and retinopathies and show that the features derived from pupillary signal analyses, the distribution of spectral power in particular, are homologous to disease characteristics and allow for sorting patients from healthy participants with excellent sensitivity and specificity. This method thus appears as a convenient, objective, and fast tool for assessing the integrity of retino-pupillary circuits as well as idiosyncrasies and permits to objectively assess and follow-up retinopathies or neuropathies in a short amount of time. Full article