A gaze-contingent saccadic re-referencing training with simulated central vision loss.

Patients with central vision loss (CVL) adopt an eccentric retinal location for fixation, a preferred retinal location (PRL), to compensate for vision loss at the fovea. Although most patients with CVL are able to rapidly use a PRL instead of the fovea, saccadic re-referencing to a PRL develops slowly. Without re-referencing, saccades land the saccade target in the scotoma. This results in corrective saccades and leads to inefficient visual exploration. Here, we tested a new method to train saccadic re-referencing. Healthy participants performed gaze-contingent visual search tasks with simulated central scotoma in which participants had to fixate targets with an experimenter-defined forced retinal location (FRL). In experiment 1, we compared single-target search and foraging search tasks in the course of five training sessions. Results showed that both tasks improved the efficiency of gaze sequences and led to saccadic re-referencing to the FRL. In experiment 2, we trained participants extensively for 25 sessions, both with and without a gaze-contingent FRL-marker visible during training. After extensive training, observers' performance approached that of foveal vision. Thus, gaze-contingent FRL-fixation may become an efficient tool for saccadic re-referencing training in patients with central vision loss.