La dégénérescence maculaire liée à l'âge (DMLA) touche actuellement un million de Canadiens, ce qui en fait la principale cause de perte de vision au Canada. La DMLA cause l’apparition d’une tache aveugle au niveau de la macula – la zone centrale de la vision. Cette tache aveugle affecte la vision centrale rendant les perceptions visuelles floues ou déformées. L’impact de cette condition est considérable puisqu’elle rend impossible la conduite, difficile la lecture et entraîne ultimement une cécité totale. La DMLA a également été identifiée comme facteur de risque de la dépression et de l’isolement sociale, ce qui porte d’autant plus atteinte à la qualité de vie des patients. Une des avenues de réadaptation pour les patients est d’améliorer leur utilisation de leur fonction visuelle résiduelle, notamment la vision périphérique. Le but de la présente recherche est d’investiguer le potentiel réadaptatif d’un entraînement imposant l’utilisation de la vision périphérique chez des participants en bonne santé en présence d’une perte de vision centrale simulée. Une compréhension des changements dans les comportements des mouvements oculaires en présence d'un scotome artificiel central aidera à développer des programmes de réadaptation pour les personnes atteint de DMLA et plus largement les personnes présentant une perte visuelle centrale. Les résultats démontrent une adaptation des stratégies visuelles des participants, entraînant une augmentation de la performance, une réduction des temps de réponse et une meilleure discrimination, suggérant ainsi que l’entraînement est susceptible de contribuer à la réadaptation des personnes atteintes de pertes visuelles centrales. / Age Macular Degeneration (AMD) currently affects one million Canadians, making it the leading cause of vision loss in Canada. AMD causes the appearance of a blind spot on the macula – the central area of vision. This blind spot affects the central vision making visual perceptions blurry or distorted. The impact of this condition is considerable since it impedes driving as well as reading and ultimately leads to total blindness. AMD has also been shown to be a risk factor for depression and social isolation, further compromising quality of life for patients. One of the avenues of rehabilitation for patients is to improve their use of their residual visual function, in particular their peripheral vision. The purpose of the present research is to investigate the rehabilitative potential of training requiring the use of peripheral vision in healthy participants in the presence of a simulated central vision loss. An understanding of changes in eye movement patterns in the presence of a central artificial scotoma will help develop rehabilitation protocols for people with AMD and more broadly people with central visual loss. Results demonstrate an adaptation of visual strategies among participants, resulting in increased performance, reduced response times and better discrimination, suggesting that training is likely to contribute to the rehabilitation of people with central vision loss.

The loss of central vision subsequent to macular disease is often extremely debilitating. People with central field loss (CFL) must use other peripheral areas of the retina in order to see; areas with inferior resolution capacity, which are also affected by off-axis optical errors. The overall aim of the work encompassed by this thesis was to identify and evaluate methods of improving vision for people with CFL; with focus on the effects of off-axis optical correction and stimulus motion on resolution acuity and contrast sensitivity. Off-axis optical errors were measured using a commercially-available COAS-HD VR open-view aberrometer. We used adaptive psychophysical methods to evaluate grating resolution acuity and contrast sensitivity in the peripheral visual field; drifting gratings were employed to   measure the effect of motion on these two measures of visual performance. The effect of sphero-cylindrical correction and stimulus motion on visual performance in healthy eyes and in subjects with CFL was also studied; in addition, the effect of adaptive optics aberration correction was examined in one subject with CFL. The COAS-HD aberrometer provided rapid and reliable measurements of off-axis refractive errors. Correction of these errors gave improvements in low-contrast resolution acuity in subjects with higher amounts of oblique astigmatism. Optical correction also improved high-contrast resolution acuity in most subjects with CFL, but not for healthy subjects. Adaptive optics correction improved both high and low contrast resolution acuity in the preferred retinal locus of a subject with CFL. The effect of stimulus motion depended on spatial frequency; motion of 7.5 Hz improved contrast sensitivity for stimuli of low spatial frequency in healthy and CFL subjects. Motion of 15 Hz had little effect on contrast sensitivity for low spatial frequency but resulted in reduced contrast sensitivity for higher spatial frequencies in healthy subjects. Finally, high-contrast resolution acuity was relatively insensitive to stimulus motion in the periphery. This thesis has served to broaden the knowledge regarding peripheral optical errors, stimulus motion and their effects on visual function, both in healthy subjects and in people with CFL. Overall it has shown that correction of off-axis refractive errors is important for optimizing peripheral vision in subjects with CFL; the use of an open-view aberrometer simplifies the determination of these errors. In addition, moderate stimulus motion can have a beneficial effect on contrast sensitivity for objects of predominantly low spatial frequency.