# Coordination of Eye and Head Movements in Central Field Loss

> **NIH NIH R00** · SMITH-KETTLEWELL EYE RESEARCH INSTITUTE · 2020 · $229,882

## Abstract

ABSTRACT
Age-related macular degeneration is the most common cause of vision loss in the central visual field, making
central field loss (CFL) a major problem in the world today. Two-thirds of patients with CFL complain of
vestibular problems, such as dizziness and instability, leading to a high incidence of potentially fatal accidents
and falls. The problem is exacerbated by the patient population's advanced age, due to the documented
decline in vestibular function in senescence. Vestibular deficits in CFL patients are likely due to miscalibrated
or non-optimal stabilizing eye movements - many essential oculomotor behaviors are highly reliant on retinal
input. Individuals with compromised vestibular responses have difficulties with visual field stability, navigation,
and self- and external motion perception. These limitations are particularly true for CFL patients, whose visual
acuity is already compromised and for whom the vestibular system becomes the predominant source of motion
information. Furthermore, vestibular deficits likely affect patients' use of head movements to compensate for
oculomotor limitations due to eccentric viewing and a patchy visual field. Despite the day-to-day importance of
visual and vestibular interaction, these behaviors have not been comprehensively studied in CFL.
This proposal seeks to address this gap. The first aim examines the contribution of head movements to smooth
pursuit in CFL patients. This aim extends previous work quantifying smooth pursuit deficits in CFL to a more
natural, head-unrestrained condition to determine if head movements are helpful or detrimental in CFL.
Understanding the contribution of head movements can guide future rehabilitation strategies and clinical
testing in this population. The second aim examines the effect of CFL on the angular vestibuloocular reflex
(VOR). The reflex has little foveal dependence and is thus likely to be unaffected in CFL. However, foveal
vision is known to contribute to both the calibration of this reflex and to its suppression when the head
movement follows target motion. A deficit in any aspect of angular VOR will have consequences on the visual
instability and vestibular discomfort of the affected individuals. Understanding these problems would inform
necessary treatments in this population. The final aim examines the effects of CFL on translational VOR, a
behavior that is completely fovea-dependent and is essential when body movement is present. Determining the
degree of its impairment and exact influences of CFL is key to understanding vestibular dysfunction due to this
visual deficit. VOR responses will be studied during passive and volitional, active motion. Previous research
suggests fundamental differences in the processing of these two types of behavior, which indicates that they
might be affected differently by central vision loss. If present, this dichotomy could have implications on how
patients are advised and trained to interact with their envir...

## Key facts

- **NIH application ID:** 9988402
- **Project number:** 5R00EY026994-05
- **Recipient organization:** SMITH-KETTLEWELL EYE RESEARCH INSTITUTE
- **Principal Investigator:** Natela M. Shanidze
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $229,882
- **Award type:** 5
- **Project period:** 2016-09-30 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9988402

## Citation

> US National Institutes of Health, RePORTER application 9988402, Coordination of Eye and Head Movements in Central Field Loss (5R00EY026994-05). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9988402. Licensed CC0.

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