Perceiving Altered Reality (REALTER): Understanding the Impact of Maculopathy on Reading with Extended Reality

Abstract Central vision loss due to binocular maculopathy significantly impairs daily tasks like reading by disrupting oculomotor behavior, particularly saccadic movements. This study employed the REALTER system, an extended reality simulator, to replicate severe binocular maculopathy in eighteen healthy participants. Using the MNREAD Acuity Chart, we measured reading speed and acuity, and col- lected data on ocular movements to verify the system’s capability as a tool for accurate saccade detection. Importantly, the study highlights that the read- ing difficulties caused by maculopathy result in a decline in visual acuity and reading speed, similar to that observed in individuals actually affected by this condition. Our findings revealed significant changes in saccadic patterns, includ- ing increased frequency and amplitude, which closely mirrored those observed in actual patients. We believe that these results suggest REALTER as an effec- tive tool for studying low vision by using simulated impairments in healthy individuals. This approach avoids the need to stress real patients with macu- lopathy during the acquisition of oculomotor knowledge. Additionally, it provides valuable insights into compensatory mechanisms and enhances the training of ophthalmologists in understanding the effects of low vision.