Proceedings of: Workshop on Improving Building Design for Persons with Low Vision

Research and its applications, medium-term and long term

Comment by Bob Massof: Well, just in two days of discussion I’ve been motivated of thinking how we would approach this from a research perspective. I think there’s a tremendous opportunity here to develop the [support] of this project with bringing together the expertise. I marvel at just the kind of expertise that’s out there and with bringing parties together, I think we can really build a project. So I just want to throw out some of the ideas that I’ve heard. I think first of all that there is a funding mechanism which is through the NIH for supporting these types of collaborations.

So I think it’s not pie-in-the-sky to talk about it. And there’s been some pretty spectacular collaborations, especially the one I’m developing, what’s called adaptive optic supply to the eye. That’s getting right down and seeing individual photoreceptors live through imaging and using technology that – the same type that’s used to look at galaxies thousands of light-years away by correcting for the averages in atmosphere. This corrects for the averages in the eye.

So that was literally pie-in-the-sky until this project started. So while that may sound like it’s too hard but I think the first step in just hearing a lot of the discussion about the regulations, like where do these things come from and what’s behind the recommendations and what’s behind the guidelines. It doesn’t sound like there’s an awful lot of data, and that some of it just is summary type of information. It’s not really getting down to a level of computational type of approach.

Comprehensive modeling of vision

So I think the first step would be to create a physics-based model of the environmental conditions so that you really can computationalize it in a database from any viewpoint of what the illumination of the environment is going to be. So, if I put my eye over here, this is what it’s going to look like. This is before you build anything, before you spend any money on actual hardware that this all can be part of the design phase to create a model that is a physics-based model.

On our side of the world, we’re already building physics–based models of retinal imaging and if you marry these two models together, the physics-based model of the environment becomes [integral] to the physics-based model of producing the image on the retina. What would have to be included in the model of the retina, which is very active research and we know people who are doing this type of research and we probably will be able to talk them into collaborating on this type of project, is some of the more subtle things that is very important to plan.

I think I mentioned yesterday the Stiles-Crawford Effect, which is the directional sensitivity of the photoreceptors. But there are physics-based models for that effect and that could be built into a computational model to handle scatter of light. So you can end up making measurements of fundus reflectance and things of that sort, build those parameters into the model. And so take the environmental, you put a glare source or a point source in the environment and we can look exactly at what would happen to the retinal imaging through those types of models.

The next step is to really fully characterize the population we’ve been talking about with respect to the parameters that we build consensus and support. People talk about contrast, play with color and illumination. So we really want to describe what the characteristics of not only the low vision population but the older population in general. Some of this John Brabyn showed to suggest that low vision is kind of in the eye of the beholder literally.

We can then have a description of the important vision parameters and there are unemployed psychophysicists I think we can put to work on that project and we have collaborative networks set up already to collect these data and we don’t need – well, John will know what I’m talking about – white bars and review systems to do this, that we can do it with equipment that readily can be put into a clinic out in the field and so we can gather rather large quantities of data in a reasonable period of time.

That then also gets added to on most of the people on this side really developing kind of a conceptual model of what are these constraints on the design. You’re bringing in legal requirements, you’re bringing in things that pose constraints on what you can do and so those should factor into whatever model we’re developing so that gets taken into consideration and limits your options.

Every modeling effort has to have constraints. They might as well come from the outside as well as those from the inside. And then, finally, there needs to be some qualitative research that’s done on the side dealing with the aesthetics and dealing with the functional usability both from the standpoint of the owners and from the standpoint of the people who are expected to use it so that if you have this tension between the artistic and the practical, you know, how do you place value on those two things, on those people who have a stake in it, and there are tools out there for doing that.

We’re always doing quality of life research in health care and so many of the concepts and many of the tools that are used for quality of life research could really get transferred over to these various kinds of questions more subjective types of measurements of subjective phenomena, the so-called latent barriers and that ought to be built in.

So by putting a collaboration together with all the appropriate expertise, working in parallel to create these pieces, you can kind of put a whole system together that would allow you to rather than having to build consensus among all parties really allow you to do something in a very quantitative and very objective way and then you’re not – we’re always saying in campaigns, you can have your own opinions but not your own facts. This puts all the facts under the control of something that we all agree to, something that’s all objective, and then now you can get down to making decisions without arguing over how we’re making decisions.

Comment by Fred Krimgold: Well, I just wanted to very strongly endorse what Bob has suggested because I think, you know, that given the expertise that’s been revealed in this room, the idea of developing parallel models of individual visual capability and the salient factors in the environment that influence the functioning of that individual visual system allows us to structure our understandings, our experience, the existing models, [and] the resources available in a way that allows them to interact in such a way that we can evaluate existing environments, we can evaluate hypothetical environments, we can evaluate potential policies.

It gives us a really powerful new tool for looking at this whole set of issues and it certainly qualifies as a serious area of applied research for both physical environment engineering architecture and on the medical ophthalmological side and it can then provide a basis which I think will be tremendously valuable to whatever application comes after it, be it a regulatory application. We have – we will then have an organized foundation for presenting those arguments and for again looking at costs and benefits, if that’s relevant, if that has to be dealt with. And it’s a very exciting possibility.

I think it’s the sort of thing if there is a funding source that would be appropriate for pulling together that kind of cross-disciplinary group -- and by cross-disciplinary I mean not just academic disciplines but practitioners, and -- that is, both medical practitioners and [design and operations] practitioners, we could do something that would be tremendously stimulating and valuable and it might well be done under the auspices of NIBS, which has the kind of relationship with federal agencies that could facilitate this kind of a collaborative effort.

Comment by Cheri Wiggs: What Bob was mentioning is actually a program announcement that is written specifically to encourage the type of collaboration that he described in bioengineering, and bioengineering is defined pretty broadly. So there’s actually a program announcement at NIH that specifically is meant to encourage that kind of research effort. So it exists.