Gaze behavior among experts and trainees during optic disc examination : does how we look affect what we see?

O’Neill, Evelyn C., Kong, Yu Xiang George, Connell, Paul P., Ong, Dai Ni, Haymes, Sharon A., Coote, Michael A. and Crowston, Jonathan G. 2011, Gaze behavior among experts and trainees during optic disc examination : does how we look affect what we see?, Investigative ophthalmology and visual science, vol. 52, no. 7, pp. 3976-3983, doi: 10.1167/iovs.10-6912.

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Title Gaze behavior among experts and trainees during optic disc examination : does how we look affect what we see?
Author(s) O’Neill, Evelyn C.
Kong, Yu Xiang George
Connell, Paul P.
Ong, Dai Ni
Haymes, Sharon A.
Coote, Michael A.
Crowston, Jonathan G.
Journal name Investigative ophthalmology and visual science
Volume number 52
Issue number 7
Start page 3976
End page 3983
Total pages 8
Publisher Association for Research in Vision and Ophthalmology
Place of publication Rockville, Md.
Publication date 2011-06-07
ISSN 0146-0404
Keyword(s) glaucoma
optic disc examination
retinal nerve fiber layer examination
Summary Purpose. The authors compared the visual gaze behaviors of glaucoma subspecialists with those of ophthalmology trainees during optic disc and retinal nerve fiber layer (RNFL) examination.

Methods. Seven glaucoma subspecialists and 23 ophthalmology trainees participated in the project. Participants were shown eight glaucomatous optic disc images with varied morphology. Eye movements during examination of the optic disc photographs were tracked. For each disc image, graders were asked to assign a presumptive diagnosis for probability of glaucoma. There was no time restriction.

Results. Overall, trainees spent more time looking at disc images than glaucoma subspecialists (21.3 [13.9–37.7] vs. 16.6 [12.7–19.7]) seconds; median [interquartile range (IQR)], respectively; P < 0.01) and had no systematic patterns of gaze behavior, and gaze behavior was unaltered by disc morphology or topographic cues of pathology. Experienced viewers demonstrated more systematic and ordered gaze behavior patterns and spent longer times observing areas with the greatest likelihood of pathology (superior and inferior poles of the optic nerve head and adjacent RNFL) compared with the trainees. For discs with focal pathology, the proportion of total time spent examining definite areas of pathology was 28.9% (22.4%–33.6%) for glaucoma subspecialists and 13.5% (12.2%–19.2%) for trainees (median [IQR]; P < 0.05). Furthermore, experts adapted their viewing habits according to disc morphology.

Conclusions. Glaucoma subspecialists adopt systematic gaze behavior when examining the optic nerve and RNFL, whereas trainees do not. It remains to be elucidated whether incorporating systematic viewing behavior of the optic disc and RNFL into teaching programs for trainees may expedite their acquisition of accurate and efficient glaucoma diagnosis skills.
Language eng
DOI 10.1167/iovs.10-6912
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2011, The Association for Research in Vision and Ophthalmology
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Document type: Journal Article
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School of Medicine
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