Exploring the Potential of AR in Simulating Central Vision Loss: An Experimental Study with HoloLens2

Central vision loss (CVL) is an increasingly prevalent condition that significantly affects essential daily activities such as reading and visual search. This study simulates a central scotoma in a controlled experimental setting using the Microsoft HoloLens 2 augmented reality (AR) headset, enabling the investigation of compensatory mechanisms when the foveal region is compromised. Thirty-three participants performed a reading task (Task 1) and a visual search task (Task 2) under both normal vision and AR-simulated defect conditions, while eye-tracking data were recorded to analyze differences in visual behaviour and compensatory strategies. Key performance metrics included error rates, task completion times, and eye movement metrics such as the number and duration of fixations and saccades. Results showed that simulated central vision loss induced a more effortful visual exploration strategy, with an increased number of fixations and saccades, as well as longer total fixation duration, while saccadic timing remained stable. Specifically, the mean number and total duration of fixations during the reading task were approximately 14 and 8 s under normal vision, and 18 and 11 s under CVL condition, respectively. These findings demonstrate the potential of AR-based methods to replicate visual impairments in research settings. Future work could expand on the use of extended reality technologies for assistive and rehabilitative applications in individuals with central vision deficits.