How People With Vision Impairment Use Their Gaze to Hit a Ball

Purpose: Understanding the impact of vision impairment on dynamic tasks requiring visual processing is crucial for developing effective adaptive strategies that support individuals with vision impairment in optimizing their performance in natural tasks. This study aimed to establish the gaze patterns used by individuals with vision impairment when hitting a moving target. Methods: Nineteen tennis players with vision impairment were recruited and their eye and head movements were tracked while they returned tennis serves. Results: Participants used a variety of different strategies to track the ball visually, dictated largely by the nature of their impairment rather than its severity. Cluster analysis showed distinct strategies based on the type of vision impairment: those with peripheral vision loss foveated the ball closely and avoided predictive eye movements; those with poor oculomotor control initially tracked the ball but lagged as it approached; and those with central vision loss used a variety of strategies that did not align with the use of a single preferred retinal locus: some tracked the ball using a single preferred location in their peripheral vision, some switched the area of retina used to track the ball, and another did not move their gaze at all. Conclusions: Tennis players with vision impairment adopt a variety of impairment-specific adaptations to their gaze-tracking strategies, enabling them to successfully hit an approaching tennis ball despite severe vision impairments. Translational Relevance: This study provides insight into the impairment-specific gaze strategies that well-adapted individuals with vision impairment adopt when hitting a moving target.