Evaluation of Peripheral Visual Perception Using a Cubic Neuro-Visual Functional Screening Device

Abstract

Background: Standard visual acuity tests prioritize central spatial resolution but consistently fail to identify functional peripheral visual deficits that impact spatial orientation and mobility. This cross-sectional observational study introduces and validates a novel Cubic Neuro-Visual Functional Screening Device designed to assess peripheral visual perception and central-peripheral visual integration dynamically. Methods: One hundred and fifty participants aged 5–60 years were enrolled across five clinical cohorts: healthy controls (n=50), amblyopia (n=30), glaucoma (n=35), stroke-related peripheral field defects (n=20), and peripheral perception disturbance with normal visual acuity (n=15). The primary outcome was peripheral stimulus recognition response time, measured via a digital precision chronometer while the patient maintained central fixation, monitored by a micro-camera. Results: Healthy controls achieved a mean response time of 0.78 ± 0.12 s, demonstrating significantly faster processing compared to an aggregate pathological group mean of 1.38 ± 0.25 s (p < 0.05). A crucial clinical finding emerged in patients with normal central visual acuity (6/6) but functional disturbances, who exhibited significant peripheral processing delays (1.20 ± 0.15 s). Furthermore, distinct behavioral compensatory mechanisms, including micro-saccades and head tilting, were systematically observed in pathological cohorts. Gender did not significantly influence response times. Conclusions: The cubic screening device demonstrates substantial clinical potential in differentiating healthy from pathological peripheral visual processing. The findings highlight a critical diagnostic gap in relying solely on Snellen acuity, emphasizing the necessity for accessible, rapid functional peripheral assessment tools in routine clinical and neuro-visual rehabilitation settings.