How does the extent of central visual field loss affect adaptive gait?

• Central visual field loss affects gait.
• Is adaptive gait affected after loss exceeds a certain size, or is it progressive?
• Obstacle crossing wearing contact lenses occluding central vision compared to full.
• 20° central loss affected adaptive gait compared to 10° and full vision.
• Gait is compromised only after central visual field loss exceeds a certain size.

Visual impairment is one of the most important clinical risk factors associated with falls. Currently it remains unclear whether adaptive gait is progressively affected as the extent of central visual field loss (CFL) increases, or when CFL exceeds a certain size. 10 participants (aged 22 ± 3 years) negotiated a floor based obstacle in full vision (no occlusion) and wearing custom made contact lenses which simulated 10° CFL and 20° CFL. Movement kinematics assessed the period immediately prior to and during obstacle crossing. In the 20° CFL condition, participants exhibited adaptations in gait which were consistent with being more cautious and more variable during the approach to and crossing of the obstacle, when compared to both 10° CFL and full vision conditions. Specifically, in the 20° CFL condition participants placed their lead foot further from the obstacle, lifted both their lead and trail feet higher and slower over the obstacle, and took longer to negotiate the obstacle when compared to the 10° CFL and full vision conditions. Data highlights differences in adaptive gait as a function of the extent of CFL when compared to full vision. More importantly, these adaptations were only associated with loss of the central 20° of the visual field, suggesting that gait is compromised only after central visual field loss exceeds a certain level.