Perception of Gaze Direction in Glaucoma: A Study on Social Cognition

Optom Vis Sci. 2020 Apr;97(4):286-292. doi: 10.1097/OPX.0000000000001496.


Significance: Discriminating quickly where another person's gaze is directed is a key component of social interaction, as gaze direction conveys information about others' intentions (approach or avoidance) and shift in gaze is used in group conversation. This study shows that patients with glaucoma are delayed in their discrimination of gaze direction.

Purpose: The purpose of this study was to investigate whether glaucoma affects the perception of gaze direction.

Methods: Twenty-four patients with open-angle glaucoma, 24 age-matched controls, and 20 young normally sighted controls were presented with faces displayed centrally for 200 milliseconds. The gaze could either be direct or averted, and the head could be a frontal view or a rotated view. Half of the participants in each group were asked to press a key only for faces with a direct gaze. The other half responded for a face with an averted gaze. The orientation of the head had to be ignored.

Results: Accuracy was greater than 90% correct for all three groups. We found no difference in performance between young and older controls, except for shorter response times for the frontal view than for the rotated face in young participants. Patients with glaucoma needed on average 140 milliseconds longer to decide if the gaze was averted than for the direct gaze, and they were less accurate than controls in perceiving the gaze as direct when the head was rotated.

Conclusions: Patients with glaucoma often experience impaired vision due to a reduced sensitivity in central vision. Although lower central sensitivity had little effect on their ability to discriminate gaze orientation, they required on average 140 milliseconds longer than age-matched controls to perceive an averted gaze.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Sensitivity / physiology
  • Female
  • Fixation, Ocular / physiology*
  • Glaucoma, Open-Angle / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Orientation / physiology
  • Reaction Time / physiology
  • Social Cognition*
  • Visual Fields / physiology