About My Research
Center/Research Area Affiliations
Biography
At Schepens Eye Research Institute of Mass. Eye and Ear, Dr. Bowers' primary focus is vision rehabilitation research. She has made significant contributions to the field as an optometrist in the United Kingdom, as well as an educator and researcher—first at Glasgow Caledonian University and now at Schepens Eye Research Institute of Mass. Eye and Ear.
Her achievements were recognized in 2010 when she was awarded the Borish Outstanding Young Researcher Award from the American Academy of Optometry. In 2013, Dr. Bowers received the prestigious Envision Low Vision Research Award.
Her current research projects encompass three main areas:
- Evaluating the effects of vision impairment on driving skills and behaviors
- Investigating novel vision and attention tests to help identifying at-risk drivers
- Evaluating the benefits of optical and electronic devices to help visually impaired people when driving and walking
Research Accomplishments
A major focus of Dr. Bowers’ research has been the implementation of assessment tools in a high-fidelity driving simulator to enable systematic evaluations of drivers with a range of vision impairments. Her first study of drivers with hemianopia (the loss of half the field of vision on the same side in both eyes) revealed a very wide range in the ability of people with hemianopia to compensate for their hemifield loss by scanning (i.e., making eye and head movements toward the affected side). While some participants scanned well and had detection rates on the side of the field loss that were similar to those of drivers with a full field of vision, others did not scan well and frequently failed to see pedestrian hazards on the side of the field loss. These findings were replicated in subsequent studies. Another series of studies of drivers with central visual field loss (e.g., from age-related macular degeneration) provided the first data to demonstrate the extent to which a blind area in central vision can delay detection of hazards when driving.
Dr. Bowers has made major contributions in the field of rehabilitation of patients with hemianopia. She designed and implemented an open-label and then a randomized controlled multi-center clinical trial to evaluate peripheral prism glasses for walking, and also led an on-road, placebo-controlled pilot study of peripheral prism glasses for driving. Through these trials an evidence base has now been established for the utility of the device as a mobility aid. Such evidence-based research is rare in the field of vision rehabilitation.
In addition, Dr. Bowers led a laboratory-based study of peripheral prism glasses and perceptual-motor training for patients with hemianopia. A key aspect that differentiated this study from other studies of rehabilitation interventions for patients with hemianopia was the use of functional outcome measures to evaluate mobility performance in simulated and real world walking and driving tasks.
Education
1998: PhD, Vision Rehabilitation Research, Glasgow Caledonian University, Scotland
Postgraduate Training
2002-2005: Schepens Eye Research Institute of Mass. Eye and Ear
Honors
2015: Diplomate, Vision Science Section, American Academy of Optometry
2013: Envision Award in Low Vision Research
2010: Irvin and Beatrice Borish Outstanding Young Researcher Award, American Academy of Optometry
2008: Fellow, American Academy of Optometry
- Knowing me, knowing you-A study on top-down requirements for compensatory scanning in drivers with homonymous visual field loss. PLoS One. 2024; 19(3):e0299129.
- Egocentric Boundaries on Distinguishing Colliding and Non-Colliding Pedestrians while Walking in a Virtual Environment. IS&T Int Symp Electron Imaging. 2024; 36:2141-2148.
- Invited Session IV: Extended reality--applications in vision science and beyond: Using a driving simulator to evaluate the effects of vision impairment and assistive technology. J Vis. 2023 Dec 01; 23(15):17.
- Gaze Scanning at Street Crossings by Pedestrians With Homonymous Hemianopia With and Without Hemispatial Neglect. Invest Ophthalmol Vis Sci. 2023 Nov 01; 64(14):26.
- Driving Difficulties and Preferences of Advanced Driver Assistance Systems by Older Drivers With Central Vision Loss. Transl Vis Sci Technol. 2023 10 03; 12(10):7.
- Letter to the Editor: Update on Experiences of a Driver with Vision Impairment when Using a Tesla Car-Full Self-driving (Beta) in City Driving. Optom Vis Sci. 2023 06 01; 100(6):351-353.
- Effects of Perceptual-motor Training on Collision Judgments with Peripheral Prism Expanded Vision. Optom Vis Sci. 2022 12 01; 99(12):875-884.
- Driving With Hemianopia X: Effects of Cross Traffic on Gaze Behaviors and Pedestrian Responses at Intersections. Front Hum Neurosci. 2022; 16:938140.
- Change blindness in simulated driving in individuals with homonymous visual field loss. Cogn Res Princ Implic. 2022 05 15; 7(1):44.
- Clinical Report: Experiences of a Driver with Vision Impairment when Using a Tesla Car. Optom Vis Sci. 2022 04 01; 99(4):417-421.
- Use and Perceptions of Advanced Driver Assistance Systems by Older Drivers With and Without Age-Related Macular Degeneration. Transl Vis Sci Technol. 2022 03 02; 11(3):22.
- Auditory Reminder Cues to Promote Proactive Scanning on Approach to Intersections in Drivers With Homonymous Hemianopia: Driving With Hemianopia, IX. JAMA Ophthalmol. 2022 Jan 01; 140(1):75-78.
- Home-Use Evaluation of a Wearable Collision Warning Device for Individuals With Severe Vision Impairments: A Randomized Clinical Trial. JAMA Ophthalmol. 2021 Sep 01; 139(9):998-1005.
- Head Scanning Behavior Predicts Hazard Detection Safety Before Entering an Intersection. Hum Factors. 2023 08; 65(5):942-955.
- Automatic processing of gaze movements to quantify gaze scanning behaviors in a driving simulator. Behav Res Methods. 2021 04; 53(2):487-506.
- Driving with hemianopia VIII: Effects of a vibro-tactile assistance system on safety and gaze behavior in pedestrian crossing situations. Safety (Basel). 2021 Mar; 7(1).
- Driving With Hemianopia VII: Predicting Hazard Detection With Gaze and Head Scan Magnitude. Transl Vis Sci Technol. 2021 01; 10(1):20.
- The effects of age on the contributions of head and eye movements to scanning behavior at intersections. Transp Res Part F Traffic Psychol Behav. 2020 Aug; 73:128-142.
- Data Acquisition, Processing, and Reduction for Home-Use Trial of a Wearable Video Camera-Based Mobility Aid. Transl Vis Sci Technol. 2020 06; 9(7):14.
- Towards Wide Range Tracking of Head Scanning Movement in Driving. Intern J Pattern Recognit Artif Intell. 2020 Dec 15; 34(13).
- The Effects of Age, Distraction, and Simulated Central Vision Impairment on Hazard Detection in a Driving Simulator. Optom Vis Sci. 2020 04; 97(4):239-248.
- Hazard Detection With Monocular Bioptic Telescopes in a Driving Simulator. Transl Vis Sci Technol. 2020 03; 9(4):26.
- Bioptic Telescope Use in Naturalistic Driving by People with Visual Impairment. Transl Vis Sci Technol. 2020 03; 9(4):11.
- The Effects of Hemianopia on Perception of Mutual Gaze. Optom Vis Sci. 2019 11; 96(11):860-865.
- The Effects of Age and Central Field Loss on Head Scanning and Detection at Intersections. Transl Vis Sci Technol. 2019 Sep; 8(5):14.
- The effects of simulated acuity and contrast sensitivity impairments on detection of pedestrian hazards in a driving simulator. Transp Res Part F Traffic Psychol Behav. 2019 Jul; 64:213-226.
- Effects of simulated mild vision loss on gaze, driving and interaction behaviors in pedestrian crossing situations. Accid Anal Prev. 2019 Apr; 125:138-151.
- The effects of age and cognitive load on peripheral-detection performance. J Vis. 2019 01 02; 19(1):15.
- Evaluation of a Paradigm to Investigate Detection of Road Hazards when Using a Bioptic Telescope. Optom Vis Sci. 2018 09; 95(9):785-794.
- Peripheral Prisms Improve Obstacle Detection during Simulated Walking for Patients with Left Hemispatial Neglect and Hemianopia. Optom Vis Sci. 2018 09; 95(9):795-804.
- Preliminary Evaluation of a Wearable Camera-based Collision Warning Device for Blind Individuals. Optom Vis Sci. 2018 09; 95(9):747-756.
- Driving With Hemianopia VI: Peripheral Prisms and Perceptual-Motor Training Improve Detection in a Driving Simulator. Transl Vis Sci Technol. 2018 Jan; 7(1):5.
- Driving with Hemianopia V: Do Individuals with Hemianopia Spontaneously Adapt Their Gaze Scanning to Differing Hazard Detection Demands? Transl Vis Sci Technol. 2017 Sep; 6(5):11.
- THE EFFECTS OF GUIDANCE METHOD ON DETECTION AND SCANNING AT INTERSECTIONS - A PILOT STUDY. Proc Int Driv Symp Hum Factors Driv Assess Train Veh Des. 2017 Jun; 2017:340-346.
- Bioptic Telescope Use and Driving Patterns of Drivers with Age-Related Macular Degeneration. Transl Vis Sci Technol. 2016 Sep; 5(5):5.
- Driving with homonymous visual field loss: a review of the literature. Clin Exp Optom. 2016 Sep; 99(5):402-18.
- Driving with central field loss III: vehicle control. Clin Exp Optom. 2016 Sep; 99(5):435-40.
- High-Power Prismatic Devices for Oblique Peripheral Prisms. Optom Vis Sci. 2016 05; 93(5):521-33.
- A Pilot Study of Perceptual-Motor Training for Peripheral Prisms. Transl Vis Sci Technol. 2016 Feb; 5(1):9.
- Mobile gaze tracking system for outdoor walking behavioral studies. J Vis. 2016; 16(3):27.
- Driving with Central Visual Field Loss II: How Scotomas above or below the Preferred Retinal Locus (PRL) Affect Hazard Detection in a Driving Simulator. PLoS One. 2015; 10(9):e0136517.
- Asymmetry in the Collision Judgments of People With Homonymous Field Defects and Left Hemispatial Neglect. Invest Ophthalmol Vis Sci. 2015 Jun; 56(6):4135-42.
- Peripheral prism glasses: effects of moving and stationary backgrounds. Optom Vis Sci. 2015 Apr; 92(4):412-20.
- The effect of central vision loss on perception of mutual gaze. Optom Vis Sci. 2014 Aug; 91(8):1000-11.
- Driving with hemianopia: IV. Head scanning and detection at intersections in a simulator. Invest Ophthalmol Vis Sci. 2014 Mar 13; 55(3):1540-8.
- Visual attention measures predict pedestrian detection in central field loss: a pilot study. PLoS One. 2014; 9(2):e89381.
- Randomized crossover clinical trial of real and sham peripheral prism glasses for hemianopia. JAMA Ophthalmol. 2014 Feb; 132(2):214-22.
- Driving with hemianopia: III. Detection of stationary and approaching pedestrians in a simulator. Invest Ophthalmol Vis Sci. 2014 Jan 20; 55(1):368-74.
- Can we improve clinical prediction of at-risk older drivers? Accid Anal Prev. 2013 Oct; 59:537-47.
- Central visual field loss and driving--reply. JAMA Ophthalmol. 2013 Jun; 131(6):819-21.
- Considering Apical Scotomas, Confusion, and Diplopia When Prescribing Prisms for Homonymous Hemianopia. Transl Vis Sci Technol. 2013 May; 2(4):2.
- The effect of strabismus on object detection in the ring scotoma of a monocular bioptic telescope. Ophthalmic Physiol Opt. 2013 Jul; 33(4):550-60.
- Driving with central field loss I: effect of central scotomas on responses to hazards. JAMA Ophthalmol. 2013 Mar; 131(3):303-9.
- A pilot evaluation of on-road detection performance by drivers with hemianopia using oblique peripheral prisms. Stroke Res Treat. 2012; 2012:176806.
- Peripheral prism glasses: effects of dominance, suppression, and background. Optom Vis Sci. 2012 Sep; 89(9):1343-52.
- Hazard Detection by Drivers with Paracentral Homonymous Field Loss: A Small Case Series. J Clin Exp Ophthalmol. 2011 Dec 06; 2011(Suppl 5):1.
- Object detection in the ring scotoma of a monocular bioptic telescope. Arch Ophthalmol. 2011 May; 129(5):611-7.
- Driving with hemianopia, II: lane position and steering in a driving simulator. Invest Ophthalmol Vis Sci. 2010 Dec; 51(12):6605-13.
- Does a line guide improve reading performance with stand magnifiers? Optom Vis Sci. 2009 Sep; 86(9):E1078-85.
- Driving with hemianopia, I: Detection performance in a driving simulator. Invest Ophthalmol Vis Sci. 2009 Nov; 50(11):5137-47.
- DEVELOPMENT AND EVALUATION OF VISION MULTIPLEXING DEVICES FOR VISION IMPAIRMENTS. Int J Artif Intell Tools. 2009 Jun 01; 18(3):365-378.
- Community-based trial of a peripheral prism visual field expansion device for hemianopia. Arch Ophthalmol. 2008 May; 126(5):657-64.
- Applications of Augmented Vision Head-Mounted Systems in Vision Rehabilitation. J Soc Inf Disp. 2007 Dec; 15(12):1037-1045.
- Reading with optical magnifiers: page navigation strategies and difficulties. Optom Vis Sci. 2007 Jan; 84(1):9-20.
- Establishing Mobility Measures to Assess the Effectiveness of Night Vision Devices: Results of a Pilot Study. J Vis Impair Blind. 2005 Oct; 99(10):663-670.
- On-road driving with moderate visual field loss. Optom Vis Sci. 2005 Aug; 82(8):657-67.
- Short-term in-office practice improves reading performance with stand magnifiers for people with AMD. Optom Vis Sci. 2005 Feb; 82(2):114-27.
- Bioptic telescopes meet the needs of drivers with moderate visual acuity loss. Invest Ophthalmol Vis Sci. 2005 Jan; 46(1):66-74.
- Evaluation of a prototype Minified Augmented-View device for patients with impaired night vision. Ophthalmic Physiol Opt. 2004 Jul; 24(4):296-312.
- Preferred retinal locus and reading rate with four dynamic text presentation formats. Optom Vis Sci. 2004 Mar; 81(3):205-13.
- Determining magnification for reading with low vision. Clin Exp Optom. 2002 Jul; 85(4):229-37.
- Illumination and reading performance in age-related macular degeneration. Clin Exp Optom. 2001 May; 84(3):139-147.
- Oral and silent reading performance with macular degeneration. Ophthalmic Physiol Opt. 2000 Sep; 20(5):360-70.
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The Bowers Laboratory uses the realistic, but controlled environment of a high-fidelity driving simulator to evaluate the impact of central vision loss (e.g., due to age-related macular degeneration), peripheral vision loss (e.g., due to glaucoma or retinitis pigmentosa) and hemianopic visual field loss (loss of half the field of vision e.g., after a stroke). The laboratory is evaluating the effects of these vision impairments on detection of hazards while driving, on steering and lane-keeping skills, and on eye and head movement behaviors.
When evaluating the benefits of optical devices for mobility tasks, we use two main approaches:
- Laboratory-based studies, including assessments in controlled environments such as the driving simulator
- Multicenter clinical trials using community-based, low vision clinics where the primary outcome measures are clinical success (whether the devices are still being used six months after being prescribed) and participants’ reports of the benefits of the devices (assessed by questionnaires).
Driving with Hemianopia
This project continues Dr. Bowers’ prior research on driving with hemianopia. The current study is investigating the ability of people with hemianopia to compensate for the hemifield loss by scanning (eye and head movements) in realistic scenarios involving a range of different hazards within the safe environment of the driving simulator. We are interested in the question of why some people with hemianopia compensate well by scanning yet others do not. In later stages of the project we will evaluate a novel intervention aimed at improving the scanning of drivers with hemianopia.
Why do Drivers Fail to See Hazards at Intersections?
The aim of this project is to understand more about the factors that may contribute to the finding that older drivers are more likely to be involved in intersection crashes than middle-age drivers. Interestingly, people sometimes report that they looked but failed to see the vehicle with which they crashed. We are using novel laboratory tests of visual attention and peripheral vision, complemented by more real-world tests in the driving simulator to investigate this observation. Using eye and head tracking we are recording whether older drivers actually fail to look in the direction of a hazard and do not see it, or whether they look directly at the hazard but do not consciously see it.
Driving with Bioptic Telescopes
People with reduced visual acuity are permitted to drive in 45 states with the aid of a small telescope, called a bioptic telescope, mounted at the top of their spectacle lens. The aim of the project is to investigate when and how bioptic telescopes are used and the safety of driving with bioptic telescopes. Using an in-car recording system and computerized analysis programs, we will record participants' daily driving activities for several months and then automatically process the vast amount of data to select segments of interest for analysis. This naturalistic driving evaluation will be complemented by lab-based tests and driving simulator evaluations. This project is being conducted in collaboration with Dr. Gang Luo.
Collision-Warning Device for People with Blindness or Severe Vision Loss
People with total blindness or severe vision loss often use a long cane when walking to warn them of potential obstacles in their path. However, the traditional long cane only detects objects at ground level. Dr. Gang Luo and colleagues have developed a collision warning device to provide long-cane users with warnings of potential collisions from objects above ground level (e.g., over-hanging tree branches). The goal of this project is to establish a strong evidence base for the functional efficacy of the device by conducting a randomized controlled clinical trial of the device in which participants use the device in their daily activities for one or two months.
Current Members of Dr. Alex Bowers’ Laboratory
Postdoctoral Fellows
- Steven Savage, PhD
- Garrett Swan, PhD
- Jing Xu, PhD
Research Assistant
- Lily Zhang, MS
Graduate Student
- Christine Zhang, BS
Visiting PhD Students
- Ilja Feldstein, MSc
- Christian Lehsing, MSc
Visiting MS students
- Birte Emmerman BSc
- Olivia Herzog BSc
- Roman Hoelzl BSc
- Lorenz Steckhan BSc
Learn more about her laboratory
Alumni
More than 20 trainees have worked in Dr. Bowers’ laboratory.