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. 2024 Feb 12;14:3558. doi: 10.1038/s41598-024-52618-y

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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SLO images of a right HFD patient’s retina with eccentric fixation. (a) eccentric fixation of a cross, (b) reading a single word in vertical direction. By using a slightly eccentric retinal locus she creates a small perceptual area along the vertical midline, thus placing the line optimally in the seeing visual hemifield. (c) reading a short sentence in horizontal orientation. The text appears upside down for the examiner, but upright for the patient. The image shows an example of the foveola (yellow circle) landing outside the end of the line. This is a favorable spontaneous adaptive behavior that indicates that the benefit by shifting the text into the seeing hemifield existed before the training. It can be caused by a hypermetric saccade and eccentric fixation during reading. (d) reading a short sentence in vertical direction. The lines are not limited by the scotoma. The patient reads the first line (right) with her eccentric fixation locus and shifts the line into her seeing hemifield.