Diagnosing the Periphery: Using the Rey-Osterrieth Complex Figure Drawing Test to Characterize Peripheral Visual Function.

Peripheral vision is strongly limited by crowding, the deleterious influence of neighboring stimuli on target perception. Many quantitative aspects of this phenomenon have been characterized, but the specific nature of the perceptual degradation remains elusive. We utilized a drawing technique to probe the phenomenology of peripheral vision, using the Rey-Osterrieth Complex Figure, a standard neuropsychological clinical instrument. The figure was presented at 12° or 6° in the right visual field, with eye tracking to ensure that the figure was only presented when observers maintained stable fixation. Participants were asked to draw the figure with free viewing, capturing its peripheral appearance. A foveal condition was used to measure copying performance in direct view. To assess the drawings, two raters used standard scoring systems that evaluated feature positions, spatial distortions, and omission errors. Feature scores tended to decrease with increasing eccentricity, both within and between conditions, reflecting reduced resolution and increased crowding in peripheral vision. Based on evaluation of the drawings, we also identified new error classes unique to peripheral presentation, including number errors for adjacent similar features and distinctive spatial distortions. The multifaceted nature of the Rey-Osterrieth Complex Figure-containing configural elements, detached compound features, and texture-like components-coupled with the flexibility of the free-response drawing paradigm and the availability of standardized scoring systems, provides a promising method to probe peripheral perception and crowding.