Dinesh Venugopal¹ (), Batuhan Erkat¹, Roksana Sadeghi^2,3, Chau Tran⁴, Will Gee⁴, Brittnee Livingston⁵, Gislin Dagnelie², Arathy Kartha¹; ¹SUNY College of Optometry, Department of Biological and Vision Sciences, New York, NY, United States, ²Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, MD, United States, ³Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States, ⁴BaltiVirtual, Baltimore, MD, United States, ⁵Central Association for the Blind and Visually Impaired, Utica, NY, United States

People with ultra-low vision (ULV) perceive limited visual information and experience substantial challenges in complex environments. However, the impact of visual complexity on wayfinding performance in ULV remains largely under-explored. This study aimed to quantify the effects of visual complexity on walking speed and turn deviations during visual wayfinding in individuals with ULV using virtual reality (VR). Participants with normal vision (NV) (n=10) and ULV (n=14) completed visual wayfinding tasks in a virtual cafeteria under three complexity levels: ordered tables (A), disordered tables (B), and cluttered surroundings (tables, seated avatars, balloons, posters) with a moving avatar (C). At each level, participants were instructed to locate and walk towards the cashier at the opposite side (~4.3m away) at a comfortable speed. The NV participants also completed wayfinding tasks with ULV-simulating filters (sULV; using Bangerter foils). Head positions were tracked; turns were segmented using the simplified Ramer–Douglas–Peucker algorithm (ε=10cm) and compared to an optimal path to compute turn deviations. Walking speed (m/s) and turn deviations were compared across participant groups and levels using Generalized Estimating Equations. The ULV group showed the greatest impairments, with walking speed at C decreased by 0.10m/s compared to A and 0.05m/s compared to B (both p<0.05), and turn deviations increased by 5.1 and 3.3 turns, respectively (both p<0.05). In sULV, walking speed at C decreased by 0.05m/s compared to levels A and B (both p<0.05), while turn deviations increased by 2.9 turns compared to A (p<0.001) but showed no difference compared to B. The NV group showed no differences in walking speed or turn deviations across levels. In both ULV and sULV groups, walking speed and turn deviations were significantly correlated (ρ = –0.79 and –0.67, respectively; both p<0.001). Visual complexity significantly impaired wayfinding performance in individuals with ULV and sULV.