Extending the eXpanded Nystagmus Acuity Function for vertical and multiplanar data.

We updated and extended the functionality of the eXpanded Nystagmus Acuity Function (NAFX), for application under more diverse circumstances, improving its clinical predictive value. The original NAFX "tau-surface" of minimum-necessary-foveation times had been individually calculated for each combination of position and velocity limits. We have replaced it with an idealized mathematical function that repairs the irregularities in its surface due to idiosyncrasies in the subject data used for the initial calculations. To extend applicability to multiplanar data, we combine horizontal and vertical eye-movement data into a single waveform using vector summation. Torsional eye movements have little effect on visual acuity and are ignored. Age-related visual acuity relationships, derived from population data, more accurately relate the NAFX value to acuity for individual patients. Using the same patient fixation data that established the original NAF and NAFX functions, we verified that the updated NAFX yielded equivalent results for uniplanar data. For biplanar data, the results were also comparable to those of uniplanar data of the same magnitude. The updated NAFX yields greater accuracy in prediction of potential visual acuity for subjects of all ages, for uniplanar and multiplanar nystagmus, extending the objective, direct measure of post-therapy waveform improvement, allowing selection of the best therapy for a wider range of nystagmus patients.