Gamification Enhances User Engagement and Task Performance in Prosthetic Vision Testing

Purpose: Visual function testing in retinal prosthesis users relies on repetitive psychophysical tasks that are cognitively demanding and fatiguing. Gamification may increase engagement, but its effects on perceptual performance in implanted users remain unclear. Methods: Three Argus II users completed circle localization and motion direction discrimination in clinical and gamified versions. Visual stimuli, trial structure, and response requirements were matched within each participant; gamified versions added scoring, background music, and affectively framed end-of-trial auditory feedback. Difficulty and response format were calibrated to individual abilities: eight-alternative forced-choice for two participants and four-alternative forced choice restricted to cardinal directions for one participant. Results: Gamification improved accuracy and reduced angular error in localization but did not improve motion discrimination. Effects were task dependent and varied across participants, with reduced precision in the gamified motion task for one user. Participants preferred gamified localization and reported higher enjoyment and sustained attention; responses to gamified motion were mixed. Conclusions: Gamification can influence measured performance and user experience in prosthetic vision testing, but benefits are not universal and depend on task demands and cognitive load, indicating that engagement can affect outcomes in tests often treated as objective. Translational Relevance: Personalized, engagement-aware gamified tools with adaptive difficulty may improve the usability and scalability of prosthetic vision assessment and rehabilitation, including at-home training.