Scientific advances such as gene therapy have created many new possibilities to improve vision.

But how can experts and individuals with low vision measure the real-world impact of treatments? 

A new functional vision test developed by CERA researchers Lisa Lombardi and Lauren Moussallem may have the answer.

They hope that their new test – known as the Assessment Tool for Occupational performance and Mobility-Multisensory approach (ATOMM) – will eventually become an internationally recognised standard assessment tool for real-world functional vision evaluation.

Lombardi, an optometrist and Senior Clinical Research Coordinator, says activities of daily life can be complex for people with low vision – and difficult to ‘capture’.

“Traditional vision assessments, such as reading letters on an eye chart, don’t necessarily reflect a person’s ability to function in everyday life,” she says. 

“Tasks such as crossing a street or making a cup of tea, require more than just visual acuity — they need a combination of tactile, auditory and cognitive strategies.”

A US-developed assessment has been used in Australia, but Lombardi and Moussallem recognised the test was not always suited to Australian life. Particularly, references to following the lines of a crosswalk which don’t apply to Australian conditions. 

Moussallem, an orthoptist and clinical research coordinator, says the pair decided to develop a tool that would be more practical, efficient and globally applicable. 

Objective assessment 

ATOMM is designed to capture not only whether someone can complete a task, but also how they do it. 

The test consists of 15 tasks divided into three domains: daily living, outdoor navigation and social interactions. 

Participants complete the test in their own home and local environment, making the results more applicable to their daily lives. 

The assessor gives an objective rating and the participant rates how well they feel they performed. 

Lombardi says the test may play a significant role in detecting real-world changes in functional ability before and after medical interventions, such as gene therapy, retinal devices, or orientation and mobility training. 

“For instance, if a patient who previously relied entirely on a cane or guide dog for navigation begins using residual or bionic vision after a treatment, this tool may capture that shift,” she says.

More applications

Moussallem says that while originally developed for clinical research and bionic vision trials, the ATOMM has broader potential applications, including rehabilitation programs, evaluating new devices and offering insight into the daily challenges faced by vision-impaired individuals.

Lombardi’s work has already been recognised with the 2025 LOOK International Scholarship from Optometry Australia. The prestigious award highlights her contribution to vision research and the advancement of clinical tools that improve patient outcomes.

After their pilot study demonstrated the reliability and repeatability of the test, the pair presented their findings at an international orientation and mobility conference in Texas, in November 2024. 

The test received overwhelming interest from professionals.

The team is now working to expand the study with additional participants and with the hope of seeking regulatory approval from bodies such as the FDA in the US and TGA in Australia. 

Their work has been supported by CERA philanthropic funding and an Australian Vision Research grant. 

This story was originally published in Share our vision: Annual Review 2024.