Bichi Chen,* Na Lin,* Li Tian, Jieli Mao, Maoyuan Yang, Xueqin Sun, Fan Lu, Ruzhi Deng

National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ruzhi Deng, National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, People’s Republic of China, Email drz@eye.ac.cn Fan Lu, National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, People’s Republic of China, Email lufan@mail.eye.ac.cn

Purpose: To investigate the impact of mild visual acuity loss on the Müller-Lyer illusion in adults and evaluate its potential as a clinical indicator for visual-cognitive integration mechanisms.
Methods: Three experiments were conducted. Experiment 1 measured illusion intensity in 49 young adults (25.08 ± 3.38 years) before and after inducing transient visual acuity loss (0.40 logMAR) via Bangerter occlusion foils. Experiment 2 compared 26 cataract patients (65.19 ± 3.87 years) with 59 age-matched controls (63.98 ± 5.57 years). Experiment 3 tracked 14 cataract patients (69.50 ± 6.14 years) pre- and post-surgery. Illusion intensity was quantified using a two-alternative forced-choice task.
Results: Illusion intensity remained stable across conditions: no differences were observed before /after wearing occlusion glasses (4.33% vs 3.75%, p = 0.141), between cataract patients and controls (8.79% vs 8.20%, p = 0.301), or pre-/post-surgery (9.46% vs 9.87%, p = 0.357). However, normally-sighted elderly participants exhibited stronger illusions than young adults (8.20% vs 4.33%, p < 0.001). Multivariate regression confirmed age as the sole predictor of illusion intensity (β = 0.088, p = 0.001), independent of visual acuity.
Conclusion: The intensity of Müller-Lyer illusion in adults is modulated by age but resistant to mild visual acuity loss, implicating its utility in studying visual-cognitive integration.

Keywords: Müller-Lyer illusion, illusion intensity, visual acuity, aging, visual cognition