Improvement of reading speed after providing of low vision aids in patients with age‐related macular degeneration

Abstract

Age-related macular degeneration (AMD) is the most common cause of severe visual impairment, including loss of reading ability, among elderly persons in developed countries. The aim of the present study was to evaluate reading ability before and after providing of appropriate low vision aids. Five hundred and thirty patients with different stages of AMD (age 82 +/- 8 years) were included in this retrospective study. All patients underwent a standardized ophthalmological examination including evaluation of magnification requirement and careful providing of low vision aids. Before and after the provision of low vision aids, reading speed [words per minute (wpm)] was evaluated using standardized reading texts. For the whole group, the average best-corrected distance visual acuity of the better eye was 0.18 +/- 0.15, with 69% of patients having visual acuity of 0.1 (20/200) or better. The mean magnification requirement was 7.4 +/- 6.3-fold (range 2-25). Visual rehabilitation was achieved with optical visual aids in 58% of patients, whereas 42% of patients needed electronically closed-circuit TV systems. Mean reading speed was 20 +/- 33 wpm before and increased significantly to 72 +/- 35 (p < 0.0001) after the provision of low vision aids for the whole group. Between patients with visual acuity < 0.1 and patients with visual acuity of 0.1 or better, there are highly significant differences in reading speed before (0.4 +/- 3.8 versus 20 +/- 28 wpm, p <or= 0.0001) and after providing of visual aids (40 +/- 13 versus 84 +/- 30 wpm, p <or= 0.0001). Patients with severe visual impairment (visual acuity <or= 0.1) showed significantly lower improvement of reading speed compared to patients with visual acuity of 0.1 or better following rehabilitation (p <or= 0.0001). Before providing of low vision aids, only 16% of patients were able to read; in contrast, reading ability was achieved in 94% of patients after the provision of low vision aids for the whole group. Our results indicate the great value of low vision rehabilitation through adequate providing of vision aids for the improvement of reading ability, with a highly significant increase of reading speed without training of eccentric viewing in patients with retained central fixation. The prompt implementation of low vision aids in patients with macular degeneration will help them to maintain and regain their reading ability, which can lead to an increase in independence, communication, mental agility and quality of life.