Although Japan has an established welfare system for individuals with visual impairments, medical-welfare coordination remains limited. To address this gap, the Low Vision Care Hub (LVCH) was established within a university hospital. We evaluated the impact of LVCH on visitor satisfaction before and after consultation STUDY DESIGN: A single-center, one-group pre-post study METHODS: Individuals with self-reported functional vision difficulties who visited LVCH between July 1 and December 20, 2024 were included. Consultation was provided based on seven domains of low vision care outlined by the Japan Society for Low-Vision Research and Rehabilitation. Satisfaction was measured on a custom 6-point ordinal scale (0-5) pre/post consultation. Changes in satisfaction scores were analyzed using the Wilcoxon signed-rank test. Multivariable logistic regression adjusted for potential confounders RESULTS: Ninety-three participants were included. Satisfaction scores significantly increased after consultation (p < .001) and improvements were consistent across sex, age groups, and visual impairment classification using the International Council of Ophthalmology (ICO) criteria (all p < .001). Notably, participants not meeting the ICO-defined low vision criteria also improved (p < .001). On multivariable logistic regression, only older age (≥ 60 years) remained significantly associated with a markedly improved satisfaction score (OR = 2.98, 95% CI 1.10-8.05, p = .03) CONCLUSION: Consultations provided at LVCH significantly improved visitor satisfaction, including those who did not meet the ICO low vision criteria. Consultation may be particularly effective in individuals aged over 60 years. Overall, early-stage intervention through structured consultation may benefit individuals with functional vision difficulties.

Dual sensory impairment-that is, concurrent hearing and vision impairment-is common in aging populations. Individuals with dual sensory impairment face unique social and functional challenges, but the benefit of conventional rehabilitation in addressing these challenges is not well researched. To determine the association between hearing impairment and the likelihood of achieving a clinically meaningful functional improvement following vision rehabilitation. This was a cross-sectional analysis of data collected by the Low Vision Rehabilitation Outcomes Study, a prospective cohort study on clinical outcomes of vision rehabilitation. Data were included from outpatient low vision rehabilitation services provided at 28 clinical centers across the US between April 2008 and May 2011. The analyses included 611 adults with vision impairment and available self-reported hearing status. Of these, 407 had complete postrehabilitation follow-up data. Data were analyzed from July 2024 to March 2025. Self-reported hearing impairment status at baseline (normal hearing vs hearing impairment). The primary outcome was the improvement in general capability as measured by the Activity Inventory before and after rehabilitation, computed using the method of successive dichotomizations. Rehabilitation was considered effective if the improvement reached a minimum clinically important difference (MCID). Multivariable logistic regression was used to evaluate the association between hearing impairment and achieving MCID. Covariates included age, sex, visual, psychological, physical, and cognitive status. Among the 611 participants (mean [SD; range] age, 73 [15.3; 19-101] years; 403 [66%] female), 358 had normal hearing and 253 had self-reported hearing impairment. Baseline ability did not differ by hearing status (β, -0.08; 95% CI, -0.56 to 0.41; P = .75). However, a smaller proportion of participants with hearing impairment achieved MCID following vision rehabilitation (39/169 [23%] vs 74/238 [31%]; odds ratio [OR], 0.58; 95% CI, 0.34-0.95; P = .03); this association was not attenuated by possession of hearing aid (17/74 [23%] vs 21/95 [22%]). In addition to better hearing status, participants with severe vision impairment (OR, 3.32; 95% CI, 1.2-11.86; P = .04) and higher depressive symptoms (OR, 1.38 per logit increase; 95% CI, 1.17-1.63; P < .001) were more likely to achieve MCID. In this study, self-reported hearing impairment was associated with reduced likelihood of functional improvement following vision rehabilitation. These findings support the need for interdisciplinary efforts in rehabilitation programs to better serve individuals with dual sensory impairment.

Digital, smart, and electronic low vision aids (LVAs) have expanded options for visual rehabilitation and functional independence among people with visual impairment. However, adoption of these technologies remains limited, particularly in low- and middle-income countries such as Jordan, where access, affordability, and training resources may be constrained. To examine barriers to the adoption of electronic LVAs and identify factors associated with their use among eye care professionals in Jordan. A descriptive cross-sectional survey was conducted among 270 eye care professionals working in hospitals, rehabilitation centers, and private clinics across Jordan. The questionnaire assessed awareness, training exposure, institutional support, and perceived barriers related to electronic LVAs. Descriptive statistics and inferential analyses were used to examine adoption patterns and predictors, with statistical significance set at P<.05. Of the 270 participants, 156 (57.8%) were optometrists, 78 (28.9%) were ophthalmologists, and 36 (13.3%) were low vision specialists. The mean age was 36 (SD 8) years, and the mean professional experience was 12 (SD 6) years. Overall, 117 of 270 (42.2%) participants reported current use or recommendation of electronic LVAs. The most frequently reported barriers were high device cost (n=213, 79%), lack of training (n=184, 68.1%), limited institutional support (n=173, 64%), and low patient awareness (n=154, 57%). In multivariable analysis, greater training exposure (odds ratio [OR] 1.82, 95% CI 1.31-2.53; P<.001), stronger institutional support (OR 1.48, 95% CI 1.12-1.96; P=.008), and higher awareness scores (OR 1.35, 95% CI 1.05-1.72; P=.02) were positively associated with aid adoption, whereas high device cost was negatively associated with aid adoption (OR 0.41, 95% CI 0.27-0.62; P<.001). Adoption of electronic LVAs among eye care professionals in Jordan remains limited. Cost, training exposure, and institutional support are key factors influencing uptake. These findings suggest that strengthening professional training and institutional support may facilitate broader integration of electronic LVAs into low vision rehabilitation services.

Introduction This study documents the results of the rehabilitation services offered to 1136 persons with vision impairment in Jordan over the period 2012–2020. Information is presented about the causes of visual impairment, functional vision assessment, offered rehabilitation services, functional problems and needs, and recommended low vision devices. Methods A retrospective file study was carried out on data of 1136 service users (538 children, 598 adults). The data was classified and analyzed to give descriptive statistics including main cause of low vision; service users’ priorities; visual functions (distance and near visual acuity, reading acuity, contrast sensitivity, peripheral visual field, and color vision); and prescribed low vision devices. Results Just under half of service users (n = 498, 43.8%) had moderate visual impairment (0.3 &gt; Visual Acuity ≥ 0.1). Only 8.5% of the files represented individuals who had a binocular visual field of less than 20 degrees in either the vertical or horizontal planes. Near tasks (writing, reading, technology use, and work-related tasks) were reported as the first priority by the majority of the service users (78.9%). Retinal diseases represented the cause of half of low vision cases (n = 568, 50.0%), followed by albinism (n = 83, 7.3%). Among the 1078 assistive low vision devices that were prescribed (first and second choices), near-field devices were prescribed as a first choice (58.01%), then distance devices (12.32%). Discussion The findings indicate that retinal diseases are the dominant cause of low vision in this population, the majority of whom needed remediation for near tasks. Implications for Practitioners Comprehensive assessment of visual functions that includes visual acuity, reading acuity, visual field, contrast sensitivity, and color vision is essential to provide better rehabilitation and to recommend proper low vision devices. The study reveals to decision makers the importance of planning and developing low vision services.

Background: Low vision significantly affects an individual’s ability to perform day-to-day activities, particularly reading. The present study aimed to evaluate the effectiveness of appropriate optical devices and specialized training in improving distance and near vision, thereby enabling patients to continue their routine activities.Materials and Methods: This prospective study included 46 patients aged 20–65 years with various ocular conditions causing visual impairment. All participants underwent a comprehensive ophthalmic evaluation, including assessment of magnification requirements. Suitable low vision devices were prescribed accordingly. Reading speed was measured in words per minute (wpm) using the M.N. Reading Chart after patients were provided with the prescribed optical aids and training.Results: The average best-corrected distance visual acuity (BCVA) in the better eye was 6/36 ± 6/9. Among patients using optical aids, 58% demonstrated improvement in visual acuity. Mean reading speed increased significantly from 8 ± 26 wpm before intervention to 72 ± 33 wpm after magnification. Overall, 94% of patients achieved functional reading ability with magnification devices. Improvements were also observed in mobility and orientation, with several patients attaining fair to good mobility levels. Additionally, 73.3% of patients were able to continue their employment following low vision rehabilitation.Conclusion: Standardized measurement of reading speed is essential for assessing the effectiveness of low vision rehabilitation services. Provision of appropriate optical aids and training significantly enhances reading performance, mobility, and occupational continuation among visually impaired individuals.

Intraocular and optic pathway metastases constitute rare but profoundly disruptive manifestations of advanced cancer, often leading to rapid and irreversible bilateral vision loss. Although the ophthalmic literature extensively documents tumor behavior and treatment outcomes, the psychological and existential implications of impending blindness remain largely unexamined. This narrative review synthesizes evidence across oncology, vision-loss psychology, and grief studies to conceptualize the phenomenon of existential darkness, defined as the convergence of sensory extinction, identity disruption, anticipatory grief, and existential fear experienced as patients confront the loss of sight within a terminal prognosis. The clinical trajectory of ocular metastasis characterized by abrupt decline, limited survival, and high bilateral risk creates a compressed period in which psychological adaptation becomes extraordinarily challenging. Patients frequently experience despair, meaning collapse, relational disconnection, and heightened death anxiety, yet psychosocial frameworks specific to vision-threatening metastasis are absent. Integrating meaning-centered psychotherapy with early low-vision rehabilitation emerges as a promising, though untested, strategy to support agency, coherence, and dignity during visual decline. By articulating existential darkness as a distinct psycho-oncological construct, this review identifies critical gaps and outlines a foundation for clinical and research efforts that address the profound human experience of losing the visible world at the end of life.

Purpose Achromatopsia (ACHM) is a rare hereditary retinal disorder characterized by low vision, photophobia, and nystagmus. Due to its rarity, the relevant literature is limited. This study aimed to evaluate the structural and functional retinal changes observed in the ACHM spectrum using multimodal imaging. Methods In this prospective cross-sectional study, 62 eyes of 31 patients within the ACHM spectrum who applied to the Low Vision Rehabilitation Unit of Ankara University Faculty of Medicine were evaluated. Assessments included macular pigment optical density (MPOD), microperimetry, contrast sensitivity (CS), fundus autofluorescence (FAF), and optical coherence tomography (OCT). Eyes were classified into five stages based on photoreceptor layer damage. Results The mean best-corrected visual acuity (BCVA) was 0.85 ± 0.18 logMAR. Fundus examination showed normal findings in 42%, irregular retinal pigment epithelium (RPE) in 48%, and atrophic RPE in 10%. Mean MPOD was 1.32 ± 2.27 dB, retinal sensitivity 20.85 ± 4.61 dB, and central macular thickness (CMT) 124.88 ± 59.15 µm. Fixation was extrafoveal in 92% and unstable in 83%. Photoreceptor damage was present in 72% of eyes: stage 1 (28%), stage 2 (13%), stage 3 (14%), stage 4 (19%), and stage 5 (26%). The ellipsoid zone was absent in 59%, foveal hypoplasia in 52%, and hypoautofluorescence in 57%. Significant correlations were observed between ellipsoid zone integrity and age, CMT, and FAF pattern (p = 0.044, p = 0.005, p < 0.001). Conclusion This study highlights reduced MPOD, photoreceptor damage (72%), ellipsoid zone loss (59%), and foveal hypoplasia (52%) within the ACHM spectrum. The findings of this study may contribute to the literature on structural and functional retinal changes observed in cases within the ACHM spectrum and may be useful in the design of future clinical studies.

Purpose: Low vision is a significant public health issue that affects daily functioning and mental well-being.Psychosocial support is often overlooked in vision rehabilitation programs.This study aimed to assess the effects of structured psychosocial counselling on mental health and functional independence in individuals with low vision. Methods:A randomized controlled trial (NCT06914076) was conducted at Sial Hospital, Ali Pur Chatha, over four months (20 March-20 June) 32 low vision patients aged 18-65.The experimental group received structured psychosocial counselling; the control group did not.DASS-21 and VFQ-25 were used.Shapiro-Wilk test for normality, Repeated Measures ANOVA for within-group analysis, and Dunn-Bonferroni test for post-hoc comparisons (SPSS v27). Results:The mean age of Group A was 37.4414.39and Group B was 39.696.71,with balanced gender distribution.Baseline data were normally distributed (p>0.05).Repeated measures ANOVA showed significant 12-week improvements in depression, anxiety, stress, and visual functioning in Group A (p<0.001).Post-hoc Dunn-Bonferroni tests confirmed significant between-group differences for depression (p<0.001),anxiety (p=0.005),stress (p=0.005), and VFQ-25 (p<0.001),favoring the intervention group.Conclusion: Structured psychosocial counselling led to notable improvements in mental health and daily functioning among individuals with low vision.The intervention group experienced reduced levels of depression, anxiety, and stress.These results support the value of counselling as part of low vision rehabilitation.

Glaucoma is one of the most common causes of irreversible visual impairment world wide. Providing low vision rehabilitation (LVR) services is a primary mode of support for patients with permanent vision loss. This retrospective, cross-sectional study evaluated the rate at which patients with severe open-angle glaucoma (OAG) were referred for LVR services at an academic medical center. Patient demographics, glaucoma severity, appointment history, performance on visual field (VF) testing, presenting visual acuity (VA), and change in best-corrected visual acuity (BCVA) after low vision refraction were abstracted from the electronic record and summarized by using descriptive statistics. Logistic regression analysis was used to assess the relationship between study variables and the likelihood of referral for LVR evaluation. Out of 522 patients with severe OAG, 88% of whom qualified as having low vision, 14 were referred for an LVR evaluation (2.7%). Referrals were most strongly associated with VA (adjusted odds ratio [aOR], 7.20; 95% confidence interval [CI], 2.11–24.64, p = 0.001) but not glaucoma-associated VF loss (aOR, 0.90; 95% CI, 0.24–3.37, p = 0.876). Thirteen of 14 patients referred for LVR completed visits (93%). More than one-third of those patients improved in their better-seeing eye after a low vision refraction, gaining an average of −0.18 ± 0.24 logMAR (half gaining ≥2-lines of BCVA). Patients with severe OAG are at risk of progressive visual disability from their eye disease. We found, however, that the majority of these patients were not referred to LVR services, despite meeting eligibility criteria and growing evidence demonstrating their potential benefit.

Introduction: Central vision loss significantly impairs reading ability, and few technological tools aim to support both reading and eccentric viewing training. This study aimed to develop a user-centered mobile application, Eccentric Visor, to enhance reading accessibility and support eccentric vision training using evidence-based methods and computer vision techniques. Methods: The application was developed through an iterative, user-centered co-design process to produce a Minimum Viable Product (MVP). Key features include customizable text presentation and a visual fixation marker to support the steady eye strategy. Usability and acceptability were evaluated through structured questionnaires and open-ended feedback from individuals with central vision loss and low vision rehabilitation professionals. Results: The MVP incorporated reading enhancement strategies such as font and contrast adjustments and dynamic scrolling text. Most users found the application easy to use and effective for practicing eccentric viewing. All professionals indicated they would recommend the app in clinical contexts, highlighting its utility as both a reading aid and a potential training tool. Conclusion: Eccentric Visor shows promise as a digital resource that may support both accessible reading and eccentric viewing training. Preliminary findings suggest the app is usable, adaptable, and well-received by users and clinicians. It may also serve as a platform for future enhancements and formal efficacy studies. Implications for practitioners: By integrating customizable features with evidence-based design, Eccentric Visor may offer rehabilitation professionals a practical tool to support independent reading and ongoing visual training.

Purpose: To determine the influence of the Google Lookout smartphone application on enhancing the performance of functional vision; reading and medicine recognition in patients with macular disease. Methodology: The comparative quasi-experimental study was a within-subject study carried out at the Low Vision Clinic, Mayo Hospital, between April and September 2025 following the Ethical Review Board approval. At 5% significance, 80% power of test, and 95% confidence level there was a calculated total sample of 36 participants. Since the same participants were measured in both of the conditions, within-subject design was used. Each participant used the app to complete a two-functional vision task, including short-text reading and medicine identification, in two different conditions, first without the app and secondly with the Google Lookout application. A ten-minute instruction on using the app and the interpretation of voice feedback was given to the participants before the test with the app. Both conditions were time taken and accuracy. The Wilcoxon Signed Ranks Test with the level of significance of p &lt;0.05 was used in data analysis. Results: Google Lookout was found to be helpful in enhancing the accuracy of reading and medicine-recognition tasks. The mean reading accuracy improved between 9.4 ±1.6(without app) and 13.1 ±1.2 (with app) (p &lt;0.001) and the performance of medicine-identification was also significantly improved (p = 0.001). In spite of the fact that the time to complete tasks was higher because of the audio processing stage and the additional time required for comprehension. The general accuracy of the tasks and the rates of success were higher. According to these findings, Google Lookout is useful in supporting activities that rely on central vision and improving functional independence of macular disease patients. Conclusion: The Google Lookout app effectively enhances the accuracy of reading and medicine-recognition tasks in patients with macular disease, supporting its role as a supplementary low-vision rehabilitation tool.

BACKGROUNDVisual impairment during early childhood can hinder motor, language, and social development, yet data on its developmental impact across common pediatric ocular diseases remain limited.AIMTo investigate the developmental impact of low vision and blindness on children under six with common ocular diseases.METHODSThis retrospective study reviewed records of new patients under six with visual impairment at Siriraj Hospital’s low vision rehabilitation center (January 2017-October 2022). We collected ocular, systemic, and developmental data; recorded visual acuity in the better-seeing eye after refractive correction; and assessed developmental domains with the Denver II. Univariable and multivariable logistic regression identified factors associated with developmental delay.RESULTSA total of 161 pediatric patients (mean age 24.9 ± 18.9 months) were enrolled and evaluated based on their ability to fix on and follow an object or light source. Some were further assessed using the Allen picture chart and all had visual acuity worse than 1.07 ± 0.58 LogMAR, and 83.2% were identified as having global developmental delay (GDD). The three most common ocular causes were cortical visual impairment (CVI), optic neuropathy/atrophy, and optic nerve hypoplasia. Extremely poor visual acuity (inability to fixate and follow) was significantly associated with GDD [adjusted odds ratio (AOR) 41.0] and delays in all developmental domains: Gross motor (AOR 10.0), fine motor (AOR 12.8), language (AOR 5.3), and personal-social skills (AOR 13.4) (P ≤ 0.002). Multiple disabilities, most often visual impairment with cerebral palsy, were also significantly associated with gross motor delays (AOR 7.7) and fine motor delays (AOR 4.0) (P < 0.05). CVI was also related to delays in language and personal-social skills (AOR 9.1 each) (P < 0.05).CONCLUSIONThis study underscores the developmental issues in children with visual impairment, especially those with poorer acuity, CVI, and multiple disabilities. Significant delays were observed in all domains, including GDD. A timely referral to specialists is strongly recommended.

Background:Low vision care and rehabilitation (LVCR) remains critically underdeveloped in sub-Saharan Africa, despite a high prevalence of moderate to severe visual impairment.Objective:This study assessed the current state of LVCR in five sub-Saharan African countries using a modified World Health Organization (WHO) health systems framework.Method:A qualitative design was employed, involving semi-structured interviews which were based on a modified WHO health system building blocks: governance and leadership, health service delivery, human resource, low vision aid and technology, and financing. Optometrists providing low vision care in Ghana, Nigeria, Malawi, Kenya, and South Africa were recruited as participants through a combination of stratified random sampling and snowballing. Thematic analysis was conducted to identify the underlying themes.Results:Practitioners reported systemic deficiencies across all five blocks investigated. Governance and leadership lacked clear policies, coordination, and data infrastructure. Health service delivery was characterized by poor coverage, the absence of dedicated LVCR centres, and limited integration into public health systems. Human resources were inadequate, with no structured training or recruitment of practitioners, and low recognition of the sub-specialty. Essential assistive technologies were largely inaccessible due to high costs and procurement challenges. Financing was insufficient, with patients primarily paying out-of-pocket and health insurance schemes offering limited support.Conclusion:None of the five blocks of the WHO health systems framework were adequate for LVCR in this study. Consequently, strengthening each block particularly governance, workforce development, and financing is essential for advancing equitable and sustainable LVCR systems in sub-Saharan Africa.

Importance of Screening for Contrast Sensitivity, Falls, and Mobility Limitations in Older Adults With Maculopathy.

IntroductionDiabetic retinopathy (DR) often causes vision loss and functional impairment. Standard low vision rehabilitation improves visual function but many patients cannot access it because of cost, travel, and limited specialist availability. We aimed to compare a home-based digital vision rehabilitation program to standard in-clinic rehabilitation in patients with DR.MethodsWe conducted a retrospective matched cohort study at a tertiary eye center in China. Adults with moderate to severe visual impairment from DR were included. A total of 380 patients were analyzed after 1:1 propensity score matching (190 per group). One group underwent a 12-week home-based digital physiotherapeutic vision training program delivered via a mobile app with daily exercises and weekly telehealth supervision, while the other group received standard in-person low vision rehabilitation over 12 weeks. The primary outcome was change in visual functional status measured by the Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 (VA LV VFQ-48). Secondary outcomes included visual acuity, vision-related quality of life, depressive symptoms, mobility, metabolic control, and cost. Outcomes were assessed at baseline, 12, 24, and 48 weeks.ResultsBoth the home-based digital training and standard in-clinic rehabilitation groups achieved substantial improvements in vision-specific functional status over 48 weeks. VFQ-48 scores increased by 22–26 points in each group, indicating clinically meaningful gains, and the digital program’s improvement was comparable to standard care (demonstrating non-inferiority for the primary outcome). All secondary outcomes improved comparably in both groups, with no significant between-group differences. The digital intervention cost 7791 Chinese yuan (CNY) per patient over 48 weeks compared to 10,305 CNY with standard care, providing a net savings of 2514 CNY per patient. Both approaches were well tolerated, with no major safety concerns.ConclusionsHome-based digital rehabilitation was non-inferior to standard in-clinic rehabilitation in improving functional vision, while substantially reducing costs and maintaining safety. These findings support implementing home-based or hybrid telerehabilitation models to broaden access to vision rehabilitation services.Level of EvidenceLevel III retrospective cohort study.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40123-025-01283-z.

To date, (cost-)effectiveness of multidisciplinary inpatient low vision rehabilitation (ILVR) programs is unknown and adequate patient-reported outcome measures (PROMs) are lacking. The purpose of this exploratory study was to identify relevant patient-reported outcomes (PROs) within ILVR, personal, contextual and procedural factors affecting ILVR outcomes, and PROMs implementation preferences. Semi-structured interviews were conducted among adults with vision impairment (VI) who follow(ed) an ILVR program between January 2020 and January 2022 (n = 19). Healthcare providers of each professional group were interviewed as well (n = 10). Tailored interview guides were used to explore PROMs in ILVR from an early development stage. Interview data was sorted into categories of relevant PROs, personal, contextual and procedural factors, and implementation suggestions. Participants indicated seven potential PROs: mindset, knowledge and strategies, practical skills, self-reliance, social participation, relationships and personal development. Personal, contextual and procedural factors affecting these PROs were related to patient characteristics, coping mechanisms, social support, rehabilitation circumstances, quality of care and transfer to the home environment. Implementation suggestions such as modes of administration, frequency, burden and customization were discussed. This exploratory study provides the first step toward future development and implementation of PROMs in ILVR. Further establishment of a set of PROMS requires an extensive process of matching the themes with accurate PROMs, in which it seems generic and specific PROMs for individuals with VI can be effectively combined. Moreover, the accessibility and the burden on patients and healthcare providers should be taken into account, for example by using different modes of administration and computer adaptive testing.

This study aimed to evaluate the effectiveness of low vision aids (LVAs) in improving both distance and near vision among patients with low vision of various etiologies and to identify the most used low vision devices. This retrospective study reviewed 149 patient files from 1 January 2019 to 31 December 2023. Visual acuity assessments included distant visual acuity measured unilaterally and bilaterally at 3 m using the Distance Test Chart (Lea symbols) before and after using LVAs (monocular or binocular telescopes). Near visual acuity was tested using the Lea symbols line test charts progressing from 8.00 M to 0.32 M, measured binocularly at the patient’s preferred distance and then at 25 cm using a +4.00 D reading add. Reading acuity was assessed using printed Arabic texts in different Times New Roman fonts before and after using LVAs (magnifiers, prismatic glasses, etc.). The diagnosis of ocular diseases causing low vision was recorded. ARMD and Macular dystrophies were the most common causes of low vision (18.1% and 17.4% respectively). There was a statistically significant improvement in near and reading visual acuity ( p &lt; .001). The use of LVAs improved reading and near visual acuity by 3.57 ± 1.76 and 2.25 ± 2.79 lines, respectively. The percentage of patients able to read font size 2 increased from 2.7% to 53.0% after using near vision aids. A statistically significant improvement in distance visual acuity was also found ( p &lt; .001), with a mean improvement of 2.40 ± 1.97 lines. As a conclusion; LVAs are an effective means of providing visual rehabilitation for distance, near, and reading vision among patients with low vision.

Abstract: Low vision affects millions of individuals worldwide, significantly impairing their quality of life. Conventional optical aids, including external telescopic systems and intraocular implants, have limitations such as bulkiness, restricted field of view (FOV), and optical aberrations. Advances in nanophotonics and metamaterials have led to the development of metalenses – flat, ultra-thin optical elements that manipulate light with high precision. Their compact design, reduced aberrations, and enhanced optical performance make them a promising alternative for intraocular telescopic applications. This review analyses studies listed in PubMed, Web of Science, Scopus, and CrossRef and examines the feasibility of intraocular metalens telescopes for low vision rehabilitation. Fundamental principles of metalenses, their material science aspects, and their optical properties, particularly in the visible spectrum, are examined. In addition, their integration into intraocular telescopic systems and potential synergies with emerging technologies, such as augmented reality (AR), is explored. Special emphasis is placed on the biocompatibility and functionality of graphene-based metalens implants. Metalenses exhibit superior optical precision, a wider FOV, and tunable focal properties compared to conventional intraocular telescopes. Biocompatible materials like graphene provide long-term stability and compatibility intraocularly. Furthermore, AR-assisted metalens systems may offer dynamic image enhancement, improving visual perception for individuals with low vision. Intraocular metalens telescopes represent a novel and promising approach to vision restoration. Their advanced optical properties, combined with the potential for real-time adaptability and integration with digital augmentation technologies, could significantly improve the effectiveness of intraocular vision aids. Further research is needed to optimize their design, biocompatibility, and clinical applicability for widespread use in ophthalmology.

Background: Low vision significantly impacts daily activities in urban areas like Lahore, Pakistan. Understanding the prevalence and underlying causes of low vision is crucial for developing effective health policies, enhancing service accessibility, and strengthening low-vision rehabilitation efforts. Objective(s): To assess the frequency and leading cause of low vision in Lahore. Methodology: This four-month observational cross-sectional study was started at the University of Lahore Teaching Hospital (ULTH) and LRBT, involving 140 patients aged 10 to 60 years diagnosed with low vision. Using a non-probability convenient sampling method, the study ensured ethical compliance by obtaining informed consent and maintaining participant confidentiality. Data collection included comprehensive eye exams (e.g., visual acuity, refraction, slit-lamp, fundoscopy, tonometry, and visual field testing), structured questionnaires, and medical record reviews to assess demographics, medical history, and the impact of low vision on quotidian life. Data was securely recorded and analyzed using SPSS version 27, with descriptive statistics to identify common causes of low vision. Results: Of the total 140 participants, 71 were female (50.7%) and 69 were male (49.3%). In terms of age, the prime group was those aged 51–60 years (56 participants, 40.0%), followed by the 41–50 year group (29 participants, 20.7%). Among the causes of low vision, Retinitis Pigmentosa was the most common, affecting 33 participants (23.6%), followed by Glaucoma (18 cases, 12.9%) and Cataract (15 cases, 10.7%). ARMD (Age-Related Macular Degeneration) and Diabetic Retinopathy accounted for 11 (7.9%) and 10 (7.1%) cases, respectively. Other notable causes included Myopia (8.6%), Macular Dystrophy (6.4%), Maculopathy (5.7%), Nystagmus (4.3%), Corneal Opacity (3.6%), and Optic Atrophy, which was the least common, affecting only 4 participants (2.9%) and other diseases also include, retinal detachment, macular scar and PVD. Conclusion(s): This study concluded that retinal disorders, particularly Retinitis Pigmentosa and Glaucoma, are the leading contributors to low vision in this population, with a clear trend of increased prevalence among individuals over 50 years of age.

To evaluate foveal lesion and preferred retinal locus (PRL) locations and their effects on visual acuity in juvenile macular dystrophy (JMD) patients. In this retrospective study, 14 JMD patients (28 eyes) with bilateral central vision loss were examined using scanning laser ophthalmoscope/optical coherence tomography. Best-corrected visual acuity (BCVA), dimensions and location of the macular lesion, PRL location, and PRL stability were evaluated. Mean BCVA was 0.84±0.17 logarithm of the minimum angle of resolution. PRL was superiorly located in 64.3% of eyes and nasally located in 35.7%. PRL location was significantly associated with patient age (r=0.541, p=0.002); nasally located PRLs were more common in younger patients (mean age 15.1±2.8 years) while superiorly located PRLs were more common in older patients (mean age 22.4±6.9 years). Superiorly located PRLs were significantly closer to the fovea than nasally located PRLs (p=0.014). Visual acuity worsened as lesion size increased and PRL-fovea distance increased. PRL-fovea distance was longer in younger patients and positively correlated with lesion dimensions and PRL-lesion distance. In JMD patients, PRLs are predominantly located superiorly or nasally. In younger patients, PRLs are typically located nasally and farther from the fovea, with poorer visual acuity compared to older patients. Cortical adaptation mechanisms may play a role in changing PRL location with age. Understanding PRL characteristics in JMD is crucial for developing effective low-vision rehabilitation strategies.