Macular degeneration causes progressive damage to the central macula--the part of the retina responsible for seeing color and acute vision. The peripheral parts of the retina enable you to see sudden movements at night. There is no cure for age-related macular degeneration (ARMD). However, since peripheral vision is not destroyed during ARMD, patients can be trained to make best use of the remaining vision.
What Is Eccentric Viewing?
Patients need to learn how to scan the environment, look at a television, printed words and even faces by using the remaining peripheral vision. This technique is called "eccentric viewing." The person looks at people and objects by looking above, below or to the side of a visual target, such as the face of someone who's talking. Eccentric viewing requires practice and may require using different viewing positions for different condition or situations.
Eye Exercises to Avoid Blind Spots
Occupational therapists work with patients to help them become aware of any blind spots--called scotomas--and how to avoid them so objects don't appear and disappear. The therapist holds objects in various locations and asks the patient to look either above, below or to the sides of it to make it disappear or appear. One training "game" involves holding up playing cards and asking the patient to identify them, trying to increase their speed. With practice, patients can use progressively smaller objects.
Eye-Exercises to Improve Reading Skills
After a patient learns to use eccentric vision to find objects, she is ready to practice reading large print. The patient might require use of strong reading glasses or a magnifier and strong lighting directed on the reading material. Once she has found the best position to look (whether below, above or to the side of the word), the patient must not move her head, but rather move the reading material. In the scrolling technique, the reader places the paper on a clip board, then holds up the clipboard, moving it from left to right. Some people prefer to mount reading material on a sliding stand that moves back and forth. Patients must practice using their fingers to follow the text (see Resources).
References
- "Age-Related Macular Degeneration; What You Should Know"; National Eye Institute; 2003.
- "Low vision Rehabilitation"; Mitchell Scheiman; 2007
- "Foundations of Low Vision: Clinical and Functional Perspectives"; Anne L. Corn and Alan J. Koenig; 2004.
