[Requirements for low vision magnification aids in age-related macular degeneration: Data from the Tübingen low vision clinic (comparison of 2007-2011 with 1999-2005)]

The Accessibility of Commercial Off-The-Shelf Virtual Reality for Low Vision Users: A Macular Degeneration Case Study

Virtual reality (VR) is demonstrating increasing potential for therapeutic benefit in elderly care, but it is still generally considered to be the domain of the visually unimpaired. Even where VR and augmented reality (AR) are being explored for use with low vision, it is generally with a focus on creating bespoke software and hardware. However, the properties of commercial off-the-shelf (COTS) headsets, such as high luminance, may render them accessible even to very low vision users. Using a case-study approach, we explored the differences in visual perception from baseline to pass-through AR and commercial VR applications for an elderly female (Mrs. M) with advanced age-related macular degeneration. We found notable improvements in object, face, and color recognition, particularly with higher display brightness. Furthermore, Mrs. M was able to engage fully and enthusiastically with a number of (unmodified) VR applications, providing detailed descriptions of both static and moving elements. We suggest that the high luminance available in COTS VR may support more stable fixation closer to the fovea, improving visual resolution. Furthermore, the improvements we noted in color perception support previous suggestions that increasing luminance may improve photosensitivity by reducing the uptake of limited oxygen by the rod cells. We conclude that low vision should not automatically preclude users from engaging in VR research or entertainment, and that they may be able to use well-illuminated VR applications without any special modifications.

How 16,000 people used a smartphone magnifier app in their daily lives

BACKGROUND

Smartphone video magnifier apps are being used by millions of people to assist their vision. To understand the behaviour of app users, an exploratory investigation was conducted based on 'big data' collected from their daily uses.

METHOD

A mobile magnification app was developed with embedded analytics data collection modules. Seven months after it was released to the public, 30 days of app use data were collected from 16,787 active users across 129 countries. App launches and function use were analysed.

RESULTS

The app was most commonly used for one to three minutes a day, while a very small portion of users (0.5 per cent) used it over 100 times within the month and over 30 minutes each time. Some of the focused objects (13 per cent with Apple iPhone and 21 per cent with Apple iPad) were further than two metres away. Two functions that can be used to address the image shaking problem - live image stabilisation and snapshot - were compared, and it was found the former was used more often than the latter in terms of event/launch ratio and event duration. The flash light function (daily mean 209 seconds per device) was used more than focus locking (47 seconds) and inverted colour (28 seconds).

CONCLUSIONS

The mobile magnification app was mostly used for brief spot reading, while long reading occurred as well. As versatile devices, smartphones were used for near and sometimes far vision reading. This study presents a novel methodology helpful for understanding the behaviour of users and evaluating the utility of specific functions.

Intraocular lenses in age-related macular degeneration

Purpose

The aim of this work is to review the lenses, assessing their advantages and disadvantages. We describe a total of seven types of intraocular lenses (IOLs) recommended for age-related macular degeneration (AMD).

Methods

We used the PubMed web platform to search for implantable devices in various stages of AMD. We searched for both prospective and retrospective studies and also case reports.

Results

Clinical results in AMD patients have been described for a total of seven types of IOLs recommended for AMD: an implantable miniature telescope (IMT), IOL-VIP System, Lipshitz macular implant (LMI), sulcus-implanted Lipshitz macular implant, LMI-SI, Fresnel Prism Intraocular Lens, iolAMD and Scharioth Macula Lens.

Conclusions

We conclude that to objectively ascertain the effectiveness and safety of these lenses, further independent clinical studies with longer follow-up data are necessary prior to the general use of these optical devices.

[Ophthalmological rehabilitation of visually impaired children]

BACKGROUND

There are very few studies on visually impaired children in Germany; therefore, the aim of this study was to investigate the current spectrum of diseases of visually impaired children and the care of these children in schools and kindergartens with aids and integrative support.

PATIENTS AND METHODS

In a retrospective study all children (n =303) who attended the outpatient department for the visually impaired of the University Eye Hospital Tübingen in 2013 and 2014 were evaluated. The target values were ophthalmological diagnosis, best corrected visual acuity, needs for magnification, prescribed aids, measures for early support and integrative care and inclusion during schooltime.

RESULTS

The most frequent diagnosis in this collective which led to visual impairment in children was optic atrophy (22.4%) followed by hereditary retinal dystrophy (18.5%), congenital nystagmus (9.9%), albinism (8.6%), retinopathy of prematurity (ROP, 7.9%), aniridia (4.6%), cerebral visual impairment (CVI, 4.3%) and severe myopia (3%). Of the children 21% suffered from multiple disabilities, 66% were visually impaired (visual acuity ≤0.3 and >0.05), 9% were severely visually impaired (visual acuity ≤0.05) and 6% were legally defined as blind (visual acuity ≤0.02). Of the schoolchildren 52% (n = 241) were able to visit a mainstream school within the framework of integrative care. For 77% of these schoolchildren integrative care was already provided by a special pedagogic institution at the time of presentation for school entry and 73% of all the schoolchildren needed magnifying aids at school: 20% used optical magnifying aids (e.g. reading stones) and 53% needed electronic magnifying aids, such as screen magnifiers or camera reading systems.

CONCLUSION

Particularly for children, the use of magnifying aids for reading is essential for education in schools and 73% of the children used optical or electronic devices for reading. Of the children 52% attended a mainstream school and were additionally supported by special pedagogic counseling services.

[Internet search for counseling offers for older adults suffering from visual impairment]

BACKGROUND

Visual impairment is a relevant problem of aging. In many cases promising therapeutic options exist but patients are often left with visual deficits, which require a high degree of individualized counseling. This article analyzed which counseling offers can be found by patients and relatives using simple and routine searching via the internet.

METHOD

Analyses were performed using colloquial search terms in the search engine Google in order to find counseling options for elderly people with visual impairments available via the internet.

RESULTS

With this strategy 189 offers for counseling were found, which showed very heterogeneous regional differences in distribution. The counseling options found in the internet commonly address topics such as therapeutic interventions or topics on visual aids corresponding to the professions offering rehabilitation most present in the internet, such as ophthalmologists and opticians. Regarding contents addressing psychosocial and help in daily tasks, self-help and support groups offer the most differentiated and broadest spectrum. Support offers for daily living tasks and psychosocial counseling from social providers were more difficult to find with these search terms despite a high presence in the internet.

DISCUSSION

There are a large number of providers of counseling and consulting for older persons with visual impairment. In order to be found more easily by patients and to be recommended more often by ophthalmologists and general practitioners, the presence of providers in the internet must be improved, especially providers of daily living and psychosocial support offers.