How effective is eccentric viewing training? A systematic literature review

Abstract

Purpose: The global prevalence of age-related macular degeneration and associated central vision loss is rising. Central vision loss hinders the performance of many activities of daily living. Adaptive strategies such as eccentric viewing and steady eye strategy may be used to compensate for central vision loss. In order to establish the potential of these rehabilitation strategies, this systematic review evaluates current literature regarding the effectiveness of eccentric viewing and steady eye strategy training in people with central vision loss. Results: The search strategies identified 2605 publications, 36 of which met the inclusion criteria for the review, but only three of which were randomised controlled trials. This literature shows that eccentric viewing and steady eye strategy training can improve near visual acuity, reading speed, and performance of activities of daily living in people with central vision loss. However, there was insufficient literature to establish a relationship between training and distance visual acuity or quality of life. There is no conclusive evidence to show that a particular model of eccentric viewing training is superior to another, little clear evidence of a relationship between participant characteristics and training outcomes and no data regarding the cost effectiveness of training. Conclusion: This report highlights the need for further robust research to establish the true potential and cost effectiveness of eccentric viewing and steady eye strategy training as a rehabilitation strategy for individuals with central vision loss.

Adding access to a video magnifier to standard vision rehabilitation: initial results on reading performance and well-being from a prospective, randomized study

“…A systematic review of eccentric viewing also noted that a failure to separate effects of eccentric viewing training from effects of using lowvision devices was one reason that reviewed studies failed to meet criteria for well-designed trials. 19 In this study we offered the VM to subjects in the intervention group at their first contact with the clinic so that effects of training would be separated temporally from receiving the device. We offered all subjects standard VR so that any improvement in reading that might be attributed to education about rehabilitation strategies, information about remaining visual function, or simply contact with caring professionals would be balanced between the two groups.…”

Prognosis and Treatment of Visual Field Defects

“…Blind spot enlargement Considered ubiquitous in papilledema 7 ; treatment not necessary unless encroaching upon fixation 77,78 Central/ring scotoma Optical assistance with magnification or size scaling 79,80 Microperimetry-assisted identification of preferential retinal locus [81][82][83] Biofeedback and training 84 Cecocentral scotoma Eccentric viewing training 85 Visual restitution therapy 60 Functional training 86 Hemianopia Optical modalities such as monocular or binocular prisms 55,66,67 Saccadic compensation training 87 Restorative training 71…”

Evaluating the Effectiveness of an Established Community-Based Eccentric Viewing Rehabilitation Training Model—the EValuation Study

“…13,3). The aim was to obtain a complete dataset on 112 learners, based on a sample size calculation that included subgroup analyses for the effects of the use of magnification, the age of the participants, and the initial reading speed.…”