Delta Journal of Ophthalmology (Jan 2020)

Eccentric viewing training for low-vision rehabilitation in patients with central scotoma

  • Adel G Zaky,
  • Boshra El Bayoumi,
  • Esraa S El-ghoubashy,
  • Abdelrahman E Sarhan,
  • Marwa A Zaky

DOI
https://doi.org/10.4103/DJO.DJO_29_20
Journal volume & issue
Vol. 21, no. 4
pp. 261 – 267

Abstract

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Background Eccentric viewing (EV), also known as eccentric fixation, involves identifying a functioning area of the retina that is as close to the fovea as possible and to learn to use it effectively, which is known as the preferred retinal locus. Objective The aim of this study was to evaluate the value of subjective EV training in vision rehabilitation in patients with central scotoma. Patients and methods The direction of EV was monitored in 33 low-vision patients with bilateral central scotomas. The preferred retinal locus was identified, and the preserved visual field was found. The patients were divided randomly into two groups regarding their use of optical low-vision devices with EV training. After 2 months of training, changes in near and far best-corrected visual acuity (BCVA) and reading speed were evaluated. Results After 2 months of EV training, the near BCVA and mean reading speed significantly improved, whereas the far BCVA did not significantly improve (0.1 LogMar on average). The mean near BCVA improved from 0.97±0.19 to 0.63±0.26 LogMar (P<0.001), and the mean reading speed improved from 26.48±9.31 words per minute (wpm) to 53.82±10.81 wpm. The group that used low-vision devices with EV training showed significantly more improvement in near and far BCVA than the group that did not use low-vision devices. The group that used low-vision devices with EV training showed significantly more improvement in near BCVA (0.41±0.17 LogMar) than the group that did not use low-vision devices (0.78±0.28 LogMar, P<0.001). Moreover, the group that used low-vision devices with EV training showed significantly more improvement in far BCVA (0.75±0.17 LogMar) than the group that did not use low-vision devices (1.02±0.28 LogMar, P<0.001). Conclusion EV training can be used as a very effective method for low-vision rehabilitation in patients presenting with central scotomas. It can give very good results by using simple and inexpensive equipment.

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