Technology

Technology aids low vision patients

The latest devices and services can improve their quality of life.

BY BRYAN GERRITSEN, CLVT

The number of persons with low vision is burgeoning due to an aging population with eye conditions such as macular degeneration, diabetic retinopathy and glaucoma. When these patients look to you for advice and for answers, the last thing they want to hear is, “There is nothing else we can do.”

We can indeed do many things for these patients, even for those with serious vision loss, and this includes technology to aid their daily lives. You need to be aware of and informed about these wonderful low vision options and resources to help instill confidence and hope in these patients. This will also give them great appreciation for you and your practice.

Here are some of the technologies available to assist low vision patients’ daily lives.

Low-tech options

Low vision devices do not need to be expensive or high tech. Many other types of low-tech, low-cost devices can help with accomplishing various tasks. Some of the wonderful low-cost options include:

• LED illuminated stand magnifiers. These do not need to be held — the patient merely glides it along the page.

• Flip-up loupes clipped to glasses. These inexpensive options may be helpful for seeing a computer screen, reading sheet music, sewing, or other handwork.

• Telescopic glasses. These devices provide 2x magnification and may be beneficial for seeing TV and movies better, as well as for seeing faces and scenery.

• A table or floor lamp with a magnifier attached. Can assist patients in writing checks, doing crossword puzzles, or sewing (Figure 1).

Figure 1: Table lamp with a magnifier attached for writing or hand work.ALL IMAGES COURTESY BRYAN GERRITSEN, CLVT

Accompanying training with each device, and other vital training such as with eccentric viewing to help see around their central scotomas, is absolutely critical. If the patients are not trained on using the technology, they probably won’t use it. The low vision OD often trains the patient unless a tech is qualified to do so. Although most often the scotoma is central, occasionally this is not the case, so the training takes on a different complexity. Also, some occupational therapists specialize in training on devices in the patients’ homes as well as training them to maintain their independence in their homes.

Portable digital magnifiers

Some patients struggle with even the best LED magnifiers, finding them tedious and too hard because of the relatively small field of view they afford. Offer these patients electronic and digital options, such as portable digital magnifiers, that can help them with reading, writing, seeing photographs, doing handwork, and other tasks.

With these devices, a camera aims at the text, which displays on a monitor (often high definition) that allows the patient to read items wherever they are. They can be used in an easy chair, bed, at a restaurant, store, or church and for reading mail, bills, bank statements, recipes, or newspapers. Digital magnifiers not only enlarge the text as much as desired (generally in a range of 2x to 17x) but also enhance the contrast and dramatically brighten the text, which most low vision patients need.

Retinal specialists who see these devices demonstrated are excited about this option available for patients with low vision. Digital magnifiers generally range from about $495 to $1,295, and can come with a 3.5”, 4”, 5”, 7” or even 13” monitor (Figure 2). The devices are rechargeable, and generally hold a full charge for three to four hours of continual use. Many include a carrying case and have a two-year warranty. Some of the devices have a handle and may require patients to hold while using it to read. Older patients may prefer models that rest flat on a page and do not need to be held.

Figure 2: 4” portable digital magnifier.

Desktop closed circuit TV systems (CCTVs)

While portable digital magnifiers can help a person read a column of text, CCTVs (sometimes called “video magnifiers”) have a 22” or 24” HD monitor and help a person see an entire page (Figure 3). Thus, patients can read faster, likely with greater enjoyment, and don’t need to move it as much as magnifiers. Patients who use a CCTV for reading, writing, seeing photographs, and reading a prescription bottle often say it changed their lives.

Figure 3: Patient using a CCTV to view a picture.

Still, no device is perfect, and CCTVs are fairly expensive (about $3,300). Also, a desktop CCTV usually requires that a person bring reading or viewing materials to the CCTV’s location — a desk. Thus, patients may still need an LED magnifier or a portable digital magnifier for portable use and for “spot reading” around the house or at a restaurant or store.

OCR and speech output

Many companies now make CCTVs with optical character recognition (OCR) and speech output. In addition to enlarging and enhancing images, OCR software transforms text into speech. This benefits patients with serious vision loss, because they don’t need to struggle reading a couple letters at a time and putting them together to form words and sentences. Patents can listen as they follow along visually on the screen.

Like a regular CCTV, they can adjust the print to any size, color or background. In addition, they can select their preferred voice, speed, and volume. If they don’t want to bother their spouse while listening, they can use headphones, and can also store and later retrieve documents.

CCTVs with OCR and speech generally run from $2,595 to $3,995. Some stand-alone machines with OCR and speech cost less ($1,995 to $2,495), and patients can still add their own monitor if desired. A camera with OCR and speech, powered by a laptop, can run as little as $1,295.

Apps

Many helpful apps for phones and tablets may assist visually impaired persons. One is the American Foundation for the Blind’s VisionConnect (AFB.org/VisionConnect). This free iOS app provides a searchable directory of services available in the United States and Canada for persons with low vision, such as computer and technology training, low vision services, and much more. Other apps can help with money or color identification, scanning labels, and a variety of tasks. (For a list of apps that can be particularly beneficial for low vision patients, visit http://appadvice.com/applists/show/apps-for-the-visually-impaired.)

Conclusion

Never find yourself telling patients or their families that there is nothing else you can do. Help them learn about the available options, and let them know that there is hope. OP

Bryan Gerritsen, CLVT is a certified low vision therapist and orientation and mobility specialist. He works with 13 eye centers and doctors’ offices throughout Utah to help provide low vision rehabilitation services for patients with vision loss. E-mail him at bryangerritsen@gmail.com.