Low vision rehabilitation in patients with age-related macular degeneration at a tertiary eye care centre in southern India

Purpose: To evaluate the specific needs and types of low vision devices (LVDs) in patients with age-related macular degeneration (AMD) so as to use the residual vision effectively. Methods: One hundred consecutive patients with diagnosis of AMD were evaluated to ascertain the degree of visual disability. Different LVDs were used to suit the specific needs of individual patients. The distribution of LVDs for distance and near and other rehabilitation measures were stratified for vision greater than or equal to6/18 and <6/18. Statistical analysis was performed using χ(2) test/Fisher's exact test and paired t-test. Results: The percentage of patients with visual acuity <6/18 reduced from 72.2% (26/36) to 47.2% (17/36) with the use of standard spectacles (P = 0.03). Similarly, the percentage of patients with visual acuity <6/18 reduced from 85.7% (6/7) to 14.3% (1/7) with the use of a telescope ( P = 0.029). The optical devices for near tasks included spectacle magnifiers (n = 59), stand magnifiers ( n = 19), and hand magnifiers (n = 18). With these LVDs, the near vision improved from 0.13 (decimal notations) to 0.39 (P < 0.001). Eighty-six patients were given at least one of the LVDs and 20% were prescribed more than one near device ( bifocals, spectacle magnifiers, hand magnifiers, stand magnifiers). Additionally, patients also needed counselling ( n = 89) and training on eccentric viewing ( n = 39), coin identification ( n = 45), and independent mobility ( n = 41). Conclusion: The overall management of a patient with AMD must include counselling, prescription of appropriate LVDs and training to utilize the residual vision to its fullest advantage. This is expected to improve the patient's quality of life.