Smartphones and Other Gadgets Help Low Vision

March 2, 2012 — As the population ages, more and more people are turning up in doctors' offices with low vision, and new gadgets and rehabilitation techniques are becoming available to help improve their quality of life.

The American Academy of Ophthalmology (AAO) is working to educate medical practitioners — including ophthalmologists — that more than many realize can be done to help patients with low vision, said Lylas G. Mogk, MD, an AAO clinical correspondent.

Low vision — a loss of eyesight that cannot be corrected or treated and makes daily tasks more difficult — is becoming more common as more people have such diseases as macular degeneration, glaucoma, and diabetic retinopathy, Dr. Mogk told Medscape Medical News.

Device to assist with low vision

"What people often hear from a physician is that there is nothing more that can be done," said Dr. Mogk, director for vision rehabilitation and research at the Henry Ford Health System in Detroit, Michigan. "There may be nothing more that can be done about the retina but there is a lot that can be done to help the patient function."

Instead of focusing only on medical treatments, physicians should direct patients to rehabilitation programs, she said. In these programs specialists carefully evaluate patients to determine exactly what they can see and what they can't.

They then assign the patients to work with occupational therapists who can teach techniques and recommend tools to get around the problem.

Among the hottest new gadgets are applications available for smartphones and other portable devices, said John Kitchens, MD, a partner at Retina Associates of Kentucky in Lexington.

Perhaps the most useful program uses the camera in the device to magnify whatever is on its screen, in combination with the device's external light to improve contrast, said Dr. Kitchens. One such program is iRead, which is available for iPhones and Android phones for free from the iTunes store. It was developed by Richard G. Davis, MD, an ophthalmologist in Long Island, New York.

Patients with macular degeneration can learn to use such magnification devices to make use of their peripheral vision. Although peripheral vision is not damaged by the condition, it is naturally less clear than central vision.

These products are helpful especially for quick tasks, such as reading the price tag on an item on a store shelf or reading a restaurant menu.

And e-book readers and tablets such as the Kindle and iPad can also magnify text, making it possible for people with mild low vision to read books.

However, Dr. Mogk pointed out that there are still many patients for whom these devices don't offer enough magnification to make actual reading possible. Or, if they do offer enough magnification, the screen is too small to accommodate more than a snippet of highly enlarged text.

Patients with more severe vision loss can use closed-circuit television (CCTV) devices. These come in 3 different forms. Portable devices are helpful for reading notes at a meeting but are still not adequate for reading at home because the screen is too small.

The second device is a camera that reads and magnifies onto a 17- to 24-inch screen, similar to a television screen. The patient holds the text to be magnified under the camera.

The third type of CCTV device is a camera similar in design to a computer mouse that the patient rolls over the text. The image is projected onto a television.

Other helpful gadgets include:

Cutting boards colored white on one side and dark on the other side, allowing the patient to choose a side depending on the color of the food to be cut, ensuring high contrast;
Appliances with large buttons;
Portable LED lights;
High-contrast bank checks;
Simple-to-operate compact disc players to play audio books; and
Voice recognition programs for telephones and computers, such as Siri, the program introduced with the latest model of the iPhone.

"Siri is fantastic for patients with low vision," Dr. Kitchens told Medscape Medical News. "It not only transcribes your voice to text, but it will read back what you just created."

Another smartphone application addresses the problem from a different angle, said Dr. Kitchens. SightBook by DigiSight Technologies allows the patient to test his or her own vision and report the results back to the physician.

This can help patients catch a change before it leads to serious damage. "Some patients will pick up on a problem readily, but others may not notice a change in vision, especially if it's only in one eye," said Dr. Kitchens.

The development of such technology has proved a real boon for patients with low vision, said Dr. Kitchens. "And it's only going to get better."

The AAO lists resources for low vision rehabilitation on its Web site as part of an initiative called SmartSight.

Dr. Mogk and Dr. Kitchens have disclosed no relevant financial relationships.