Department für Augenheilkunde, Sehbehindertenambulanz, Universität Tübingen, Tübingen, Germany.
Dtsch Arztebl Int. 2011 Dec;108(51-52):871-8. doi: 10.3238/arztebl.2011.0871. Epub 2011 Dec 26.
Despite therapeutic progress, many diseases of the eyes and visual pathways still cause persistent visual deficits that make everyday life more difficult in many ways. Rehabilitation aims to compensate for these limitations by optimizing residual vision. The demand for visual rehabilitation will increase markedly in the near future.
We summarize the state of the art in visual rehabilitation on the basis of a selective review of the literature, including randomized, controlled trials (RCTs) in the Cochrane and PubMed databases as well as Cochrane reviews. We also pay particular attention to studies illustrating an important principle or a clinically established method.
Central visual field defects impair reading. Persons with an absolute central scotoma can regain reading ability by eccentric fixation and text magnification. Many kinds of magnifying visual aids are available. Specific reading training can further improve reading speed. Peripheral field defects impair orientation. Persons with a concentric field defect can be helped by tactile aids, such as a cane, and with orientation and mobility training. Persons with hemianopia can benefit from compensatory saccadic training.
Suitable rehabilitative measures chosen after the thorough diagnostic evaluation of a visual impairment and analysis of its effects can usually restore reading ability, improve orientation, and thereby enhance the patient's independence and quality of life. As the demand for visual rehabilitation is increasing, steps will need to be taken to make it more widely available. Furthermore, as the scientific basis for visual rehabilitation is currently inadequate in some areas, more research in the field will be needed.
尽管治疗取得了进展，但许多眼部和视觉通路疾病仍会导致持续的视力缺陷，从而在许多方面使日常生活更加困难。康复的目的是通过优化残余视力来弥补这些限制。在不久的将来，对视觉康复的需求将显著增加。
我们根据文献的选择性回顾，总结了视觉康复的最新进展，包括 Cochrane 和 PubMed 数据库中的随机对照试验 (RCT) 以及 Cochrane 综述。我们还特别关注那些说明重要原则或临床确立方法的研究。
中央视野缺损会损害阅读能力。绝对中心暗点的患者可以通过偏心注视和文本放大来恢复阅读能力。有许多种放大镜可供选择。特定的阅读训练可以进一步提高阅读速度。周边视野缺损会损害定向能力。同心视野缺损的患者可以受益于触觉辅助工具，如手杖，以及定向和移动训练。偏盲的患者可以从补偿性扫视训练中获益。
在彻底评估视力障碍并分析其影响后选择合适的康复措施，通常可以恢复阅读能力，提高定向能力，从而提高患者的独立性和生活质量。由于对视觉康复的需求正在增加，需要采取措施使其更广泛地普及。此外，由于视觉康复的科学基础在某些领域目前还不够充分，因此需要在该领域进行更多的研究。
