Eccentric viewing training and low vision aids: current practice and implications of peripheral retinal research.

Macular degeneration results in more new cases of legal blindness in the United States than any other disease and accounts for over 165,000 first visits to physicians each year. Magnification, illumination control, and eccentric viewing training are the only documented, effective vision rehabilitation techniques known. Magnification has been used for decades, control of illumination has had a known effect for many years, and eccentric viewing training has been systematically used for less than 10 years. These techniques, although having demonstrated efficacy, require extensive individual patient training and a considerable investment of professional training time for optimum results. More recently developed techniques use prism correction for near and distance viewing or scanning laser ophthalmoscopy for training. Current knowledge of peripheral retinal function offers new avenues of research to improve upon current rehabilitation techniques. Computer technology also offers the hope of developing easily used, cost-effective materials and equipment to train the patient to use the peripheral retina in place of the damaged/diseased macula. In this paper, we examine current and emerging rehabilitation techniques and highlight some areas of research that hold promise of improving rehabilitation practices for patients having central visual field losses.