Miller Andrew, Macnaughton Jane, Crossland Michael D, Latham Keziah
Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK.
UCL Institute of Ophthalmology, London and NIHR Moorfields Biomedical Research Centre, London, UK.
Ophthalmic Physiol Opt. 2025 May;45(3):699-712. doi: 10.1111/opo.13453. Epub 2025 Jan 24.
Wearable electronic low vision enhancement systems (wEVES) improve visual function but are not widely adopted by people with vision impairment. Here, qualitative research methods were used to investigate the usefulness of wEVES for people with age-related macular degeneration (AMD) after an extended home trial.
Following a 12-week non-masked randomised crossover trial, semi-structured interviews were completed with 34 participants with AMD, 64.7% female, mean age 80.2 (±6.0) years, mean distance visual acuity 0.81logMAR (±0.32). Reflexive thematic analysis was used to analyse the data.
Four themes were developed: (i) early positivity and potential; (ii) you're not good enough: performance barriers of the device; (iii) you're annoying: practicality barriers of the device and (iv) we can fix this together. First, participants expressed joy in an aesthetically appealing device perceived as potentially enabling, different and complementary to their current solutions. Imagined usefulness included not only reading, shopping and television but also resuming abandoned hobbies. The second theme captured performance barriers that restricted numerous activities but were most acutely noted with manipulation tasks. Barriers included image quality, screen size and short-lived adverse effects. The third theme conveyed the multiple practical challenges that caused annoyance, preventing imagined usage even when performance appeared superior to other solutions. Slow start-up times and the inability to use wEVES dynamically prevented integration within users' lifestyles. The final theme reflected that wEVES remained a desirable concept, but future iterations require inclusive design methodology to ensure development is directed by consumers' needs.
Performance and practicality barriers limit the usefulness of a device initially seen as desirable. Current devices do not align with users' requirements for flexible use, even when performance is good. Improvements in technology may solve performance barriers, but these changes must be inclusively designed and evaluated to ensure the device integrates more successfully into the lives of users with AMD.
可穿戴式电子低视力增强系统（wEVES）可改善视觉功能，但视力障碍者对其接受度不高。在此，我们采用定性研究方法，调查在长时间居家试用后，wEVES对年龄相关性黄斑变性（AMD）患者的实用性。
在一项为期12周的非盲随机交叉试验后，对34名AMD患者进行了半结构化访谈，其中女性占64.7%，平均年龄80.2（±6.0）岁，平均远距离视力为0.81logMAR（±0.32）。采用反思性主题分析法对数据进行分析。
归纳出四个主题：（i）早期的积极态度和潜力；（ii）你还不够好：设备的性能障碍；（iii）你很烦人：设备的实用性障碍；（iv）我们可以一起解决这个问题。首先，参与者对一款外观吸引人的设备感到高兴，该设备被认为具有潜在的赋能作用，与他们目前的解决方案不同且具有互补性。想象中的用途不仅包括阅读、购物和看电视，还包括重拾被搁置的爱好。第二个主题体现了限制众多活动的性能障碍，而在操作任务中这些障碍最为明显。障碍包括图像质量、屏幕尺寸和短暂的不良反应。第三个主题传达了导致烦恼的多重实际挑战，即使性能似乎优于其他解决方案，这些挑战也会妨碍想象中的使用。启动时间缓慢以及无法动态使用wEVES阻碍了其融入用户的生活方式。最后一个主题反映出wEVES仍然是一个理想的概念，但未来的迭代需要采用包容性设计方法，以确保开发以消费者需求为导向。
性能和实用性障碍限制了一款最初被认为很理想的设备的实用性。当前的设备即使性能良好，也不符合用户对灵活使用的要求。技术改进可能解决性能障碍，但这些改变必须经过包容性设计和评估，以确保设备更成功地融入AMD患者的生活。
