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Review
. 2013 Oct 23;10(10):CD003303.
doi: 10.1002/14651858.CD003303.pub3.

Reading aids for adults with low vision

Affiliations
Review

Reading aids for adults with low vision

Gianni Virgili et al. Cochrane Database Syst Rev. .

Update in

  • Reading aids for adults with low vision.
    Virgili G, Acosta R, Bentley SA, Giacomelli G, Allcock C, Evans JR. Virgili G, et al. Cochrane Database Syst Rev. 2018 Apr 17;4(4):CD003303. doi: 10.1002/14651858.CD003303.pub4. Cochrane Database Syst Rev. 2018. PMID: 29664159 Free PMC article. Review.

Abstract

Background: The purpose of low-vision rehabilitation is to allow people to resume or to continue to perform daily living tasks, with reading being one of the most important. This is achieved by providing appropriate optical devices and special training in the use of residual-vision and low-vision aids, which range from simple optical magnifiers to high-magnification video magnifiers.

Objectives: To assess the effects of reading aids for adults with low vision.

Search methods: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 1), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, (January 1950 to January 2013), EMBASE (January 1980 to January 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to January 2013), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov/) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 31 January 2013. We searched the reference lists of relevant articles and used the Science Citation Index to find articles that cited the included studies and contacted investigators and manufacturers of low-vision aids. We handsearched the British Journal of Visual Impairment from 1983 to 1999 and the Journal of Visual Impairment and Blindness from 1976 to 1991.

Selection criteria: This review includes randomised and quasi-randomised trials in which any device or aid used for reading had been compared to another device or aid in people aged 16 or over with low vision as defined by the study investigators.

Data collection and analysis: At least two authors independently assessed trial quality and extracted data.

Main results: We included nine small studies with a cross-over-like design (181 people overall) and one study with three parallel arms (243 participants) in the review. All studies reported the primary outcome, results for reading speed.Two studies including 92 participants found moderate- or low-quality evidence suggesting that reading speed is higher with stand-mounted electronic devices or electronic devices with the camera mounted in a 'mouse' than with optical magnifiers, which in these trials were generally stand-mounted or, less frequently, hand-held magnifiers or microscopic lenses. In another study of 20 participants there was moderate-quality evidence that optical devices are better than head-mounted electronic devices (four types).There was low-quality evidence from three studies (93 participants) that reading using head-mounted electronic devices is slower than with stand-based electronic devices. The technology of electronic devices may have changed and improved since these studies were conducted.One study suggested no difference between a diffractive spectacle-mounted magnifier and either refractive (15 participants) or aplanatic (15 participants) magnifiers.One study of 10 people suggested that several overlay coloured filters were no better and possibly worse than a clear filter.A parallel-arm study including 243 participants with age-related macular degeneration found that custom or standard prism spectacles were no different from conventional reading spectacles, although the data did not allow precise estimates of performance to be made.

Authors' conclusions: There is insufficient evidence on the effect of different types of low-vision aids on reading performance. It would be necessary to investigate which patient characteristics predict performance with different devices, including costly electronic devices. Better-quality research should also focus on assessing sustained long-term use of each device. Authors of studies testing several devices on the same person should consider design and reporting issues related to their sequential presentation and to the cross-over-like study design.

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Conflict of interest statement

Declarations Of Interest: Gianni Virgili shares the patent on the MNREAD Italian charts with the University of Minnesota, Minneapolis, USA.

Figures

Figure 1
Figure 1
Results from searching for studies for inclusion in the review.
Figure 2
Figure 2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figure 3
Figure 3
Forest plot of comparison: 1 Electronic device (various types of CCTV) versus optical device, outcome: 1.1 Reading speed (words per minute).
Figure 4
Figure 4
Forest plot of comparison: 2 Stand-based closed-circuit television (CCTV) versus head-mounted electronic device (HMD), outcome: 2.1 Reading speed (words per minute).
Figure 5
Figure 5
Forest plot of comparison: 3 Stand-based closed-circuit television (CCTV) versus hand-held, mouse-based electronic device (HHD), outcome: 3.1 Reading speed (words per minute).
Figure 6
Figure 6
Forest plot of comparison: 6 Diffractive spectacle mounted magnifiers versus control, outcome: 6.1 MNREAD maximum reading speed (words/minute).

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References

References to studies included in this review

    1. Culham LE, Chabra A, Rubin GS. Clinical performance of electronic, head-mounted, low-vision devices. Ophthalmic and Physiological Optics. 2004;24(4):281–90. - PubMed
    1. Eperjesi F, Fowler CW, Evans BJ. The effects of coloured light filter overlays on reading rates in age-related macular degeneration. Acta Ophthalmologica Scandinavica. 2004;82(6):695–700. - PubMed
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References to studies excluded from this review

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References to studies awaiting assessment

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Additional references

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    1. Ahn SJ, Legge GE. Psychophysics of reading. XIII. Clinical predictors of magnifier-aided reading speed in low vision. Vision Research. 1995;35(13):1931–8. - PubMed
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    1. Binns AM, Bunce C, Dickinson C, Harper R, Tudor-Edwards R, Woodhouse M, et al. How effective is low vision service provision? A systematic review. Survey of Ophthalmology. 2012;57(1):34–65. - PubMed
    1. Cheng D, Woo GC. The effect of conventional CR39 and Fresnel prisms on high and low contrast acuity. Ophthalmic and Physiological Optics. 2001;21(4):312–6. - PubMed

References to other published versions of this review

    1. Virgili G, Acosta R. Reading aids for adults with low vision. Cochrane Database of Systematic Reviews. 2006;(4) doi: 10.1002/14651858.CD003303.pub2. - DOI - PubMed

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