Rehabilitation of reading in older individuals with macular degeneration: A review of effective training programs

ABSTRACT

Macular degeneration (MD) is the most common cause of visual impairment among older adults. It severely affects reading performance. People with MD have to rely on peripheral vision for reading. In this review, we considered several training programs that aim to improve peripheral reading, with a focus on eccentric viewing, oculomotor control, or perceptual learning. There was no strong support in favor of one particular training method for rehabilitation of reading in MD, but there is evidence that older individuals with MD can be trained to improve reading performance, even within limited time.

Keywords:

• Reading
• Rehabilitation
• Low vision
• (Age-related) macular degeneration
• Central vision loss

Notes

¹Crowding (also called lateral masking) refers to the phenomenon that it is more difficult to recognize a letter that is flanked by other letters than one in isolation. It involves spatial interference between adjacent letters.

²In principle, the fovea can be considered as the PRL for normally sighted persons, but the term PRL is usually used to refer to the preferred eccentric retinal area for fixation in people with central scotoma.

³The scanning laser ophthalmoscope (SLO) is no longer available on the market, but a comparable instrument has been developed, namely the Micro Perimeter 1 (MP1).

⁴In the lexical-decision training, participants were presented with strings of three letters. Participants had to indicate whether the string was a word or a non-word.

⁵Because retinal implants can only be placed outside the fovea, people with retinal implants also have to rely on a peripheral retinal area for reading. However, in case of central scotoma larger parts of the retina can be used for reading compared to retinal implants.