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Feb 22, 2022

Reading Glasses for Macular Degeneration and Low Vision

By Dr. W. Jarrod Long, OD, FIALVS

As a low vision optometrist for 25 years and one of the first Fellows of the International Academy of Low Vision Specialists, I can tell you with certainty that most of my low vision patients have macular degeneration.  I can also state that, along with driving, reading is at the top of my macular degeneration patients’ list of goals.  Today we’ll cover my approach to hands-free reading.

First, the measurements.

While high-contrast, “eye-chart” vision is important to measure when it comes to reading it is equally important to measure reading speed with varied sizes of text, contrast, and lighting.  Due to the size, position, and severity of the particular area(s) of degeneration, reading ability is often poorly correlated with “single letter/number” visual acuity measurements.  What’s more, because the two eyes can compete for dominance, we need to determine if it’s better with just one eye, the other eye, or both together.  It can be frustrating for a patient with a poorer-seeing, previously dominant, eye to try to read.  They will often be caught closing one eye while reading.

With these measurements and observations documented, my next discussion with the macular degeneration patient usually follows one of two scripts.  If they can read large print fluently with regular glasses, but slow down and, ultimately, cannot read the small print goal, then I explain that I will make the small print look like the larger print with stronger, possibly specialized, reading glasses and they will be thrilled to read fluently, hands-free again!

Unfortunately, the other discussion I sometimes need to have with a patient is clarifying that they do not read fluently at any size no matter how much I magnify, clarify, or enhance the print.  Again, it goes back to the nature of macular degeneration and the unique characteristics of their vision loss.  On the bright side, these patients can be helped with reading glasses for smaller print.  However, I feel that it is helpful if they understand the nature of their vision loss and that it will take practice and more time to learn to use the best areas of their macula in order to steadily improve their enjoyment of reading.

So, for more information on the reading glasses that I prescribe for those with macular degeneration please see the accompanying chart.  While quite thorough, this chart is not intended to be comprehensive.  It reflects my particular prescribing preferences honed over the past several years.

For an even more detailed explanation of the glasses listed on the chart, you can take a look at my video here: https://youtu.be/0jvjR-A6ZJ0.  Keep in mind that it is quite technical and is primarily intended for low vision and other eye care professionals.

One final note about macular degeneration patient success or failure with low vision reading glasses…proper lighting and working distance are of utmost importance and cannot be stressed enough!

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