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Low Vision Therapy for Macular Degeneration

Joshua Dunaief, MD, PhD

Scheie Eye Institute, University of Pennsylvania

  • Expert Advice
Published on:
A gentleman with low vision using an electonic text magnifier.

For patients with vision challenges caused by macular degeneration, low-vision therapists can be extremely helpful. This service may be provided initially by an ophthalmologist, or by optometrists who are certified and trained in low vision. The team working with these healthcare providers may include a specially trained occupational or rehabilitation therapist who will optimize your eyeglass prescription, come to your home and recommend modifications, and have information concerning your eligibility for special benefits. A few examples of tips and advice that low-vision therapists can provide are outlined in this article.

Some Helpful Tips:

A Customized Prescription

Patients with mild to severe vision loss can benefit significantly from obtaining a specialized eyeglass prescription. Some patients benefit from higher magnification for reading than would be given to a patient with normal vision, or special glasses with very high magnification and prisms. Others can benefit from a yellow or orange tint to increase contrast. Bioptic telescopes built into eyeglasses can improve distance vision.


Generally, magnification and lighting together are helpful. Magnifiers with built-in lights are available in hand-held and hands-free varieties. 

Electronic devices can also be beneficial. These typically take images of small print and magnify them on a computer-like screen. They are hand-held or desktop versions.

Speaking of computers, the size of the type or image can be adjusted using commands in the software. Also, computer screens can have their brightness and color balance adjusted, as can hand-held devices.

Voice Commands and Audio Options

Increasingly, devices such as the iPhone will respond to voice commands. This is very helpful for people who can’t see the screen. There is also software that will convert voice to type or vice-versa.

Many books and newspapers are now available in audio format and available from a local library or by mail order.

Minimizing Falls

The risk of falling should be minimized. Adaptations in the home, such as good lighting and level floors, can be very helpful. Precautions such as holding someone’s arm or use of a cane should be taken whenever that would be advisable. Asking for help is much better than falling, and many people are happy to assist.

Patience is Crucial

It’s important to try out several different low vision aids in the optometrist’s or other specialist’s office and see which seems to work best. There can be a steep learning curve, so devices that may not seem helpful at first eventually become very useful with increased experience. Working with a device at home during a “trial period” is a good way to determine whether it will be helpful.

Special Benefits

The visually impaired are often eligible for special benefits, especially if they are certified as legally blind (vision of 20/200 or worse in both eyes or a visual field of 20 degrees or less). These may include social security benefits, tax exemptions, or identification cards to use instead of a driver’s license when proof of identity is required. Local organizations may also offer help such as rides to doctors’ appointments.

About the author

Headshot of Dr. Joshua Dunaief

Joshua Dunaief, MD, PhD

Scheie Eye Institute, University of Pennsylvania

Joshua Dunaief, MD, received his BA magna cum laude in Biology from Harvard (1987), MD/PhD from Columbia College of Physicians and Surgeons (1996), completed ophthalmology residency at the Wilmer Eye Institute, Johns Hopkins in 2000, and medical retina fellowship at Scheie Eye Institute, University of Pennsylvania in 2004.

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