Current methods of visual rehabilitation

Despite therapeutic progress, many diseases of the eyes and visual pathways still cause persistent visual deficits that make everyday life more difficult in many ways. Rehabilitation aims to compensate for these limitations by optimizing residual vision. The demand for visual rehabilitation will increase markedly in the near future.

We summarize the state of the art in visual rehabilitation on the basis of a selective review of the literature, including randomized, controlled trials (RCTs) in the Cochrane and PubMed databases as well as Cochrane reviews. We also pay particular attention to studies illustrating an important principle or a clinically established method.

Central visual field defects impair reading. Persons with an absolute central scotoma can regain reading ability by eccentric fixation and text magnification. Many kinds of magnifying visual aids are available. Specific reading training can further improve reading speed. Peripheral field defects impair orientation. Persons with a concentric field defect can be helped by tactile aids, such as a cane, and with orientation and mobility training. Persons with hemianopia can benefit from compensatory saccadic training.

Suitable rehabilitative measures chosen after the thorough diagnostic evaluation of a visual impairment and analysis of its effects can usually restore reading ability, improve orientation, and thereby enhance the patient's independence and quality of life. As the demand for visual rehabilitation is increasing, steps will need to be taken to make it more widely available. Furthermore, as the scientific basis for visual rehabilitation is currently inadequate in some areas, more research in the field will be needed.