Stand magnifiers for low vision: description, prescription, assessment

Stand magnifiers are still one of the most commonly prescribed classes of low vision devices. Their performance can be difficult to understand because stand magnifiers usually do not give an image at infinity. This review summarises the methods of describing image enlargement for stand magnifiers, emphasising their relationship to equivalent viewing distance (EVD). This is done in terms of the underlying optical equations, and measurement methods, and methods of prescribing. In the past, methods of determining EVD have been somewhat indirect, requiring accurate measurement of lens power, and image position. The use of digital photography provides an alternative, more direct, simpler method of determining EVD, which can be accomplished in-office. This method is described and it is demonstrated how it gives comparable results to older methods with small, clinically non-meaningful differences, that may be due to differences in image distance reference planes. Describing the performance of stand magnifiers in terms of their dioptric power, or in terms of 'nominal magnification' or 'trade magnification', is imprecise and misleading. It is better to use indices such as equivalent viewing power and EVD, which take into account the magnifier dioptric power, the image position of the magnifier and the distance a patient is from the magnifier. While EVD is a useful index for prescribing stand magnifiers, manufacturers do not always provide sufficient technical details to determine EVD for their stand magnifiers, and available tables of EVDs are more than a decade old and are likely to need updating. Photographic comparison provides a method for determining EVD, and this method can also be applied to other low vision devices.