[Vision rehabilitation of patients with old-age macular degeneration]

Age-related degeneration of the macula retinae occurs in two forms: the serious form with invasion of blood vessels and leakage, and the atrophic form. Both forms ultimately lead to a central scotoma. The prevalence of the terminal stage of age-related macular degeneration varies from 1% in the age group 65-74 years to 11% in those 85 years or over. A total of 58,500 persons in the Netherlands have age-related macular degeneration and an estimated 22,000 persons depend on visual or optic aids. Aids for close vision are good illumination, magnification (reading glasses, magnifying glasses, telescopic lenses, television reading lenses (with possibility of changing contrast), large-letter books, playing cards with large symbols) and auditory aids. Aids for distant vision reduce troublesome light (sunglasses, filter) or enlarge the image (telescopic aids). Future new aids derive from modern computer technology (personal computer, integrated braille reader and speech synthesizer) or are based on opto-electronic image processing and presentation (mini-cameras with mini-VDUs in a sort of helmet). Effective use of aids depends on attention for the patient's desires and possibilities and on counselling in handling aids. Ophthalmological checkups remain useful for the prevention and (or) treatment of accessory disorders.