If you have advanced age-related macular degeneration (AMD), you may have some challenges in living independently. But there are tools to make life with low vision from AMD easier.
Today, assistive devices and technologies are a common part of treatment plans to help millions of people with AMD make the most of their vision. If you are living with AMD, using the right assistive device can help you age optimally to enjoy daily activities and pursue other interests.
Depending on your level of vision and daily activities, your doctor may suggest one or more of the following:
Large-print reading materials
If you're transitioning to living with AMD, you will want to opt for choices that make reading easy and less stressful to your eyes. One of the easiest changes to make is to choose books, newspapers, and magazines with bolder texts and easy fonts. Using an electronic reader often eases the ability to read standard books using the font of your choice, bolding all text and increasing the font size. These changes are included in virtually all e-readers.
Canes
Canes are basic mobility aids that make walking safer and more convenient. They’re also affordable and relatively easy to use. You can use your cane primarily for support, or choose a longer “probing” cane that extends in front of you to let you know about the terrain ahead. For even more information, you can add a “smart” handle to your cane that can sense objects your cane might miss and can help you find locations with GPS. To navigate your environment, you should hold the cane with your most dominant hand in front of your body.
A standard white cane costs $20 to $60, while a smart cane can run anywhere from $100 to $1,000. Recent advances in computer processing, advanced sensor technology, and artificial intelligence are poised to improve this technology for the visually compromised.
Eyeglasses
If you have intermediate or late-stage macular degeneration, specialized glasses can help you see both near and distant vision clearly. Your eye doctor will test your eye to see the additional lenses that can boost your vision. Depending on your needs as your vision changes over time, you may need any of the following:
- Yellow-tinted glasses. Due to early-stage AMD, little white spots in the retina can make identifying contrasts and textures difficult. Yellow-tinted glasses can help some used by brightening vision contrast and improving their field of vision. They also protect your eyes and block up to 99% of harmful ultraviolet light.
- Bioptic telescope. A small telescope mounted on glasses known as a bioptic telescope may help you see distant objects better with advanced AMD.
- Prismatic lenses. Built-in prism glasses may improve your vision by diverting light rays away from the damaged macular region of the eyes to adjoining retina that still functions (this is called eccentric fixation).
Low-vision eyeglasses can range from $200 to $3,000.
Low-vision aids
Low vision from AMD makes it harder to read text and view images. Optical aids maximize your vision by making objects appear bigger and easier to see. If you are considering low-vision aids, discuss your level of vision and daily activity with your doctor. Your options may include:
- Stand magnifiers. These are mounted on a stand and rest above the pages you are viewing. This can be helpful if you have weak or shaky hands.
- Handheld magnifiers. You hold these directly over text to see more clearly. They come in handy for shopping and other outdoor tasks. Most have built-in lighting to illuminate what you’re reading.
- Video magnifiers (CCTV). These types of magnifiers use a video camera to magnify an object and project it on a video screen. These devices can magnify things to a very high level, but they tend to be large and heavy.
Depending on the type and model, magnifiers cost between $20 and $5000.
Smartphones, tablets, and computers
Many smartphones, tablets, and computers have text-to-speech software that reads text aloud so you don't have to use your eyes. These tools can improve your listening skills by helping you pay more attention to what you hear. They also come with applications to adjust font size with simple voice commands so you can use them as a camera/magnifier.
The cost for these devices varies widely, depending on the model that you choose.
Wearable technology
This is one of the newest and most advanced types of assistive technology for people with AMD. You typically wear them over your head. They come with built-in features that may include a high-definition camera and video magnifier connected to an eyeglass headset. You can control the device with a handheld control, voice command, or buttons in the headset. These smart wearable technologies are improving rapidly and now have incorporated artificial intelligence to process the images, including facial recognition. A next generation computerized eyewear system has the ability to move the functional images back to the center to achieve a more “normal” central visual functional.
The cost of this technology varies widely. Depending on the features and the type of device, the price can range from a few hundred dollars to $10,000 or more. Many types of smart eyeglasses range from about $1,500 to $4,000.
Implantable devices
In rare instances, your doctor may recommend an implantable miniature telescope (IMT). Your doctor will perform surgery to place this device where a normal lens implant is positioned during cataract surgery. This is typically performed in only one of one eye to improve your central vision. To receive an IMT, you must:
- Be 65 or older
- Have end-stage AMD in both eyes, either wet or dry
- Have visual acuity of between 20/160 and 20/800
- Have not had results from all other forms of AMD treatment
- Have not had cataract surgery on the eye in which the IMT will be implanted
The cost of an IMT is about $15,000. It’s covered by Medicare and may be covered by some private insurers.
How to Know Which Devices Are Right for You
Some low-vision aids may be inexpensive, while others carry a steep price tag. You may want to talk to your doctor and think about the following things before you choose a device:
- Your lifestyle and daily activities
- Your personal preferences
- How easy the device is to use
- Portability
- Durability
- Your budget
- Your insurance coverage
- What features you're looking for, such as internet, audio, or GPS capability
Your eye doctor or an occupational therapist who has experience working with people living with AMD can review your needs, help you choose what's best, and teach you how to use it.
Questions to Ask Your Doctor About Adding Assistive Devices or Technologies to Your Daily Routine
When you’re looking for an assistive device, finding the one that's a great fit can take some time and effort. Your doctor can help you narrow down your choices. For the majority of patients, a low vision specialist who deals specifically with assistive devices may be the best choice and these specialists can identified with your eye care specialist.
Here are some questions to ask your doctor about adding one or more of these tools and technologies to your daily routine:
- Which device do I need?
- Which device can offer the most benefit?
- How does this meet my vision needs?
- What tasks can I perform with it?
- Is it comfortable to use?
- Is it easy to move from one place to another?
- Does the device pose any safety risks?
- How much does this cost?
- Will I pay out of pocket, or will my insurance cover it?
Paying for Low-Vision Assistive Devices
Insurance. If you have health insurance, remember to check with your insurance provider to see if adaptive devices are covered under your plan. Some private health insurance may cover costs if prescribed or recommended. Often low-vision assistive devices are not covered by existing health plans.
Patient advocacy group assistance programs. If cost is a concern, the following organizations may be able to help:
- Association of Blind Citizens Assistive Technology Fund
- iCanConnect
- NeedyMeds
- State-specific grants and assistive programs
Living Well with Low Vision, an education program offered by the patient advocacy group Prevent Blindness, has a directory of agencies and programs on its website.
