‘Eccentric Viewing’ to Improve Vision

It is not unheard of for a Bridge player whose vision is plagued with a central scotoma (a blind spot in the middle of their central vision), to be still playing without anyone being aware of their disability. This person may be someone with, for example, Age-related macular degeneration or Stargardt’s disease.

The Bridge player might be employing “Eccentric Viewing”, a technique taught by occupational therapists (OT) in which the person looks around the blind spot in order to view the subject using their peripheral vision.

The loss of central vision makes it difficult to see the words on a page or the details of a face, yet the peripheral vision remains intact.

At Lighthouse Guild, this skill, eccentric viewing, is taught by occupational therapists such as Inna Babaeva, who works as part of our Vision Rehabilitation team to identify patients who want to learn the technique.

Ms. Babaeva explained that this technique can improve the quality and speed of reading and other activities that rely on central vision, such as writing, reading music, watching TV and playing cards. She has had a number of Bridge players among her patients.

People with central vision loss tend to see the target of viewing more clearly if they look slightly away from it in order to view it with another and more clear portion of their visual field. During evaluation the best location for viewing is identified. This position, their Preferred Retinal Location (PRL) varies from person to person.

Patients are given a set exercises to improve her or his visual skills and eye movement. In addition to the training, a low vision optometrist, working with the OT identifies appropriate magnification devices.

Doing exercises with an emphasis on eccentric viewing to move images into their PRL helps patients to “rewire their brains”. They learn to achieve the correct position with less effort, and improve the clarity of what they are seeing, of especial importance for reading. Practicing these exercises at home is tiring, but necessary for success.

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