title: Effective rehabilitation of reading by training in the technique of eccentric viewing: evaluation of a 4-year programme of service delivery.
abstract: OBJECTIVE
  Central visual loss caused by conditions such as age-related macular degeneration (ARMD) is the commonest cause of blindness in the UK. Eccentric viewing training aims to teach patients how to utilise the functioning areas of macula or adjacent retina and establish a 'pseudofovea'. This technique has yet to gain acceptance in the UK despite evidence of success. Subjects with ARMD in Glasgow, UK, have received such training, and the outcome of training for this group is described.
  
  
  METHODS
  Retrospective analysis auditing the outcome of eccentric viewing training to read was carried out in 300 subjects with ARMD.
  
  
  RESULTS
  The data for 300 patients were reviewed. Fifty-eight subjects were excluded due to incomplete final data. Reading speed, font size, degree of comprehension, duration of reading, and age and number of lessons were recorded before and after training. The mean age was 75.4 (SD 12). The mean number of 1-h lessons required was 3.8 (SD 1.6). The starting mean number of corrected words per min (WPM) reading speed was 48 (SD 35) and this increased to 71.9 (SD 30.5) (p=0.000). The starting Arial font size that could be read fluently was 14.3 (SD 7.6) and this improved to 11.5 (SD 2.4). The starting mean duration of comfortable reading was 1.7 (SD 2.0) min. This increased to 15.8 (SD 14.6) min. The mean percentage of material read that was understood by the patients was 73.7 (SD 36.9)%. This improved to 92.7 (SD 16.2)% (p=0.000). Overall, the majority of patients exhibited improvement in one or more of the vision-related tasks measured.
  
  
  CONCLUSIONS
  Eccentric viewing training is successful in improving the reading ability of individuals with a central scotoma. This paper shows evidence of the success of training provided by the voluntary sector and funded by adult literacy funding. The results are comparable with those reported in the literature.
authors.affiliation: Visibility, Glasgow, UK.
authors.forename: Shelagh
authors.initials: S
authors.lastname: Palmer
authors.forename: David
authors.initials: D
authors.lastname: Logan
authors.forename: Shahriar
authors.initials: S
authors.lastname: Nabili
authors.forename: Gordon N
authors.initials: GN
authors.lastname: Dutton
mesh_terms: D000368:Aged; D032882:Comprehension; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000523:psychology; D008297:Male; D015397:Program Evaluation; D011932:Reading; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015354:Vision, Low / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation*