Reading aids for adults with low vision

Citation: Virgili G, Acosta R, Bentley SA, Giacomelli G, Allcock C, Evans JR. Reading aids for adults with low vision. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD003303. DOI: 10.1002/14651858.CD003303.pub4

What is the aim of this review?
The aim of this Cochrane Review was to compare different reading aids for people with low vision. Cochrane Review authors collected and analysed all relevant studies to answer this question and found 13 studies.

Key messages
There is insufficient evidence supporting the use of a specific type of electronic or optical reading aid. The review suggests that reading speeds improve with the use of stand-mounted electronic devices. There is little evidence for a difference between head-mounted or portable electronic devices versus optical or other electronic devices, although technology may have improved since these studies took place. There is no evidence to support the use of filters or prism spectacles.

What was studied in the review?
The number of people with low vision is increasing with the ageing population. Magnifying optical and electronic aids are commonly prescribed to help people maintain the ability to read when their vision starts to fade. Cochrane authors reviewed the evidence for the effect of reading aids on reading ability in people with low vision to find out whether there are differences in reading performance using conventional optical devices, such as hand-held or stand-based microscopic magnifiers, as compared to electronic devices such as stand-based, closed circuit television and hand-held electronic magnifiers.

Cochrane Review authors assessed how certain the evidence was for each reviewfinding. They looked for factors that can make the evidence less certain, such as problems with the way the studies were done, very small studies, and inconsistent findings across studies. They also looked for factors that can make the evidence more certain, including very large effects. They graded each finding as being of very low, low, moderate or high certainty.

What are the main results of the review?
Cochrane Review authors found 13 relevant studies. Seven were from the USA, five from the UK and one from Canada. These studies compared the effect of different reading aids on reading performance, mainly reading speed. The participants were adults attending low vision services. Most of the people were affected by macular degeneration, which causes of loss of central vision and is often age-related. Because most of the studies were small, the results were often imprecise, and it is difficult to know whether they apply to everyone with low vision.

The results were as follows.

• Reading speed may be faster with electronic devices than with optical magnifiers (moderate- and low-certainty evidence).
• Provision of a closed circuit television (CCTV) at an initial rehabilitation consultation may increase reading speeds compared with standard low-vision aids prescription alone (low-certainty evidence).
• Reading speed with head-mounted electronic devices showed inconsistent differences compared to optical devices (moderate or low-certainty evidence).
• Reading speeds with a tablet computer compared with stand-mounted CCTV were similar (low-certainty evidence).
• Addition of an electronic portable device to a preferred optical device did not appear to increase reading speed (low-certainty evidence).
• Coloured filters were no better and possibly worse than a clear filter for reading speed (low-certainty evidence).
• Custom or standard prism spectacles did not appear to convey additional benefit compared with conventional reading spectacles for people with age-related macular degeneration (low-certainty evidence).

How up-to-date is this review?
Cochrane Review authors searched for studies that had been published up to 17 January 2018.

Image details
Josef Tal checks composition using a CCTV desktop unit (2006). Film-frame photo taken by Etan Tal at his home in Jerusalem.
Attribution: Photo: Etan Tal