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BMC Ophthalmology
Published in: BMC Ophthalmology 1/2020

01-12-2020 | Corneal Diseases | Research article

Visual rehabilitation of patients with corneal diseases

Authors: Michael Oeverhaus, Dirk Dekowski, Herbert Hirche, Joachim Esser, Barbara Schaperdoth-Gerlings, Anja Eckstein

Published in: BMC Ophthalmology | Issue 1/2020

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Abstract

Background

Although most patients with visual impairment due to corneal diseases can be treated successfully with surgery, some require visual rehabilitation to restore reading ability. To evaluate the best LVAs especially in terms of reading speed and characterize this specific patient group we performed a prospective, randomized cross-over trial.

Methods

All 34 patients underwent a detailed examination (slit-lamp, funduscopy, SD-OCT, ETDRS) as screening. Only patients with corneal diseases without other ocular diseases were included. Reading-speed was assessed with International-Reading-Speed-Texts (IReST) consecutively with five different LVAs (low vision aids) during one day in a randomized cross-over design. Corneal haze was quantified with corneal densitometry (Pentacam).

Results

Patients were either visually impaired (n = 28), severely impaired (n = 4) or legally blind (n = 2). Patients read significantly faster with LVAs (p < 0.0001). Fastest reading speed could be achieved with video magnifier (CCTV). Optical magnifier and portable-electronic magnifier enabled significantly lower reading speeds (p < 0.01). In a subgroup of patients (VA < 3/60,n = 6) black background enabled patients to read significantly faster compared to white background (p = 0.03).

Conclusion

Patients with low magnification requirement can be treated successfully with optical LVAs and portable-electronic magnifiers. More severely afflicted patients need a CCTV. Black background enables fastest reading-speeds, probably due to less blinding. Visual impairment can be estimated with corneal densitometry. Our trial confirms the capability of LVAs to successfully restore the reading ability in patients with corneal diseases, which is a crucial part of visual rehabilitation.

Trial registration

This trial was registered at the German Clinical Trials Register as DRKS00010887 at 09.08.2016.
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Metadata
Title
Visual rehabilitation of patients with corneal diseases
Authors
Michael Oeverhaus
Dirk Dekowski
Herbert Hirche
Joachim Esser
Barbara Schaperdoth-Gerlings
Anja Eckstein
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2020
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-020-01436-7

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