An anatomical eye shows paths of vision and scotoma.

Eccentric Viewing or Steady Eye Strategy

Have any of you reached that stage with your macular degeneration where you’re using eccentric viewing for reading, even if you didn’t know that’s what you were doing? I’m beginning to, especially on days when my allergies are acting up and my eyes are watery and blurry. Or perhaps my particular brain is more adapted to learn the steady eye strategy.

Slowing down progression

I have wet macular degeneration in my left eye and dry in my right. When I started researching, I discovered that with one eye wet, I had a 50-50 chance of the other eye advancing to wet as well. I now get regular injections for my wet left eye to hold back the progression. But so far there is nothing other than the AREDS supplements to slow down the progression of dry. The geographic atrophy in my right eye is growing slowly, but it’s fast enough that I recently noticed a change. Not on the Amsler grid, but when reading on my iPad.

When I check the Amsler grid, with what had been my “good” eye, I can see the areas of atrophy, but changes in those indistinct borders had been so gradual it was not really noticeable. But I don’t dare not use it. It could find a new bleed in time for help.

How my dry and wet eye compensate for each other

My main scotoma is just at the bottom right of the centre line. I described it to my retinal specialist using a clock face. With what used to be my “good” eye, the numbers 4, 5, 6, and 7 have a light grey cloud over them. With my “wet” left eye, the numbers four and five have a much lighter, more translucent grey cloud over them. When both eyes work well together, they compensate for each other. We know our brains fill in the blanks for the most part, and we’ve all seen those memes on the internet where the letters are jumbled and yet we can all still read them. But a more complex article with unfamiliar words becomes a different problem altogether.

Eccentric viewing strategy

A low vision specialist can help you get started in finding your preferred retinal locus or “sweet spot” needed to learn eccentric viewing and guide you in the necessary training. They also will help in determining which, if any, assistive device would help the most. Studies show that functional vision and satisfaction significantly improved following EV training. EV training can be used as an effective method for low vision rehabilitation in patients with central scotomas.1

Steady eye strategy

Another technique is steady eye strategy; exactly what it sounds like. Your eyes remain fixed in one spot while you move the sentences through that spot. I think this may be easier with an iPad than paper. It is said to be more difficult to learn and requires more practice than eccentric viewing, but once learned, makes a tremendous difference.

This progression has given me fair warning. It’s time to start preparing for the time if or when it’s not just the bottom of the words I’m trying to read but the whole word itself that disappears.

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