Are wearable electronic vision enhancement systems (wEVES) beneficial for people with age‐related macular degeneration? A scoping review

Abstract

Introduction Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment in the United Kingdom. It has a wide-ranging detrimental impact on daily living, including impairment of functional ability and quality of life. Assistive technology designed to overcome this impairment includes wearable electronic vision enhancement systems (wEVES). This scoping review assesses the usefulness of these systems for people with AMD. Methods Four databases (Cumulative Index to Nursing and Allied Health Literature, PubMed, Web of Science and Cochrane CENTRAL) were searched to identify papers that investigated image enhancement with a head-mounted electronic device on a sample population that included people with AMD. Results Thirty-two papers were included: 18 studied the clinical and functional benefits of wEVES, 11 investigated use and usability and 3 discussed sickness and adverse effects. Conclusions Wearable electronic vision enhancement systems provide hands-free magnification and image enhancement producing significant improvements in acuity, contrast sensitivity and aspects of laboratory-simulated daily activity. Adverse effects were infrequent, minor and spontaneously resolved with the removal of the device. However, when symptoms arose, they sometimes persisted with continued device usage. There are multi-factorial influences and a diversity of user opinions on promotors to successful device use. These factors are not exclusively driven by visual improvement and incorporate other issues including device weight, ease of use and inconspicuous design. There is insufficient evidence of any cost–benefit analysis for wEVES. However, it has been shown that a user's decision to make a purchase evolves over time, with their estimates of cost falling below the retail price of the devices. Additional research is needed to understand the specific and distinct benefits of wEVES for people with AMD. Further patient-centred research should assess the benefits of wEVES in user-led activities when directly compared with alternative coping strategies, allowing professionals and users to make better prescribing and purchasing decisions. Key points Wearable electronic vision enhancement systems (wEVES) produce improvements in acuity, contrast sensitivity and the ability to complete some laboratory-simulated tasks such as recognising faces or finding items on a shelf. There is an absence of evidence concerning the performance or cost–effectiveness of newer wEVES compared with existing coping solutions. Greater functional independence and changes in quality of life predict the sustained use of wEVES, whereas discomfort, handling difficulties and high weight cause discontinuation of use.