The Usefulness of a Wearable Electronic Vision Enhancement System for People With Age-Related Macular Degeneration: A Randomized Crossover Trial

Abstract

PURPOSE: To determine the usefulness of a wearable electronic vision enhancement system (wEVES) for people with age-related macular degeneration (AMD). METHODS: Thirty-four adults with AMD, 64.7% female, mean age 80.2(±6.0), were recruited from a UK low vision service. A 12-week non-masked randomized crossover trial compared wEVES usefulness with participants' existing low vision solutions. Primary outcome measures were visual ability, vision-related quality of life (VRQoL), device usage, and user-reported preferred device. Secondary outcomes were adverse effects, willingness to purchase, and qualitative reactions. RESULTS: Overall visual ability improved with wEVES compared to existing solutions alone (mean difference -0.26; 95% confidence interval [CI], -0.48 to -0.04; P = 0.02). The wEVES were used for varied activities, including distance tasks, with few reported alternative strategies. However, these findings did not translate into changes in VRQoL (mean difference 0.10; 95% CI, -0.27 to 0.46; P = 0.59) or sustained device use. The wEVES were not the most preferred device for any task or individual, even when self-reported performance surpassed existing solutions. Adverse effects were minor, but participants' satisfaction and willingness to use wEVES declined significantly from trial baseline to end. CONCLUSIONS: The wEVES improved self-reported visual ability, indicating their potential to support vision rehabilitation for people with AMD, albeit in a device that was largely not preferred over existing solutions. A user-led home trial evaluated using mixed methods is more indicative of the usefulness of wEVES for people with AMD than a short clinical demonstration. TRANSLATIONAL RELEVANCE: To understand the usefulness of wEVES for people with AMD, broader measures than visual function and visual ability should be applied within longer user-led assessments.