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Digital eye wear provides new option for low vision patients
One practitioner says many patients can see at near, intermediate and far distances with the eSight device.
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New digital eye wear that utilizes video images may enable users with low vision or legal blindness to see with as near-normal vision as their condition allows.
The assistive technology from eSight Corp., launched during Vision Expo West in October 2013, looks like a pair of fit-over sunglasses and uses a high-resolution video camera to film what the user is looking at. Images are then delivered to a controller with a computer, processed and projected, in real time, onto two LED screens inside the eye wear, according to the company.
Ana M. Juricic, OD, spoke with Primary Care Optometry News about her experiences with the technology, which she has seen from its early prototype stage in September 2010 to the present-day version.
“The eSight eye wear applies the latest technology to low vision,” Juricic told PCON. “When a patient looks at anything in the distance, intermediate ranges such as the computer and table top distance, or even to read arms-length away, it actually translates it all into a micro-LED screen that is visible to the user’s eyes in a binocular head-mounted device. The information is sent to the eyes, and the photoreceptor cells that are still working in many cases are able to pick up the image and transmit it to the brain so the user can view a more complete magnified image that allows them to recognize details that otherwise they could not.”
Juricic said one of her patients who is legally blind due to Stargardt’s disease can see 20/40 with eSight. He can see a clock on a wall, see people’s facial expressions and read a newspaper.
Assessing the patient
In prescribing the eye wear, Juricic investigates several angles.
“As an optometrist specializing in low vision, I’ll assess the patient’s refractive error first to see if they could possibly be corrected with eye glasses,” she said. “If they do have a prescription that can be of benefit, I incorporate that prescription within the eSight eye wear to enhance the image quality.”
Juricic said she demonstrates the unit by having the patient put it on and look at a computerized eye chart to establish a baseline.
“The unit is connected to a monitor so I’m able to see what they’re seeing,” she said. “And with that, we can adjust the magnification or the contrast level to try to ensure that the best image for their eye is presented. I assess their vision with and without the unit. On average, patients can read an additional 8.5 lines on the eye chart – which amazes them and their loved ones. Afterwards, I have them look at the face of their family member or friend who might have come with them to the appointment. Then I take them into the reception area to look at the television, because in the examination room, it’s very sterile; it’s not a real-life situation. If the patient finds that the eye wear is beneficial, I prescribe it.”
A patient reads wearing the eSight eye wear.
Image: Juricic A
According to the company, eSight is mobile, hands-free and adapts automatically to tasks that involve near, mid or far vision. The company said the device is being used by patients with age-related macular degeneration, diabetic retinopathy, Stargardt’s disease, ocular albinism, Leber’s hereditary optic neuropathy, cone-rod dystrophy, optic neuropathy and other low vision conditions.
Patient selection
“I’ve found the best candidates are individuals whose vision is about 20/70 to about 20/500,” Juricic said. “It’s ideal more so for someone with a central vision loss as opposed to someone who might have a condition that affects their side vision where it’s more tunneled, like in glaucoma or retinitis pigmentosa. Those individuals would not get the full benefit because this unit will magnify the image too much and often fall outside of their viewing area.”
Ideally, a patient should have at least a 40-degree field of vision, she said.
“I find that this system, because it’s now a digitized image as opposed to as optical lens within the device, works well for some patients, particularly those who are comfortable with the technology,” she said.
Juricic said she compares it to traditional optical aids.
“Some patients definitely notice that the eSight eye wear helps fill in some of their blind spots where a traditional optical aid does not,” she said. “Others may find that they prefer the image quality from an optical aid that uses typical optical lenses. It’s not for everybody, but for the individuals who seem to enjoy it and like it, it has worked out really well because it gives them the benefit of being able to see something in the distance as well as up close and intermediate all in one aid. For most other devices, it’s either for far away or up close only, but not both.” – by Chelsea Frajerman