ROLE OF LOW VISION AIDS IN THE ENHANCEMENT OF RESIDUAL DISTANCE AND NEAR VISUAL ACUITY IN PATIENTS WITH MACULAR DISEASE

Abstract

Background: Macular disease produces irreversible central vision loss with no curative treatment, so management relies on visual rehabilitation with low vision aids; however, local data on the acuity gain achievable across the spectrum of macular disease in Pakistan are scarce.

Objectives: To quantify the improvement in residual distance and near visual acuity achieved with low vision aids in patients with macular disease, and to identify the most effective devices.

Methods: In this cross-sectional study at a tertiary care eye hospital in Karachi, Pakistan, 31 patients with macular disease prescribed a low vision aid between August 2025 and January 2026 were enrolled. Best-corrected distance acuity (logMAR) and near acuity (M-notation) before and after provision of an aid were compared using the paired t-test and Wilcoxon signed-rank test.

Results: Median age was 13 years (range 6–58); 25 patients (80.6%) were male. Distance acuity (n = 31) improved from 0.99 ± 0.20 to 0.77 ± 0.28, a mean gain of 0.22 ± 0.17 (p < 0.001), improving in 28 patients (90.3%). Near acuity (n = 21) improved from 3.58 ± 1.46 M to 2.25 ± 1.13 M, a mean reduction of 1.33 ± 0.91 M (p < 0.001). Higher-magnification telescopes gave the largest distance gains; the illuminated handheld magnifier was the most effective near device.

Conclusion: Low vision aids produced a statistically significant improvement in both residual distance and near visual acuity in macular disease. Higher-magnification telescopes were most effective for distance and illuminated handheld magnifiers for near work, supporting routine low vision rehabilitation.