2 The p-EVES Study was a prospective two-arm cross-over randomised controlled trial to determine the clinical effectiveness, acceptability, and cost-effectiveness of p-EVES devices compared to optical LVAs. The p-EVES Study was designed to answer the question of whether p-EVES devices offer real benefits to users for near tasks and activities, in addition to traditional optical LVAs. If not, eligible patients will need to purchase EVES privately, with some charities (eg Macular Society) offering limited help and possibly access to second hand markets which may reduce costs.įigure 2: Child using a smartphone reading enhancement app Some charities may help certain individuals, for example St Dunstan’s (Blind Veterans UK) may help those previously or indeed currently in the armed forces. The Access to Work scheme provides practical support and financial help for those with visual impairment, and other disabilities. 1įor those in education, children are ‘statemented’ and receive a Statement for Special Educational Needs (SEN) which outlines the help they require which may include EVES (figure 2). There is statutory provision, following assessment, for those who are deemed eligible ie for those in full time education, or those in employment via the ‘Access to Work’ scheme (throughout the UK except Northern Ireland). Also, as many patients already own computers, tablets and smartphones, access to electronic magnification is often very cheap and easy. This is changing, however, and the Welsh Low Vision scheme, for example, offers the supply of an EVES device where its usefulness can be argued. Unlike traditional optical magnifiers, EVES are usually not available for funding via the NHS. Practitioners should not ignore the fact that there may be audio options with some devices that will enhance performance in the more significantly sight impaired. ![]() From experience, the author has found that EVES will only have limited success if the acuity is worse than logMAR 1.20, and/or the contrast sensitivity worse than 22% (0.60 log CS), though some highly motivated patients may still surprise you. Common sense dictates the better these three factors are, the better the success with the aid will be. Success with any low vision aid however, does still depend on a degree of motivation and similar criteria for suggesting an optical magnifier should therefore still be used if recommending an EVES.Īs with traditional optical magnifiers, the prior assessment of visual acuity, contrast sensitivity and visual fields remains essential. Though this may obviously still hold some truth, encouragement of all age groups should now be the norm. Indeed, there has been rapid development in software used by existing electronic devices, such as tablets (figure 1) and smartphones, and these can offer often very cost-effective options using a medium everyone is familiar with and unlikely, therefore, to suffer some of the stigma associated with many low vision aids.įigure 1: Use of a tablet and a magnification appĮVES essentially present a magnified image upon a screen and may be complemented with further attempts at magnification, such as reduced working distance.Įxperienced low vision practitioners will be aware that the philosophy in the past was that electronic aids were only for the young and highly motivated visually impaired persons. Electronic devices nowadays are usually simple to use, often more so than a standard optical magnifier, and additionally have the advantage of being perceived as more socially acceptable. ![]() Manufacturers of electronic low vision aids have also moved with the times, from supplying a limited range of aids to a now fairly extensive selection.Ī patient’s success with a low vision aid does not just rest solely on acuity and other clinical measures, but is influenced by real life considerations such as ease of use and cosmesis. ![]() Patients attending low vision clinics are increasingly computer literate, some having had prior years of experience perhaps in their current or previous jobs or indeed at home. In the past, many low vision practitioners tended to shy away from recommendation of electronic low vision aids (which historically tended to be grouped together as CCTVs), or to use the preferred terminology ‘electronic visual enhancement systems’ (EVES), often, but not exclusively, due to cost factors or the patients unfamiliarity with electronic and computer-based devices.Ĭomputers and electronic devices are now well established in everyday life in schools, work environments and the home. ![]() It has long been recognised that magnification can assist a visually impaired patient, or indeed any patient, in undertaking a variety of tasks, and therefore offer the chance to improve their quality of life and perhaps maintain independence.
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