Visual performance and initial perceptions of a wearable Electronic Vision Enhancement System by people with age-related macular degeneration.

Purpose : As part of a larger study to understand the usefulness of an Augmented Reality (AR) style wearable Electronic Vision Enhancement System (wEVES) for people with age-related macular degeneration (AMD) a baseline assessment was conducted to evaluate visual function and initial qualitative views.

Methods : 30 people (60% female, mean age 81±7yrs) with AMD had a low vision assessment to optimise optical low vision aids (LVAs). Participants were familiarised with the Eye5 device (Eyedaptic, Los Angeles), which includes a wearable display and a selectable head-mounted (HM) or handheld (HH) camera input system. Distance Visual Acuity (VA), reading acuity and contrast sensitivity (CS) with the device were compared to measures taken with best-corrected spectacles and LVAs. Participants’ initial perceptions of the device were invited, along with their willingness to participate in a longer home trial.

Results : Repeated measures ANOVA showed significant changes with the device compared to spectacles in distance VA (F(1.29, 37.46)=44.03, p<0.001) and reading acuity (F(1.98, 57.36)=24.45, p<0.001), but not CS (F(1.63, 47.20)=1.44, p=0.246).
Post hoc analysis showed improvements in distance VA compared to spectacles with both the HH camera (0.41logMAR [95% CI, 0.27 to 0.55], p<0.001) and HM (0.36logMAR [95% CI, 0.22 to 0.49], p<0.001). Compared to spectacles, reading acuity improved with the HH camera (20.6points [95% CI,11.1 to 30.1], p<0.001), but not with the HM camera (10.0points [95% CI, 20.2 to -0.2], p=0.055). Compared to the optimal optical LVA, reading acuity was similar with the HH camera (-1.54points [95% CI, -5.4 to 2.3] p=1.0) and poorer with the HM camera (-12.1points [95% CI, -4.0 to -20.2], p=0.01).
27/30 participants (90%) were willing to take part in a home trial to evaluate real-world use of the device, with 3 abandoning due to lack of improvement (3), comfort (1), and diplopia (2). 10/30 felt the device offered more flexibility than current LVAs and 6 described hands-free use as beneficial. Main disadvantages reported were screen quality or size (6), poor tactile controls (6) and the wire connecting headset and phone (5).

Conclusions : This AR style wEVES showed improvement in VA but not in contrast sensitivity. Most participants saw advantages to the device and there was a strong willingness by participants to take part in a home trial.