This is for a patient with type 1 diabetes who would like to maximize peripheral vision. He was told to consider an eyelid lift for mild eyelid drooping/ptosis.

Ideally we would want to try non-invasive options first before blepharoplasty surgery which can cause worsening dry eye.

Here are some options. While most lenses try to help with peripheral vision loss, some might be able altered to maximize peripheral vision if central vision is lost.

1. Bascom Palmer Develops Digital Glasses Using AI To Help Patients With Limited Peripheral Vision

Bascom Palmer Eye Institute, University of Miami Health System
February 14, 2020 Original Article

To assess the efficacy of novel Digital spectacles (DSpecs) to improve mobility of patients with peripheral visual field (VF) loss.

Design

Prospective case series.

Methods

Binocular VF defects were quantified with the DSpecs testing strategy. An algorithm was implemented that generated personalized visual augmentation profiles based on the measured VF. These profiles were achieved by relocating and resizing video signals to fit within the remaining VF in real time. Twenty patients with known binocular VF defects were tested using static test images, followed by dynamic walking simulations to determine if they could identify objects and avoid obstacles in an environment mimicking a real-life situation. The effect of the DSpecs were assessed for visual/hand coordination with object-grasping tests. Patients performed these tests with and without the DSpecs correction profile.

Results

The diagnostic binocular VF testing with the DSpecs was comparable to the integrated monocular standard automated perimetry based on point-by-point assessment with a mismatch error of 7.0%. Eighteen of 20 patients (90%) could identify peripheral objects in test images with the DSpecs that they could not previously. Visual/hand coordination was successful for 17 patients (85%) from the first trial. The object-grasping performance improved to 100% by the third trial. Patient performance, judged by finding and identifying objects in the periphery in a simulated walking environment, was significantly better with the DSpecs (P = 0.02, Wilcoxon rank sum test).

Conclusions

DSpecs may improve mobility by facilitating the ability of patients to better identify moving peripheral hazardous objects.

2. New glasses may help minimize peripheral vision loss

December 19, 2016

Information for this release was provided by the Association for Research in Vision and Ophthalmology.

Rockville, Md. — Vision scientists may have discovered how to reduce pedestrian collisions in crowded and chaotic open space environments like bus terminals, shopping malls and city plazas involving individuals with partial blindness. Researchers have determined from which direction collisions with partially blind pedestrians are most likely to originate. This understanding will guide the development of new glasses that expand the sight of a person with limited peripheral vision.

The paper, titled, “The risk of pedestrian collisions with peripheral visual field loss,” was recently published in the Journal of Vision. The authors created a mathematical model to determine collision risk and compared that risk to the limited vision of 42 patients with retinitis pigmentosa.

“We found that the risk of collision is highest from pedestrians at an angle of 45 degrees from the patient’s walking path,” says lead author Eli Peli, OD, Professor of Ophthalmology at Harvard Medical School and a vision scientist at the Schepens Eye Research Institute of Massachusetts Eye and Ear. “This means that any visual-field expanding device will be most effective if it an cover that angle.”

Peli and his colleagues are developing new devices based on prism-containing eyewear they previously designed. Prisms are primarily prescribed to correct visual defects by bending light. To minimize the loss of peripheral vision, new prism-containing glasses would bend light to hit areas of the eye that still function, expanding what a patient could see.

Patients with blindness in the left or right half of one of their eyes (hemianopia) caused by stroke, brain tumors or trauma, or patients with limited peripheral vision from retinitis pigmentosa, Usher syndrome, choroideremia and advanced glaucoma may one day benefit from the vision-expanding devices currently under development.

Media Contact:
Katrina Norfleet
Association for Research in Vision and Ophthalmology
240-221-2924
knorfleet@arvo.org

About the Journal of Vision
The Journal of Vision (JOV) is an online, open-access, peer-reviewed scientific journal devoted to all aspects of visual function in humans and other organisms. The journal is published exclusively in digital form: full-text articles may be accessed for at jov.arvojournals.org. The journal encourages the effective use of color, multimedia, hyperlinks, program code, and other digital enhancements.Science and Translational Vision Science & Technology.

2. These options for Retinitis Pigmentosa would also work for patients with other causes of vision loss:

Side-Vision Awareness

Retinitis Pigmentosa patients often suffer from loss of peripheral (side) vision. Side-vision awareness glasses will expand the missing part of the visual field of the patient. This expands the awareness of objects in their path, thus, improving their side vision. With these, the patient may be able to drive, watch sports, and identify faces

Bioptic Telescopic

Bioptic telescopic glasses consist of telescopes placed on two optical lens systems. Bioptic telescopes can help improve the vision of patients with Retinitis Pigmentosa. With your bioptic telescopic glasses, you can see objects at a distance, make out faces, watch TV, and lots more.

Digital Magnifiers

Digital magnifiers or CCTV consist of a camera and a TV screen. Together, they serve as a low vision aid for patients with Retinitis Pigmentosa. When the camera is pointed at an object, a magnified image appears on the screen. Through the camera, patients can see and read magnified images of the object.

Low Vision Magnifying Reading

Low vision magnifying reading glasses are also recommended for patients to help enhance their vision for reading print. The glasses will magnify the fonts and make it easier for the patient to read.

Tele-Microscope Eyeglass

Tele-microscope glasses feature two or three lenses separated by an air space. The telescope helps to magnify images. Some tele-microscope eyeglass comes with a focus knob which adjusts to correct spherical errors. Tele-microscope glasses can be used for viewing both close and distant objects. This low vision device is suitable for activities such as watching TV, watching sports from a distance, making out faces, doing house chores, and lots more.

Reverse Telescopic Glasses

Reverse telescopic glasses can improve vision in patients with visual field loss. These small telescopes are carefully placed on top of the patient’s eyewear. The tip of the telescope’s head makes it possible for the patient to have a wider view. This is made possible minifying the remaining field of view of the patient. This can be compared to looking backwards through a pair of binoculars. With this, the patient can have a small, yet, sharper image.

Low Vision Magnifying Reading

At International Academy of Low Vision Specialists, our low vision doctors also recommend prismatic reading glasses to help patients with Retinitis Pigmentosa read print and text. Prismatic reading glasses come with optical quality spherical lenses. The lenses help to magnify and converge the image at the same time. They are suitable for reading and other hand-held tasks

Handheld magnifiers

Retinitis Pigmentosa patients can also use handheld magnifiers to magnify objects, especially when reading. This portable low vision aid can increase the size of an image by 1.5 or up to 20 times. Since they are portable, you can easily take your handheld magnifier along with you when heading out. The handheld magnifiers help to improve reading and viewing ability of patients.

Our low vision eye doctors at IALVS will carry out a detailed diagnosis to determine the best low vision aids or eyeglasses for you. Read more about our low vision glasses and aids.