Macular degeneration and using peripheral vision

Macular degeneration is the most common eye condition found in people who have low vision. The part of the eye called the “macula” gets bumpy rather than be the usual smooth surface that is found in the normal eye. A “black hole” appears in the patient’s central vision as a result. The problem is that our best vision is our central vision and a good deal of that area is blacked out in macular degeneration. While it is commonly thought that a black hole is circular, in most patients the blacked out area is more like an island. Islands have areas that jut in and out. This is the same situation with people who have macular degeneration. The implication of this irregular shaped black area is pretty profound. Almost all of our patients have a “sweet spot” in their visual field where they can see a bit better using their peripheral vision. This strategy is called “eccentric viewing.”

Because macular degeneration affects people in different ways, the “sweet spot” for someone might be at the “one o’clock” position in their field of vision and someone else might see better at the “nine o’clock” position. The key is teaching patients to tilt their heads up, down, right or left until they can determine their optimal viewing angle using their peripheral vision. 

Once a patient has been taught to locate their “sweet spot,” many visual tasks become a bit easier; operating a thermostat, using a TV remote or pouring liquids. Extensive reading is likely still a significant challenge but we use our vision for many daily living tasks besides reading. Learning to position their heads the correct way to maximize their peripheral vision can make many daily living tasks less difficult.