‘I sometimes see things on the floor, only when I look beyond it. Why is that?’
This is a question one of my patients recently asked me. She had advanced AMD with complete loss of central vision.
Early AMD
In the early stages of macular degeneration vision loss can be mild and only noticeable when looking at people’s faces (they cannot easily be recognised due to reduced detail vision and reduced contrast sensitivity) or when reading the paper, particularly when the print is not black on white. At this stage, a magnifier or another Low Vision aid can be extremely helpful. It is important to get this prescribed by a qualified practitioner who has experience in supporting people with sight loss.
Advanced AMD
In advanced AMD, the visual difficulties become more severe and some people go on to develop a ‘central scotoma’. This means that their vision in the middle is missing. They often see better when they use a part of their vision away from the centre, also referred to eccentric fixation.
In my patient, the lady was able to see objects when she looked beyond them, because she had preserved vision in a lower part of her retina (also referred to as ‘preferred retinal locus’, or PRL). I advised her that she could make use of her PRL by looking above people’s faces in order to see their faces better, and to look at the top of the TV screen to get a better overall image. We tried it in clinic and she was amazed by the improvement in clarity!
