The Usefulness of a Wearable Electronic Vision Enhancement System for People With Age-Related Macular Degeneration: A Randomized Crossover Trial

Purpose: To determine the usefulness of a wearable electronic vision enhancement system (wEVES) for people with age-related macular degeneration (AMD). Methods: Thirty-four adults with AMD, 64.7% female, mean age 80.2(±6.0), were recruited from a UK low vision service. A 12-week non-masked randomized crossover trial compared wEVES usefulness with participants’existing low vision solutions. Primary outcome measures were visual ability, vision-related quality of life (VRQoL), device usage, and user-reported preferred device. Secondary outcomes were adverse effects, willingness to purchase, and qualitative reactions. Results: Overall visual ability improved with wEVES compared to existing solutions alone (mean difference −0.26; 95% confidence interval [CI], −0.48 to −0.04; P = 0.02). The wEVES were used for varied activities, including distance tasks, with few reported alternative strategies. However, these findings did not translate into changes in VRQoL (mean difference 0.10; 95% CI, −0.27 to 0.46; P = 0.59) or sustained device use. The wEVES were not the most preferred device for any task or individual, even when selfreported performance surpassed existing solutions. Adverse effects were minor, but participants’ satisfaction and willingness to use wEVES declined significantly from trial baseline to end. Conclusions: The wEVES improved self-reported visual ability, indicating their potential to support vision rehabilitation for people with AMD, albeit in a device that was largely not preferred over existing solutions. A user-led home trial evaluated using mixed methods is more indicative of the usefulness of wEVES for people with AMD than a short clinical demonstration. Translational Relevance: To understand the usefulness of wEVES for people with AMD, broader measures than visual function and visual ability should be applied within longer user-led assessments.<p></p>