Enhancing Reading Performance with a Portable Electronic Magnifier: A Case Report on Low Vision Telerehabilitation

Introduction: Low vision rehabilitation is important for managing patients with visual impairments; however, many patients face significant barriers to attending in-office rehabilitation appointments because of vision-related challenges with transportation and ambulation. Therefore, telerehabilitation allows for the delivery of patient care to patients with visual impairments. Here, we discuss the effectiveness of telerehabilitation in improving reading performance using a portable electronic magnifier.

Case Presentation: A 47-year-old African–American patient presented for low vision evaluation with a history of proliferative diabetic retinopathy and primary open-angle glaucoma. He reported difficulty reading and recognizing faces. Following refraction and vision-assistive device trials, the patient was prescribed distance spectacles, 4x binoculars, and a portable electronic magnifier (PEM) with maximum magnification 13.5x. Best-corrected distance acuities were 2/16M (SE 20/160) OD, 2/32M (SE 20/320) OS, and 2/16M (SE 20/160) OU. The patient’s distance acuity improved to 4/6M (SE 20/30) with 4x binoculars. The patient was able to read 0.4m print size using the PEM.

Management and Outcome: At baseline, reading performance was evaluated using a digital iPad MNREAD chart. The MNREAD chart uses four reading performance metrics: maximum reading speed (MRS), reading acuity (RA), critical print size (CPS), and reading accessibility index (ACC).

At baseline, the patient’s reading efficiency was significantly improved with the PEM. MRS increased to 30 words/min, RA improved from logMAR 0.73 to 0.15, CPS improved from logMAR 0.9 to 0.6, and ACC increased from 0.06 to 0.16. Post-telerehabilitation, the patient’s reading performance further improved. The CPS and RA improved to logMAR 0.25 and 0.01, respectively. The ACC increased to 0.27, whereas MRS remained stable.

Discussion: Telerehabilitation is a feasible alternative method for delivering effective follow-up care for patients with low vision. It can be used for patient training with vision-assistive devices and monitoring patients’ reading efficiency.