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Logo for the Journal of Rehab R&D
Volume 41 Number 5, September/October 2004
Pages 729 — 738

Is there a standard of care for eccentric viewing training?

Joan A. Stelmack, OD, MPH; Robert W. Massof, PhD; Thomas R. Stelmack, OD

Edward Hines Department of Veterans Affairs (VA) Hospital, Hines, IL; Johns Hopkins Wilmer Eye Institute,
Baltimore, MD: Chicago Health Care System, West Side Division, Chicago, IL; Department of Ophthalmology
and Visual Science, University of Illinois at Chicago, Chicago, IL; Illinois College of Optometry, Chicago, IL
Abstract — A study was conducted to determine the current Department of Veterans Affairs (VA) standard of practice for eccentric viewing (EV) training. EV training is the process of teaching patients to realign the visual image away from a diseased foveal/macular region onto healthier retina. Optometrists and Visual Skills Instructors at all VA blind rehabilitation centers (BRCs) and VICTORS (vision impairment centers to optimize remaining sight) programs were asked to rate preference for EV prescription criteria, evaluation, and training techniques. Responses were received from 70% of BRCs and 67% of VICTORS. The respondents reported that all programs include EV training. The average minutes of training per patient varied from 20 minutes to nearly 24 hours, with instructors within a single center varying by as much as two orders of magnitude. Routinely, 82% of optometrists prescribe EV training, yet no consensus was found among these practitioners as to the criteria for selecting the best EV area. The results of this survey reveal an inconsistent standard of practice across VA centers and demonstrate the need for prospective studies of the efficacy, effectiveness, and cost-effectiveness of EV training.
Key words: eccentric viewing, eccentric viewing training, low-vision evaluation, low-vision rehabilitation, low-vision training, vision rehabilitation, vision training.

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