Methode(n) und Anwendung des Visualtrainings in der Praxis bei Patient*innen mit zentralen Gesichtsfelddefekten

Abstract

Purpose. The aim of this clinical study is to discuss eccentric viewing training for patients with central visual field defects. Material and Methods. In order to improve the usability of optical or electronic magnifying aids and to regain reading skills, eccentric viewing training may be necessary in patients with central scotoma. Based on the visual training of Nilsson et al.1, we carried out a training with two rehabilitees at the Regiomed Rehabilitation Clinic Masserberg using simple self- made aids (optical magnification by means of overaddition and illuminated magnifying glasses; prepared exercise sheets with different texts/font sizes). We were able to find an area below the lesion that can be used for reading using letters of different sizes, which are pushed from the periphery in the direction of the visual centre. Within this area, the moving test letter can be read permanently. The subsequent atten- tional training sensitises the patient to the usefulness of this area, where text samples of different sizes are subsequently presented. These were then read aloud with appropriate close correc- tion/enlargement (observing the working distance) (moving text = moving text with steady eye = unmoving eye). Results. One rehabilitation patient already benefited so much from the use of the newly adapted magnifying aids, that addi- tional visual training showed no clear additional benefit. The other rehabilitation patient could not overcome the hurdle of the small working distance, despite intensive motivation, so that no success due to the training could be determined. Conclusion. Although the small sample cannot show direct success, it can be stated that eccentric viewing training can work without complex technology. Application to a larger population should be pursued. For more variations and fast, individual adaptation, the use of special software seems desirable.