Innovative strategies for adaptation to loss of vision

Age-related macular degeneration (AMD)is a major cause of visual impairment andblindness among people aged over60 years in developed countries and it isforecast that the prevalence of AMD willincrease.1 AMD is characterised by progressive loss of central vision leading toloss of functional vision (the ability toundertake visually guided activities). Functional vision may be assessed using ‘activityof daily living (ADL) instruments,2 whichassess independent living skills, such asability to read, write, recognise faces andobjects and other daily living activities.AMD also affects the quality of life andimpedes healthy independent ageing.Individuals confronted with disability maycreate novel strategies to cope.3 This casestudy will highlight how the ability to function may be greater than expected, basedon the level of visual function and ADLinstrument measures. This study showshow appropriate devices and the exerciseof creativity can aid in the development ofnovel coping strategies. For example,threading a needle is often regarded as ahighly-visually demanding task requiringfine visual resolution and is used by someADL instruments to measure functionalvisual ability in people with visualimpairment.4–6 This clinical communication highlights strategies that do not relyheavily on vision and may be used forthreading needles and other related tasks.