Jun 21, 2024

Electronic/VR Glasses vs. Traditional Low-Vision Aids

For individuals with low vision, finding the right assistive technology can significantly enhance their quality of life. With technological advancements, options now include electronic/VR glasses and traditional low-vision aids.

Each type of device offers unique benefits and suits different needs. This article explores these differences, emphasizing the importance of professional guidance from low-vision optometrists.

The Role of Low-Vision Optometrists

Low-vision devices are most effective when prescribed by a low-vision optometrist. These specialists evaluate the patient’s condition, causing the vision impairment and take precise measurements to ensure the selected device meets the patient’s needs.

This personalized approach ensures that patients receive the most appropriate solution for their type of vision loss, leading to better outcomes and improved daily functioning.

Traditional Low Vision Aids

Traditional low-vision aids include magnifiers, telescopes, and devices attached to spectacles. These aids have been in use for decades and offer several advantages

Magnifiers: Handheld or stand magnifiers are common tools for reading and close-up tasks. They are simple to use and come in various magnification levels.
Spectacle-Mounted Devices: Include telescopic lenses attached to glasses, providing hands-free magnification for tasks like reading or watching television.
Bioptic Telescopes: These are specialized telescopes mounted on glasses that help with distance viewing tasks, such as driving or watching TV.

Cost-Effectiveness

Traditional low-vision aids are often more cost-effective compared to electronic/VR glasses. They are less expensive to produce and maintain, making them accessible to a broader range of individuals. Their simplicity and durability often result in lower long-term costs.

VR/Electronic Glasses

Electronic devices and virtual reality glasses are at the forefront of assistive technology for individuals with low vision. These devices often include features like adjustable magnification, contrast enhancement, and voice commands. Some of the most notable benefits include:

Dynamic Adjustments: Users can adjust magnification and contrast settings to suit different environments and tasks.
Wide Field of View: Electronic glasses often provide a wider view field than traditional magnifiers.
Integration with Other Technologies: VR glasses can integrate with other assistive technologies, providing a comprehensive solution for various tasks.

Higher Costs and Complexity

While electronic/VR glasses offer advanced features, they cost more. The technology involved in these devices is sophisticated, and maintenance or repairs can be expensive. Their complexity may require a learning curve, making them less accessible for some users, especially older individuals who may not be as tech-savvy. They also conceal a users eyes which may be limiting in social situations.

Choosing the Right Device: Ocutech's Bioptic Telescopes

To make an informed decision about the right assistive technology, it is necessary to grasp the variances between electronic/VR glasses and traditional low-vision aids. While electronic glasses offer advanced features, traditional low-vision aids can be more cost-effective and easier to use.

Consulting with a low-vision optometrist ensures individuals receive personalized, effective solutions tailored to their needs.

We specialize in Bioptic Telescopes designed for distance viewing tasks. These devices are beneficial for activities such as driving and watching television. By enhancing distance vision, Bioptic Telescopes help users maintain independence and improve their quality of life.

Read further for an insightful editorial by our President and Low Vision Specialist, Dr. Henry Greene.

Are today's Head-Mounted Displays (HMDs) for low vision more hype than sight?

I expect that you'll think that as a manufacturer of optical bioptic telescopes writing about Head-Mounted Displays (HMDs), I'm just carping on what might be considered our competition.

But, in reality HMDs are not yet compelling competition to optical bioptics. And that's not just my opinion (as a clinician providing low vision care for 40+ years), but also that of most experts in the field. That's not to say that head-mounted digital displays for low vision won't someday offer vision rehab opportunities. They likely will. There are, after all, limits to what conventional optics can do. It's just that they're not there yet. And it's due largely to the limits of the technology currently available to HMD manufacturers.

Why all the hoopla and patient interest?

Marketing! HMD manufacturers have great emotive testimonials: they can make the blind see; he could see her eyes for the first time in years; she can read, play piano, play cards; they can do things they never thought they'd be able to do again! But one cannot ignore the social acceptability issues of a device that hides the user's eyes—both for the user, for their companions, and for the general public they may encounter. Since distance vision is a social sense, users seek, among other goals, to make eye contact, read body language, and feel socially connected. Devices as socially disruptive as present HMDs will certainly undermine this interactive functional goal.

Registered with the FDA

HMD manufacturers claim that they are registered with the FDA. Registered is not the same as approved by the FDA. Fill out the form, pay your money and your device can be registered too! It's false credibility. Every manufacturer of any type of medical device is required by law to be registered with the FDA. The FDA is firm in its position that registering a product with the agency does not confer the FDA's approval nor prove its efficacy. What confers efficacy? Independent clinical trials, not testimonials or marketing.

New Isn't Automatically Better

Of course, new can be appealing and exciting. But new isn't automatically better just because it's new. New is better when it's clinically proven and well received by the patient. Tried and true as optical bioptics are, they may not be as exciting as HMDs, but you won't hear that from long-term users. Bioptic users will tell you that their devices have changed their lives. Ocutech's prescription return rate is less than 0.1%. Instead, we receive products to be cleaned and refurbished almost daily. That's because they are used. Many are returned to have the carrier lens prescriptions updated. Patients wouldn't bother spending the money if their bioptics weren't helpful.

Technical, Clinical and Acceptance Data

What questions should we be asking? Which patients might benefit from HMDs? Which diagnoses might respond best? What range of visual acuities is most appropriate? What display settings are most helpful? While the HMDs are capable of very high magnification, what is the highest magnification that a user can tolerate? It's usually no higher than 6 or 7x. So, what's the benefit of claiming higher powers? What is the abandonment rate? HMD manufacturers don't answer any of these questions.

Why do most HMDs completely surround the user's eyes? It's because the display isn't bright enough to be visible outdoors without enclosing the user's eyes. Try looking at the screen on your phone or your digital camera outdoors. Can't see it, can you? HMDs have a similar problem.

What is the breadth of functionality of HMDs? Can users drive with HMDs? No. Can users walk with HMDs? Only if they are lifted out of the way or have their magnification readjusted to zero. So, where's the benefit then? Can users wear them all day? No, they only run for a few hours. Are they comfortable to wear? No, they're much heavier than optical bioptics, and you may perspire underneath them. Are they easy to use? They're supposed to get easier over time, but there are controls to learn to use.

What about optical bioptics? Lightweight, great outside, drive with them (where legal and appropriate), walk with them, and socialize with them. They don't enclose the user. They are indicated for central vision loss with best-corrected acuities of 20/300 or better. The clinical data and methods are well established. And, they're easy to use—all you do is look. Do they work for everybody? Nothing works for everybody. They've been around a long time, haven't they? What's wrong with that? It means they work and are well accepted. Low vision specialists prescribe them all the time. They wouldn't continue to do that if their patients weren’t successful with them.

HMD Technical Specifications

HMDs were not originally designed for the visually impaired. They were intended for gamers and tech folks— a much larger market. Their image resolution is not high and worsens as the image is magnified. In fact, a recent study found that at the two most frequently prescribed telescope powers—2x and 4x— digital magnification yielded an image resolution of only 20/70 for 2x, and 20/150 at 4x, in effect making them unable to provide the 20/40 acuity resolution that we seek to provide when prescribing telescopes.

In addition, manufacturers claim very wide fields of view— 40 degrees, 60 degrees, even more. If it's 40 degrees at 1x, it's only 10 degrees at 4x. By comparison a 4x Keplerian optical telescope provides 12.5 degrees— arguably not much wider, but not narrower, as HMD manufacturers imply. So, one must be careful to interpret the technical specifications HMD manufacturer's present in terms of how it relates to our clinical purposes.

The direct to patient sales model

Another salient point is that HMD firms frequently use salespersons to demonstrate and sell their products directly to the consumer. No matter how sympathetic, supportive, and engaged these reps are, they are pursuing a one-time sale, not a long-term relationship. As such, they have little or no investment in the customer after the sale is made. They are not eye care professionals who provide ongoing care for their patients and as a result are personally invested in their patient's long-term support and the appropriateness of the devices they recommend.

In summary

Will Ocutech develop a digital bioptic? We have been studying and testing digital technology for over 10 years. We have expert consultants to help guide us. At this time, we feel strongly that digital HMD technology is not yet appropriate for a compelling low vision aid, and we will not produce a device and place it on the market until it can be proven effective in independent clinical trials. Starting too soon and investing a lot of money puts pressure on firms to place a product on the market before it's ready. Ocutech is committed to developing products that offer tangible benefits and improvements to the low vision community.