Clinical Low Vision Rehabilitation Interventions in Age-Related Macular Degeneration: A Case Report

A 70-year-old female with bilateral age-related macular degeneration (AMD) - wet AMD in the right eye and dry AMD in the left eye - presented with reduced unaided distance visual acuity of 20/200 (6/60) and near visual acuity of 3.2M (20/160, 6/48) OU. Retinoscopy and subjective refraction showed a prescription of -2.25 -2.50 × 175 in the right eye and +0.50 -1.50 × 120 in the left eye, achieving corrected visual acuities of 20/125 (6/37.5) OU. With an additional +3.00 diopters sphere for near tasks, the patient was able to read up to 2.5M (20/125, 6/37.5), indicating a coexisting refractive error. Amsler grid testing revealed central metamorphopsia and scotomas OU. Optical coherence tomography (OCT) confirmed bilateral drusen, retinal pigment epithelium (RPE) atrophy, and vitreomacular adhesion (VMA), with findings consistent with AMD. Functional contrast sensitivity was reduced (20/100, 6/30) OU, and visual field testing showed central scotomas and metamorphopsia. Low vision rehabilitation included the prescription of a 2.5× binocular Galilean telescope (Eschenbach 1639; Eschenbach Optik GmbH, Nuremberg, Germany) for distance, achieving 20/40 (6/12) vision OU, and a 5× illuminated hand magnifier (Eschenbach Mobilux 15105; Eschenbach Optik GmbH) for near tasks, enabling reading of 1.0M print (approximately 20/50, equivalent to 6/18+). Environmental modifications and contrast-enhancing filters were recommended. Nutritional counseling and ongoing monitoring were initiated, and the patient was educated on self-assessment with the Amsler grid. At three-month follow-up, visual function remained stable, and low vision strategies continued to support functional independence. This case underscores the importance of early low vision intervention, multidisciplinary care, and personalized rehabilitation strategies in maintaining quality of life in patients with AMD.