Age-Related Maculopathy (ARM) is the leading cause for severe visual impairment in the U.S. It affects vision in the macula, the central area of the retina that allows us to see objects in fine detail. This is why loss of macular vision often takes away the ability to read or recognize faces.

The focus in our laboratory is not on what has been lost but on how much vision remains and how it can be best used. Rehabilitation research in the U.S. and elsewhere has shown that people can learn to read again by using a still intact part of their retina instead of the damaged center, a technique called "eccentric viewing". The process requires great effort on the part of the affected person and goal-directed training by a low vision specialist, which is time-consuming and, thus, expensive. One of our goals is to lower the effort and cost by reducing the required assisted time.

Maculopathies progress in an unpredictable way that is different for each patient, damaging some areas of the macula, but not others. Thus, an individual evaluation of remaining vision is crucial for rehabilitation. We developed a simple, computer-based vision test that assesses vision not just in the center, but also in places distributed around the macula. The results of the test allow the patient and the eye care specialist to find "candidate" locations within minutes that might be usable for eccentric viewing. Because this technique requires a permanent shift of visual attention, we have investigated the ability to perform this attentional shift both in normally sighted people and people with maculopathies. We found that many have distinct directional preferences, which might later make certain locations on the retina undesirable candidates for eccentric viewing.

Another research project revealed that self-exploration of the visual field by patients with maculopathies can be enhanced by kinesthetic feedback, i.e. by pointing. We developed a high-tech method for use in the laboratory and an inexpensive low-tech method that patients can perform at home. Furthermore, we investigated the possibilities of enhancing ease and speed of reading on computer screens. This is important, because the baby boomer generation will soon be old enough to have age-related maculopathy, and they will have established habits in using computers.

For more information, visit Manfred MacKeben's lab web pages.

Collaborators: Aleksandr Gofen, August Colenbrander. Susanne Trauzettel-Klosinski, Jens Reinhard, Elke Altpeter, Ute DŸrrwŠchter, Hans Strasburger, Dorothe Poggel, Werner Eisenbarth, Lea Hyvarinen, Christoph Braun, Karin Pilz, Gesa-Astrid Hahn