Abstract:

Age-related macular degeneration (AMD) is a major cause of visual impairment and blindness among people aged over 60 years in developed countries and it is forecast that the prevalence of AMD will increase.1 AMD is characterised by progressive loss of central vision leading to loss of functional vision (the ability to undertake visually guided activities). Functional vision may be assessed using ‘activity of daily living (ADL) instruments,2 which assess independent living skills, such as ability to read, write, recognise faces and objects and other daily living activities. AMD also affects the quality of life and impedes healthy independent ageing. Individuals confronted with disability may create novel strategies to cope.3 This case study will highlight how the ability to function may be greater than expected, based on the level of visual function and ADL instrument measures. This study shows how appropriate devices and the exercise of creativity can aid in the development of novel coping strategies. For example, threading a needle is often regarded as a highly-visually demanding task requiring fine visual resolution and is used by some ADL instruments to measure functional visual ability in people with visual impairment.4–6 This clinical communication highlights strategies that do not rely heavily on vision and may be used for threading needles and other related tasks.