Eccentric viewing: A strategy to maximise your residual vision

If you have central vision loss from conditions like age-related macular degeneration (AMD), or Stargardt disease, you may find that objects in your direct line of sight (or central vision) appear blurry, distorted, or missing. This can make everyday tasks like reading, recognising faces, or watching TV more difficult. However, a technique called eccentric viewing may help make better use of your remaining vision by training your brain and eyes to look slightly off-centre.

What is eccentric viewing?

Eccentric viewing (EV) is a technique that helps you shift your focus to a different part of your vision where details may be clearer. Instead of looking directly at what you want to see, you adjust your gaze so that the image falls on a part of your vision that provides better clarity. This technique helps you work around areas where vision is limited.

Although eccentric viewing does not restore lost sight, it may be enable you to use different areas of your visual field to allow you to read large text and improve facial recognition by training your brain to rely on an alternative area for seeing details.

How does eccentric viewing work?

• First, identify your best viewing spot: A low vision specialist can help you determine which part of your vision allows you to see most clearly. This often involves vision assessments and scanning exercises to find the most effective viewing angle.
• Train yourself to use a different viewing area: If central vision is blurred but a spot to the right or above appears clearer, training exercises can teach you to look slightly to the left, right, above or below to bring objects into view, rather than looking directly at them. Over time, your brain may learn to automatically use this new strategy instead of depending on the central field of vision.
• Practice daily: At first, eccentric viewing may feel unnatural, but with professional direction and consistent training, it can become second nature. Many people report that after a few weeks of practice, they can read more easily and recognise faces better.
• Reading exercises: Use large print books or digital magnification while applying eccentric viewing. Use a grid or clock face method: Imagine a clock face over your vision, with the object at the centre. Try looking at different numbers on the clock (for example 2 o’clock, 6 o’clock) to find the clearest spot.
• Use assistive tools to enhance eccentric viewing: Magnifiers and digital zoom tools can make small text or details easier to see. Good lighting and high-contrast settings can improve visibility. Speech-to-text and audio description tools can complement your vision when reading or recognising faces.

Who can benefit from eccentric viewing?

Eccentric viewing may be useful for individuals with central vision loss. Central vision loss can be a symptom in these conditions:

• Macular degeneration (AMD)
• Stargardt disease
• Diabetic retinopathy (eccentric viewing may only work in some instances)
• Macular holes or scars
• Other macular disorders

Eccentric viewing may not work if peripheral vision is also compromised, as in advanced glaucoma or retinitis pigmentosa. Or if eye movement control is limited, or with cognitive or coordination difficulties.

Does it really work?

Research shows that eccentric viewing training can help people improve reading speed, facial recognition, and overall visual function in suitable candidates. While the adjustment period varies, most people see noticeable improvements within a few weeks to months of practice.

"Research results demonstrated there were no significant improvements in best-corrected visual acuity, however reading speed and satisfaction scores significantly improved with eccentric viewing."

Reference: Jeong, J. H., & Moon, N. J. (2011). A study of eccentric viewing training for low vision rehabilitation. Korean Journal of Ophthalmology, 25(6), 409–416.

In summary

Eccentric viewing can be a valuable technique for people with central vision loss, allowing you to make better use of your remaining sight. While it requires training and practice, it may help you maintain independence and improve everyday tasks like reading, watching TV, and recognising faces.

If you think eccentric viewing might help you, consider working with a low vision specialist to develop a personalised strategy. With time and patience, your brain may adapt, making it easier to navigate the world with low vision. To get in touch with a low vision specialist, visit Guide Dogs to reach out to your local Guide Dogs Orthoptic team.

Always speak to your GP and eye care professional about the best treatment options for you.