What to know about wearable video magnifiers for low vision

Image credit: Pexels/ArtemPodrez

For patients with low vision, the device or technology they use plays an enormous role in their independence. The population with visual impairment in the US is expected to double by 2050,¹ and so will the demand for technology solutions.

Difficulty reading is the No. 1 complaint of patients with low vision. As such, optical and video/electronic magnifiers—also known as closed-circuit televisions (CCTVs)—are optometry’s main interventions. Although CCTVs provide increased speed and duration of reading,² optical magnifiers—depending on the task—have been shown to be preferred by patients.^3,4 Learning a patient’s goals through a low-vision assessment may result in a range of various magnification device recommendations. Today, that includes wearables.

Wearable video magnifiers, also known as head-worn video magnifiers or electronic video enhancement systems, provide a real-time image and are designed to enable a user with low vision to magnify at distance or near with the added capabilities of changing contrast and brightness. These devices can be used in multiple situations, including reading a document or digital screen, working on an art project, watching TV, and attending theatre performances or sporting events.

Different than the traditional desktop or handheld CCTV, these devices are worn on the patient’s head, allowing for hands-free use. While wearable electronic magnification devices are not new,⁵ today there are more options with over a dozen to choose from. Head-worn devices have advantages, as the head plays a role in how we perceive our surroundings.⁶ Another obvious advantage is that patients just want a pair of eyeglasses. Although disadvantages such as heavy weight and poor appearance have been reported, one study found that contrast sensitivity and binocular distance visual acuity improve significantly with electronic head-mounted low-vision aids.⁷

Wearable video magnifiers come in 2 designs, open and closed. Open-design wearable video magnifiers mimic a traditional pair of eyeglasses. Closed-design wearable video magnifiers (often a virtual reality [VR] headset) enclose the user within the device, cutting off peripheral vision. Both designs pose an increased potential fall risk for patients when wearing the devices, and it is our point of view that patients should use the devices for activities that do not require them to be mobile. Both designs may use a connected smartphone (usually Android-based), either as its camera and/or screen, or tethered to the device to ensure quality battery life.

Some of the newer head-mounted devices allow for better image stabilization and offer unique features to diversify the market’s offerings, such as eSight Go’s adjustable camera angle for reading and Eyedaptic EYE6’s integration of artificial intelligence (AI). Other devices feature optical character recognition, and some companies are working on integrating augmented reality, image replacement, eye-tracking, and other innovations to assist.⁷

Wearable video magnifiers’ advantages and disadvantages

Advantages

» Worn on the head (open-design versions similar to traditional glasses)

» Hands-free

» Customizable for brightness and contrast

» Other standout features (eg, optical character recognition, voice control)

Disadvantages

» Cost

» Appearance

» Weight

» Not good for activities requiring mobility

» Grainy appearance at higher magnification and smaller field of view

» Battery life

Other magnifying wearables include bioptics, which are optical magnification devices worn above the line of sight. Ocutech’s VES-Falcon is capable of auto-focusing and providing magnification through optical lenses for distance and near activities. Although not used in a wearable device, smartphone magnification applications such as ReBokeh have been developed for patients with low vision. In addition, smart glasses continue to evolve and may be able to augment or enhance
low vision.

Select technology options available for patients with low vision include as follows:

eSight Go⁸

» Open glasses design

» 24-step magnification

» 18-megapixel camera

» 45° field of view

» Bluetooth remote control

» External battery pack worn around the neck for 4 hours of continuous use

» Tilt mode (tilts the angle of the camera down for ease of reading near documents)

Eyedaptic EYE6⁹

» Open glasses design

» 8-megapixel camera

» 10-step magnification

» Uses Android phone for battery and controller (also has voice control ability)

» 4-plus hours of continuous use

» Uses AI for scene description

» Auto zoom for viewing text

IrisVision LIVE 2.0¹⁰

» Closed-design, VR headset

» Uses Google Pixel 7 pro smartphone for camera (10.8 megapixels) for viewing screen and battery

» 14-step magnification

» Controlled by Bluetooth remote or voice commands

» Ability to stream content from TV or computer (accessory needed)

» Multiple viewing modes, including magnification bubble

NuEyes Pro 4¹¹

» Open-design headset

» 12-megapixel camera

» 43° field of view

» 4 to 12 steps magnification

» Connects to Samsung smartphone for battery

» Approximately 6 hours of continuous use

» Offers optical character recognition

Maggie Vision iVR¹²

» Closed-design VR headset

» Uses iPhone 15 for camera (24 megapixels), viewing screen, and battery

» 100° field of view

» 20 steps of magnification, with each click 0.50 increase and hold to increase by 0.25 increments

» Approximately 3 continuous hours of use

» Only wearable video magnifier to use an iPhone

» Utilize Siri while in use and for TV viewing (in development)

Making the decision with patients

There has been significant interest in wearable video magnifiers for patients with low vision by optometrists and other low-vision specialists over the years. Patients not only prefer a device that is easy to use, but one that is also socially acceptable, affordable, and aesthetically pleasing.

The advantages of wearable devices include aesthetics, hands-free capabilities, portability, and feature customization (magnification, contrast, lighting, etc). Patients, optometrists, and ophthalmologists should consider comfort, battery life, cost, and training when selecting devices and not forget about optical options such as telescopes and bioptics. With improved ophthalmic wearable technology, there are certainly better options to improve outcomes and quality of life for our patients with low vision.

Considerations in research are now looking at virtual reality, augmented reality, gaze tracking and other technologies from mainstream tech on how it can be used for low vision patients in the future.⁵ Wearables, specifically eyeglasses, are becoming quite popular in mainstream tech for gaming, entertainment, and spatial computing. Last year’s release of the Apple Vision Pro¹³ stirred some excitement in the low vision community, but its use/functionality in patients with vision loss still remains to be seen. However, other mainstream wearables are gaining popularity for people who are blind or have low vision such as Ray-Ban Meta glasses. While they do not provide any visual enhancement, the camera is using AI to extract information about text or the environment. It is exciting to know that as technology advances, there will be more choices for our patients with low vision and the technology they use to give them more independence. However, it is just as important that our patients are educated about these devices and understand whether this is the right tool for them to use.

References:

1. Varma R, Vajaranant TS, Burkemper B, et al. Visual impairment and blindness in adults in the United States: demographic and geographic variations from 2015 to 2050. JAMA Ophthalmol. 2016;134(7):802-809. doi:10.1001/jamaophthalmol.2016.1284

2. Goodrich GL, Kirby J. A comparison of patient reading performance and preference: optical devices, handheld CCTV (Innoventions Magni-Cam), or stand-mounted CCTV (Optolec Clearview or TSI Genie). Optometry. 2001;72(8):519-528.

3. Taylor JJ, Bambrick R, Brand A, et al. Effectiveness of portable electronic and optical magnifiers for near vision activities in low vision: a randomised crossover trial. Ophthalmic Physiol Opt. 2017;37(4):370-384. doi:10.1111/opo.12379

4. Culham LE, Chabra A, Rubin GS. Clinical performance of electronic, head-mounted, low-vision devices. Ophthalmic Physiol Opt. 2004;24(4):281-290. doi:10.1111/j.1475-1313.2004.00193.x

5. Deemer AD, Bradley CK, Ross NC, et al. Low vision enhancement with head-mounted video display systems: are we there yet? Optom Vis Sci. 2018;95(9):694-703. doi:10.1097/OPX.0000000000001278

6. R. Velázquez, Wearable assistive devices for the blind. In: Lay-Ekuakille A, Mukhopadhyay SC, eds. Wearable and Autonomous Biomedical Devices and Systems for Smart Environment: Issues and Characterization. Springer, 2010:331-349.

7. Crossland MD, Starke SD, Imielski P, Wolffsohn JS, Webster AR. Benefit of an electronic head-mounted low vision aid. Ophthalmic Physiol Opt. 2019;39(6):422-431. doi:10.1111/opo.12646

8. eSight Go – The advanced vision enhancement solution. eSight by Gentext Corporation. Accessed January 8, 2024. https://www.esighteyewear.com/esight-go/

9. Revolutionary AR glasses for vision loss: EYE6. Eyedaptic. Accessed January 8, 2024. https://eyedaptic.com/eye6/

10. Redefining Visual Possibilities. IrisVision. Accessed January 8, 2024. https://irisvision.com/live-2-0/?srsltid=AfmBOoofbYawCd5Vl-Ui4KdvLU1HpdOjFK9r73-DkK4OT1S1QmIcApKv

11. Pro 4 glasses. NuEyes. Accessed January 8, 2024. https://www.nueyes.com/pro4

12. Rediscover the world with Maggie iVR. Maggie Vision. Accessed January 8, 2024. https://www.maggie.vision/

13. Apple Vision Pro available in the US on February 2. News release. January 8, 2024. Accessed January 13, 2025. https://www.apple.com/newsroom/2024/01/apple-vision-pro-available-in-the-us-on-february-2/