Case Studies

Low Vision Resources

Case Study 2: Adult with Age Related Macular Degeneration

This is an interactive case on how to examine a patient with vision impairment

Brief Background


Your patient is an 89-year-old male who has presented today reporting that he has difficulties with reading and personal tasks.

Referral source:

MAC Referral Portal

Question 1: Which of the following questions would be most important to ask the patient to assist with conducting a targeted low vision workup?

Further information

He lives alone in a private residence and worries that his food items have expired as he is unable to see the expiry dates. He is able to do daily tasks such as showering and cooking but has a friend who helps him fortnightly with cooking. He would like to be able to read books more easily for longer, see food labels and the expiry dates. 

He currently walks about without mobility aids and uses community transport for shopping and public transport for access to community. He has good neighbours and family support. He socialises at the local community centre. He is a little concerned about falling. 

Eye and any other conditions:

Age Related Macular Degeneration – dry with geographic atrophy.  Bilateral intraocular lenses / YAG capsulotomy. Left corneal graft.


for blood pressure and occasional arthritis pain.

Q2: Who are the key practitioners that may be involved in the management of this patient?

Q3: What type of services are required to meet the needs of your patient?

Q4: Select which of the following tests are more appropriate as part of your clinical examination plan?

Below are the relevant findings:

  • Vision R 6/60 and L 6/60
  • Vision R 6/60 and L 6/60
  • Ret R +0.75/-1.25 x 120 L +0.75/-0.75 x 90
  • Subjective Rx R +1.25/-1.50 x 140 L +0.75/-0.75 x 90• R VA 6/38 L VA 6/48 Binoc VA 6/38
  • N12.5 with +4.00 D @ 25 cm
  • Melbourne Edge Test CS 15 dB binocularly
  • Amsler R nasal distortion L central scotoma 
  • Ocular health: atrophic macular changes R and L

Q5: What would you include in your management plan?


Hints for conducting low vision examination: