Is eccentric viewing training still a valuable tool in low vision rehabilitation?

Today’s episode explores the findings of the EFFECT study—the first randomized control trial evaluating eccentric viewing training. Erika Andersen Ko sits down with Dr. Michael Crossland, one of the study’s lead authors, to unpack the surprising results, why no significant outcomes were found across groups, and what it means for clinical practice. They also delve into the broader implications of progressive vision loss, therapeutic alliance, and how we can better identify patients who will truly benefit from this intervention.

Dr. Michael Crossland is a prolific researcher, optometrist, and professor who brings both clinical wisdom and warmth to this discussion. When not leading major studies, he’s walking through London’s parks listening to 99% Invisible after school drop-off.

Topics explored in this episode:

[07:50] The structure and goals of the EFFECT (Eccentric Fixation From Enhanced Clinical Training) study

[14:30] What PRL and TRL training involve—and how they differ

[23:10] Why the study showed no significant improvements in any group

[11:15] The role of therapeutic alliance and “connective labor” in outcomes

[30:10] Mental health challenges tied to progressive vision loss

[28:00] How clinicians are rethinking selection criteria for EV training

[21:55] The link between fixation stability and real-world functional tasks

[44:30] New directions in low vision research and digital accessibility tools

Thanks to Dr. Michael Crossland for being on the show!

Learn more about his research: https://profiles.ucl.ac.uk/6705-michael-crossland/publications

Erika Andersen Ko is a certified Low Vision Therapist with over 20 years of experience. A recognized leader in the low vision community, she has contributed through speaking, writing, and national leadership roles. Her work emphasizes interdisciplinary collaboration with professionals in optometry, ophthalmology, occupational therapy, orientation and mobility, and education. Her areas of expertise include low vision driving, PRL training, optical devices, wearable tech, driving retirement, and the impact of vision loss on mental health.

To learn more about Erika’s work, visit her Low Vision Beyond the Clinic website: https://www.lowvisionbeyondtheclinic.com/

A message from Erika:

“I have helped thousands of people with vision loss and visual impairment do more in their daily lives and feel more supported, hopeful, and confident. My coaching services combine evidence-based and holistic practices to create a safe space to heal from grief and loss while learning the skills needed to live well with low vision and making room for joy.”

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