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Low Vision Beyond the Clinic
A podcast for vision rehabilitation practitioners from across disciplines
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EPISODE 01
May 22, 2025
Eccentric Viewing Training: Should It Still Be Standard Practice?
Dr. Michael Crossland on the EFFECT Study
Is eccentric viewing training still a valuable tool in low vision rehabilitation?
Today’s premier 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.
Topics explored in this episode:
| TIMESTAMPS | TOPICS |
|---|---|
| 07:50 | The structure and goals of the EFFECT study |
| 11:15 | The role of therapeutic alliance and “connective labor” in outcomes |
| 14:30 | What PRL and TRL training involve—and how they differ |
| 21:55 | The link between fixation stability and real-world functional tasks |
| 23:10 | Why the study showed no significant improvements in any group |
| 28:00 | How clinicians are rethinking selection criteria for EV training |
| 30:10 | Mental health challenges tied to progressive vision loss |
| 44:30 | New directions in low vision research and digital accessibility tools |
Thanks to Dr. Michael Crossland for being on the show!
Dr. Crossland is a prolific researcher, optometrist, professor, and podcast fan who brings both clinical wisdom and warmth to this discussion. When he’s not leading major studies, he’s walking through London’s parks listening to 99% Invisible after school drop-off.
Learn more about his research:
https://profiles.ucl.ac.uk/6705-michael-crossland/publications
References and resources cited in the interview:
The EFFECT Study Rubin, G. S., Crossland, M. D., Dunbar, H. M. P., Brown, G. M., Petriti, B., Roche, H., Sirrell, S. V., Broom, K. T., & Hamilton, R. D. (2023). Eccentric Viewing Training for Age-Related Macular Disease: Results of a Randomized Controlled Trial (the EFFECT Study). Ophthalmology science, 4(2), 100422. https://doi.org/10.1016/j.xops.202: 3.100422
The Eccentric Viewing Training Screening Checklist (free resource)
Anxiety in Glaucoma patients with no functional vision deficits Jampel, H. D., Frick, K. D., Janz, N. K., Wren, P. A., Musch, D. C., Rimal, R., Lichter, P. R., & CIGTS Study Group (2007). Depression and mood indicators in newly diagnosed glaucoma patients. American journal of ophthalmology, 144(2), 238–244. https://doi.org/10.1016/j.ajo.2007.04.048
MN Read App (unaffiliated link; no sponsorship)
Visual Impairment and mental health Demmin, D. L., & Silverstein, S. M. (2020). Visual Impairment and Mental Health: Unmet Needs and Treatment Options. Clinical ophthalmology (Auckland, N.Z.), 14, 4229–4251. https://doi.org/10.2147/OPTH.S258783
Connective Labor episode Vedantam, Shankar (Host). (2025, March 31). Relationships 2.0: The Price of Disconnection. [Audio podcast episode]. In Hidden Brain. Hidden Brain Media.
https://hiddenbrain.org/podcast/relationships-2-0-the-price-of-disconnection/
FREE RESOURCE
Screening for eccentric viewing training can be messy.
There are a lot of factors to consider when deciding whether or not to provide eccentric viewing training.
This clinician-created checklist guides you through the process of determining who is ready for eccentric viewing training and why.
It’s like having a low vision mentor by your side.
Access the checklist.
Add your details below.
About the Host
Erika Andersen Ko is a low vision therapist with over 20 years of experience in medical and education settings, with active leadership in the field of vision rehabilitation.
In addition to clinical care, Erika is passionate about promoting interdisciplinary collaboration and integrating mental health wellness into low vision services.
