Episode 1 • May 22, 2025
Eccentric Viewing Training: Should It Still Be Standard Practice?
Dr. Michael Crossland on the EFFECT Study
About This Episode
Is eccentric viewing training still a vaulable tool in low vision rehabilitation? Today's premiere episode explores the findings of the EFFECT study, the first randomized controlled trial evalutating 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.
About the Guest
Dr. Michael 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.
Topics & Timestamps
You can use the chapter markers in the podcast player to jump to these topics.
06:37 — The structure and goals of the EFFECT (Eccentric Fixation From Enhanced Clinical Training) study
11:20 — The role of therapeutic alliance and “connective labor” in outcomes
14:30 — What PRL and TRL training involve—and how they differ
23:01 — Why the study showed no significant improvements in any group
27:32 — How clinicians are rethinking selection criteria for EV training
31:14 — Mental health challenges tied to progressive vision loss
39:59 — The link between fixation stability and real-world functional tasks
44:27 — New directions in low vision research and digital accessibility tools
Resources & References
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.2023.100422
The Eccentric Viewing Training Screening Checklist
A free clinical resource mentioned in this episode to help practitioners consider which clients may benefit from eccentric viewing training and which may not. Get the checklist (name and email required).
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
A digital reading assessment tool discussed in the episode. 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
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/
