Visually impaired (macular degeneration)

[Setebos]

I have a relative who has got quite advanced macular degeneration, who is now struggling to read at all. She has got to the point that she gets someone to tear pages out of books to enlarge them on a photocopier, but this seems to me to be sub-optimal from a technical point of view.

She has tried using an iPad, but didn't get along too well with it. I think the backlight was troubling.

Anyhow, I feel it might be worth trying an ereader, but my sense is that the experience needs to be as good as possible in order to be compelling, as this person is not a natural tech lover.

I therefore plan to acquire a device, and to set it up with the right tools before hand-over, to maximize the potential for acceptance.

I have never used an ereader, but have spent quite some time analysing the current state of the market (thanks to these fascinating forums and the enthusiastic members!).

My impression is that the market is not hugely profitable on the hardware side, and therefore moves rather slowly, but that we are on the cusp of some meaningful transitions in relation to processing power and, for the larger screen sizes, display resolution.

My plan is therefore not to spend a fortune initially, but to acquire an interim solution that could test the suitability of this type of device for my relative.

I am looking for the following characteristics:

1) Screen size. I don't know how big to get. I think the objective is to read books. Adaptable font sizes and styles are critical, because words seem to swim in and out of focus for her. Sometimes words are too small, sometimes they are too big, sometimes they are just invisible, so maximum flexibility is critical here. Within reason, a larger screen would seem to offer more scope for enlarging fonts, but the bigger screens don't seem to have made the high ppi transition yet, and don't have Carta screens. Basic quality in terms of contrast would seem the most important factor. Built-in light could be necessary, but I'm not sure - need to be able to turn it off in case it causes trouble. Weight could come into it also.

2) Audio support seems to me to be realistically necessary, as the disease undoubtedly will progress further.

3) I feel as though Android support could be quite important, to give a better range of available apps, perhaps more format adaptability etc. I like what I am hearing about Google Play Books with the Ivona TTS voices.

My preliminary conclusion is that I should consider the Onyx Boox i86 HDML Plus. Reasons are: quite large (8 inch) screen, built-in light (can you switch it off?), 250 ppi, Android and with sufficient hardware for basic apps, headphone jack and bluetooth for audio.

Possible downsides or questions include: Pearl screen that I have heard described as a bit "milky", blueish light, it's a Chinese tablet with all the normal QA and service issues, IR touchscreen (is this easy to use?), general interface issues (brightness controls, button navigation sub-optimal), software maturity\updates (is KitKat ready yet?)

In the longer term, I would hope to replace this with a 300 ppi Carta device with an i.MX 7 processor, possibly in 9.7 inches or even 13.3.

Any thoughts on the suitability of the i86 HDML Plus in the meantime? Is there anywhere I can actually buy it? I do actually have a Nook Simple Touch that I bought but have never used. Could I just use this to test the suitability of this class of device? I worry it is now too slow to provide a decent experience, or would have problems with app compatibility.

Any threads with app recommendations for the visually impaired?

[Cinisajoy]

If the lights are causing part of the problem, you might try the non-lit kindle or kobo. Do not get a fire.
Amazon has a 30 day return policy.
That way you can see if she can use an ereader before investing several hundred dollars.

[danicca]

I believe Kindle also uses Ivona voices and it's nicely integrated with audio books from audible. I realize screen is smaller, but you can use nook to check how big the letters need to be for comfortable reading and how it looks.

[Setebos]

Originally Posted by Cinisajoy

If the lights are causing part of the problem, you might try the non-lit kindle or kobo. Do not get a fire.
Amazon has a 30 day return policy.
That way you can see if she can use an ereader before investing several hundred dollars.

Thanks. A conventional backlit LCD was a problem, but it remains to be seen whether a front-lit Eink display (or any Eink display) is suitable for her.

I agree about trying things out before dropping big bucks, but I just don't want an unrepresentative experience from an outdated device. I mentioned my Nook Simple Touch, the advantage of it being I have it already, and it can theoretically run Android, but if it is too far removed from the state of the art it might just needlessly discourage my relative.

I guess I will just unbox it, and see what I can get going on it and fiddle about for a bit, but I wouldn't mind being warned off if this is a waste of time (e.g. because no decent apps will work on it, or if the screen clarity or contrast has been significantly improved upon in newer devices). I don't think it does audio, which I guess is a disadvantage, although I have no idea whether my relative would enjoy audio support anyway.

[Cinisajoy]

Originally Posted by Setebos

Thanks. A conventional backlit LCD was a problem, but it remains to be seen whether a front-lit Eink display (or any Eink display) is suitable for her.

I agree about trying things out before dropping big bucks, but I just don't want an unrepresentative experience from an outdated device. I mentioned my Nook Simple Touch, the advantage of it being I have it already, and it can theoretically run Android, but if it is too far removed from the state of the art it might just needlessly discourage my relative.

I guess I will just unbox it, and see what I can get going on it and fiddle about for a bit, but I wouldn't mind being warned off if this is a waste of time (e.g. because no decent apps will work on it, or if the screen clarity or contrast has been significantly improved upon in newer devices). I don't think it does audio, which I guess is a disadvantage, although I have no idea whether my relative would enjoy audio support anyway.

Perfect. It may be outdated but can you put a book on there and see if she can read on it. Adjust fonts till she is comfortable. No need to fiddle. Yet.
That is the first thing to check.

[Apache]

My mother has macular degeneration. I bought her a Nook HD+ a couple of years ago. It is set on the second largest font with a black background, with white letters and she is able to read her books.
Apache

[Setebos]

Originally Posted by Cinisajoy

Perfect. It may be outdated but can you put a book on there and see if she can read on it. Adjust fonts till she is comfortable. No need to fiddle. Yet.
That is the first thing to check.

Good point.

[Setebos]

Originally Posted by Apache

My mother has macular degeneration. I bought her a Nook HD+ a couple of years ago. It is set on the second largest font with a black background, with white letters and she is able to read her books.
Apache

Thank you. Yes, inverse text could be another option worth investigating.

[barryem]

An LCD is lit from behind the screen by a backlight shining into the reader's eyes. The light on an e-ink screen comes from the edges and is spread evenly over the surface of the screen and what the reader sees is reflected light. This is much easier on the eyes. The effect is similar to reading a paper book while sitting under a lamp.

As for size, there are some larger size ereaders available but they're off-brands and they won't give the kind of service and quality and ease of use that you'll get from a Kindle or a Kobo. The Kindles come with a 6" screen and Kobo's come in 6" and 6.8" sizes. These probably aren't ideal but if this person can use them they'll be better choices. I'd suggest getting one of these and trying it. If you get it from Amazon you have 30 days to return it. I suspect Kobo has a similar policy but I don't really know. It's worth looking into.

If that isn't large enough that's when I'd start looking at larger ones.

As for audio, that's not going to be found on a major brand e-ink raeder, however there are alternatives. If you use a Kindle and get an Amazon Echo it can read your current book to you aloud and knows where you left off on the Kindle. The Kindle will also know where the Echo left off. This requires syncing the Kindle but that's trivial.

Also a lot of kindle books come with audiobooks as low priced add-ons from Audible.com. The Amazon Echo can also play these, giving a real human voice with professional narration and can also sync with the Kindle.

It's also possible to do the audio portion with a smartphone instead of an Echo and it'll sync with the Kindle as well.

Kindles are my preferred ereader but I normally avoid trying to push them. I also have a couple of Kobos and they're excellent as well. i think, though, in this case you might want to look pretty seriously into the Kindle because of it's broader ecosystem.

Something else to consider, if the degeneration is likely to increase a lot is to just begin with audiobooks. Audible.com has a wide selection, as do other sources. They can be played nicely on a smartphone or MP3 player or computer or a tablet. I had cataracts that were inoperable for a number of years till and until it became possible to get surgery I listened exclusively. I enjoyed it.

Also if this person is legally blind there are a number of sources of free audiobooks and those sources have an even greater selection than what's commercially available.

Barry


Barry

[Setebos]

Originally Posted by barryem

[Advice from Barry]


Barry

Thank you, Barry, much to ponder here. It's true I had not really thought about ecosystems, because my own instincts are ways to avoid them, and I was under the impression that any ereader could use the same content. However, I haven't enough experience to understand the ease of use trade-offs.

[Cinisajoy]

Originally Posted by Setebos

Thank you, Barry, much to ponder here. It's true I had not really thought about ecosystems, because my own instincts are ways to avoid them, and I was under the impression that any ereader could use the same content. However, I haven't enough experience to understand the ease of use trade-offs.

Actually if you know what format the ereader likes then you are not locked into an ecosystem.
I can get books for all my readers without conversion from here, project Gutenberg and a few other places. Note those books are all free here and at PG. You just have to know how to sideload.
Now if you want an ecosystem that is easy to navigate and use then get a Kindle. And if you want, you can just put a gift card on Amazon. No credit card needed. There are thousands if not millions of free books there too. Note you will need a small gift card or a credit card on the account to buy even free books.

Mom is older, can't see well, probably isn't real tech savvy. I would go with a kindle.
Their customer service is usually awesome.
If you ever get a tech that isn't understanding you on the phone, just say my accent isn't understanding you.

[Pajamaman]

IMO a Kindle is a very bad idea because the fonts are so thin. Very bad for someone with poor eyesight.

A Kobo H2O would be very good because it is big and you can increase the weight of the fonts.

I think the Nook ST includes a bold version of Caecilia, which is a very clear font for bad eyesight. Look for the bold option in the settings. You do not need to run Android. The basic software will provide it.

IMO screen clarity has not improved significantly on newer devices. An non-illuminated Pearl screen is as clear as a illuminated Carta screen (whose clarity was reduced due to the layer installed to spread the light). But a clear light will aid clarity, be it sunlight, a good lamp or a back-light.

[Cinisajoy]

I think he should see if mom can read on his Nook first.
And if she likes classic books, here is a good place if he knows how to sideload books.
https://www.mobileread.com/forums/forumdisplay.php?f=132

[Setebos]

Originally Posted by Pajamaman

IMO a Kindle is a very bad idea because the fonts are so thin. Very bad for someone with poor eyesight.

A Kobo H2O would be very good because it is big and you can increase the weight of the fonts.

I think the Nook ST includes a bold version of Caecilia, which is a very clear font for bad eyesight. Look for the bold option in the settings. You do not need to run Android. The basic software will provide it.

IMO screen clarity has not improved significantly on newer devices. An non-illuminated Pearl screen is as clear as a illuminated Carta screen (whose clarity was reduced due to the layer installed to spread the light). But a clear light will aid clarity, be it sunlight, a good lamp or a back-light.

Great info, with answers to some of my detailed questions! Thanks!

[Cinisajoy]

Oh and if you don't know how to sideload books, just ask in the proper forum.
We have forums for just about every ereader.
https://www.mobileread.com/forums/forumdisplay.php?f=50