Are e-book readers for you?  In just the last few years, portable electronic devices like the Amazon Kindle, Barnes & Noble Nook and Apple iPad have surged in popularity, allowing readers instant access to countless books, newspapers and magazines.

Although many of their features, such as the ability to enlarge text, may appeal to older people with vision problems, you may wonder if these gadgets will enhance your ability to read or are best left to your adult children and grandchildren.

“Many people with age-related macular degeneration (AMD) or other eye conditions are good candidates for e-readers if they can read text about the size of a headline or find they read better with good lighting or contrast,” says John Boyer, O.D., director of Casey Eye Institute’s Vision Rehabilitation Center.  “However, since there are a myriad of devices on the market and many features to consider you need to carefully weigh all the pros and cons to find the most suitable one,” he says. Some e-book readers, such as most Kindle and Nook models, use a special technology called e-ink that gives the appearance of a printed page.  Tablet devices, such as the iPad, have LCD screens that produce bright, colorful images.

How they work

With e-readers, content is downloaded onto your device from any number of online sources.  Free digital material can be downloaded from your local library’s Web site or other public sites, such as Project Gutenberg (  You can also purchase e-books and periodical subscriptions online from sites like Amazon, Barnes & Noble or iTunes. 

If your vision loss significantly affects your ability to read standard print you may also qualify for Bookshare (, which offers thousands of titles for a modest membership fee.  However, its file format is not compatible with all devices, including the Kindle and Nook. 

Key Considerations

  • Ability to enlarge font size.  With an e-reader, you can enlarge the font size of any content you download. “This can make a big difference in the quality of reading and may make a magnifier unnecessary,” notes Dr. Boyer. “Even if you still need a magnifier with an e- reader, you can use a lower power than you would use for printed books,” he adds, pointing out that the milder the magnifier, the bigger its diameter.

However, you may not be able to enlarge the menu portion of your e-book or the on-screen keyboard.  If so, you may need to use magnification for those features or have someone help you.

  • Screen size. E-readers come in a variety of screen sizes.  Keep in mind that a smaller screen will display less text and the menu size will be smaller, says Dr. Boyer.
  • Audio Capability.  With e-readers, you can download audio books, or with the addition of text-to-speech software, have the material read to you through speakers in the device or headphones.  The text-to-speech feature allows you to follow along or just listen while the material is read out loud. 
  • Portability.  E-readers are much lighter and easier to hold than oversized large print books and magazines.  It’s especially ideal for travel, since these devices can store the equivalent of hundreds of books at one time. 
  • Light and contrast.  Many of these devices have built-in lighting, which adds that all-important contrast so crucial for readers with macular degeneration. You can heighten the contrast even more by shining an external light source onto your tablet or e-book reader.

However, some devices do better than others controlling glare, particularly when used in bright sunlight.  “Glare can be very annoying, cause discomfort and worsen contrast,” says Dr. Boyer. 

  • Accessibility and Versatility.  While the variety of large print reading material is limited, the selection of digital books and periodicals seems almost infinite.  Any book or magazine can easily be transformed into large print.  E-readers also allow you to take notes, save your place, highlight passages and even look up words.  Tablets, such as the iPad, also let you browse the Internet, use e-mail and perform other interactive functions. 
  • Navigation.  Some e-readers use a touch screen while others have small buttons for navigation.  “These devices require good dexterity and comfort using electronic gadgets,” cautions Dr. Boyer.

Before making any purchase, be sure to spend time trying it out in the store. If you can, take it outside to check whether bright sunlight causes glare.  Some public libraries will even allow you to check out a device at try it at home. 

“It’s exciting to see these products, originally intended for the mass market, become more and more capable of accommodating the needs of people with visual disabilities,” says Dr. Boyer.  “If you do purchase one, our vision rehabilitation department can help you use the features that enhance readability.”

To reach Casey’s Vision Rehabilitation Center, call 503 494-3098.