5 Elements of Accessible Web Design

A common misconception is that all you need to have a successful blog or website is good content. While content people want to read is important, if you can’t see it, or it is difficult to read, very few people are going to take the time to try. There is lots of good content to choose from.

Making your content easy to scan and read and using great graphics that can tell a story are just as important. Especially if you want to reach the millions of potential readers that are blind or visually impaired.

While a person with low vision (due to age-related macular degeneration, cataracts,glaucoma or other eye diseases that are related to aging) can increase font size or graphics by enlarging them with a pinch of the fingers or scroll of the mouse, the result is often blurry and still difficult to see.

If a person is blind and using a screen reader, what they hear may not match what is written or displayed. A picture without underlying descriptive text is worthless. And when a blind person is using a screen reader to read a web site, they will often tab from link to link to scan your article, skipping over your text, to get a sense of what the options are. “Click here” says doesn’t tell the reader anything.

Here are 5 essential elements of accessible web design.

5 elements of accessible web design

12/15/15

Susan DeRemerSusan DeRenmer, CFRE
Vice President of Development
Discovery Eye Foundation

Technology for Vision

In just over 10 years, the technology that has been developed to help people see has been amazing. While medical research continues to move forward to find treatments and potential cures of the future, those with the technological know-how have created ways for people to see NOW. Here is a very brief look at some of these technologies.

Technology for Vision

Second Sight and the Argus II

One of the pioneers in the field of vision technology, Second Sight started in 1998, and they are now currently producing the second version of their device. It is made up of two parts:

The Implant: Requiring a 4-hour surgery, a device is surgically implanted in the eye on top of the retina, and along the outside of the eye. It includes an antenna, an electronics case, and an electrode array.
technology for vision
The External Equipment: It includes glasses, a video processing unit (VPU) and a cable.
technology for vision
In a healthy eye, photoreceptors (rods and cones) in the retina convert light into tiny electrochemical impulses that are sent to the brain, where they are translated into images. If the photoreceptors don’t function correctly your brain can’t produce images. The Argus II Retinal Prosthesis System (“Argus II”) is designed to bypass the damaged photoreceptors.

A miniature video camera housed in the patient’s glasses captures an object. The video is sent to the small VPU that the patient wears. It is then processed and transmitted back to the glasses via a cable. This information is sent wirelessly to the antenna in the implant and signals are sent to the electrode array, which emits small pulses of electricity. These pulses bypass the damaged photoreceptors and stimulate the retina’s remaining cells. The visual information is then sent to the brain to create the perception of patterns of light which patients can learn to interpret as objects. Significant training is required to use the system.

The implant is designed to give you a visual field of about 3.5 inches by 6.5 inches at arm’s length; however, the actual size of light you see may be larger or smaller. Since it is strictly based on light, there is no color perception.

eSight

Another system that relies upon the user wearing glasses is eSight which started in 2012. While the Argus II is for people that have very little or no vision, the eSight is for people with low vision or that are legally blind. eSight glasses require the individual to have a certain degree of sight remaining to be successful. If you can only see shadows you probably don’t have enough remaining sight for the glasses to work for them.

This system is also composed of two parts, but it does not require any surgery:

The Headset: It contains a high-definition camera, OLED screens, and the ability to capture and display a real-time video feed. The headset is mounted on carrier frames, which enables eSight’s “bioptic tilt” feature so the user can shift between viewing modes and engage their peripheral vision.
technology for vision
The Controller: A small, lightweight processing unit that adjusts every pixel of the video in real time. It also houses the battery, which powers eSight.
technology for vision
Because most legally blind individuals retain limited sight concentrated in their peripheral vision, their eyes do not receive an adequate signal for the brain to recognize what is being seen. This can create blind spots, blurriness, inability to detect contrast, and other symptoms that reduce vision. eSight is able to significantly corrects these issues by using a high-speed camera, video processing software, a computer processor and the high quality video OLED screens to project a real-time image on the inside of the glasses, allowing people to see.

eSight requires considerably less training than the Argus II. It is intuitive, but as with learning anything new, the more you use it the easier it is to use. It is best to practice on a daily basis.

CentraSight from VisionCare Ophthalmic Technologies

The CentraSight uses a tiny telescope that is implanted inside the eye. The telescope implant was created to improve for people with end-stage age-related macular degeneration (AMD). The tiny telescope – about the size of a pea – is implanted inside one eye, behind the iris and is barely noticeable in your eye.
technology for vision
In end-stage AMD, the macula, where central vision occurs, is degenerated in both eyes without any healthy macular areas left for detailed central vision. There is no way for the individual to see around the central blind spot in their vision. It does not affect peripheral vision, which is blurry so you can’t use it to read, but you can use it to detect objects and movement.
technology for vision
Once implanted inside the eye, the tiny telescope works like a telephoto lens of a camera. It magnifies images onto the healthy areas of the retina to help improve central vision. Because the image is enlarged it reduces the effect the blind spot has on central vision. The surgical procedure is only performed on one eye because the peripheral (side) vision will be restricted in the eye with the telescope implant. This means the peripheral vision in the untreated eye will need to work in conjunction with the implanted eye. “A person uses the eye with the telescope implant for detailed central vision (such as reading “WALK” signs at a crosswalk). The other eye is used for peripheral vision (such as checking to see if cars are coming from the side).

Training with a CentraSight low vision specialist will be needed to develop the skills you need to use your new vision, such as how to switch your viewing back and forth between the eye with the telescope implant and the eye without the implant. You will still need to wear eye glasses and may need to use a hand-held magnifier with the telescope-implanted eye to read or see fine details clearly. However, in general, less magnification will be needed.

Ocumetics Bionic Lens

After eight years of research, a Canadian optometrist, Dr. Gareth Webb, has invented a tiny bionic lens that is able to enhance eyesight so that an individual can see three times better than the sharpness of 20/20 vision. The Ocumetics Bionic Lens is a button-shaped lens that can be injected into the eye in eight minutes in a procedure identical to cataract surgery.

As people get older, the lens inside the human eye becomes cloudy over time, causing blurred vision, known as cataracts. The Bionic Lens would be inserted, replacing the person’s clouded lens, similar to the intraocular lenses currently used in cataract surgery.

The Bionic Lens features a patented Ocumetics camera optics system, which is a tiny bio-mechanical camera that is able to shift focus from a close range object to optical infinity – as far as the eye can see – much faster than the human brain.

This device is still not available to the public, but Webb is hopeful that clinical trials will start soon. Depending on regulatory processes in each country, Webb hopes the Bionic Lens will be commercially available by 2017.

11/10/15


Susan DeRemerSusan DeRemer, CFRE
Vice President of Devlopment
Discovery Eye Foundation

Listen Up: Free Low-Vision Audio Recordings

Three million people in the U.S. age 40 and older have low vision. According to 2010 research by the National Eye Institute, the number of Americans with low vision will continue to grow dramatically, from 2.9 million in 2010, to 5 million in 2030, to 8.9 million in 2050, as our population ages. In response, The Hadley School for the Blind, the largest provider of distance education for people who are blind or visually impaired worldwide, has launched a series of 10 free audio recordings designed to help those living with low vision maintain their independence. Available through the new Low Vision Focus @ Hadley program the recordings share practical ways to address daily living skills made difficult by vision loss.

Low-Vision Audio Recordings

The recordings are available on CD, NLS (National Library Service) cartridge and as free mp3 audio downloads from the Low Vision Focus @ Hadley (LVF) website at www.lowvisionfocus.org. Individuals are required to register online to receive access to the free audio recordings or they should call 1-855-830-5355 for the CDs or NLS cartridges. low vision audio recordingsEach recording is approximately 30 minutes long and covers a different aspect of living independently with low vision. This series helps people move forward using step-by-step tips and techniques, along with information and resources to help maximize the vision they have.

Following are the 10 audio lesson topics and a sample tip from each:

  1. Making the Kitchen User Friendly
    It’s a good idea to have two different cutting boards – a light colored one and another that’s darker. This will allow you to choose a background color that contrasts with the color of the food you’re working with. So, slice white onion or mozzarella cheese on the dark surface, and carrots or green peppers on the light colored board.
  2. Low Vision Cooking
    When putting a pan on a burner, make it a habit to move the panhandle over the counter. It’s also a good idea to point it in a consistent direction.
  3. Doing Simple Kitchen Tasks
    When you’re cooking with spices, don’t add spices by shaking them over the mixed ingredients, because once you add too much, they can’t be removed. Instead, shake spices into your palm and pinch the amount that you want. You can always add more.
  4. Basic Tactile Marking
    When marking a microwave keypad with tactile dots, put one dot on each number – but add an extra dot on the number five. Since the five button is in the middle, the double dot will let you identify it, so you can use it to figure out where the other numbers are around it.
  5. Simple Home Modifications
    The direction that the light is coming from is just as important as the source. A lamp with a gooseneck or an adjustable swing arm will help you to position it right where you need the light. Remember, whatever you use, make sure it’s completely shaded, so no light is directed in your eyes making it difficult to see the object.
  6. Getting Around the House
    Every place in your home where sound can be heard is a great landmark for the room. Constant sounds like a ticking clock are a great way to tell where you are. Other less dependable sounds like the traffic on the street can tell you where the windows are, your neighbor’s television can let you know where the living room is, and the intermittent motor hum of your refrigerator can always point you towards your kitchen.
  7. Looking Your Best
    To mark your shampoo and conditioner, think about it this way: when you’re washing your hair, you use the shampoo first, and the conditioner second. To mark them, just put one rubber band around the shampoo, and then two rubber bands around the conditioner. It’s a simple concept – the container used first gets one mark, and the second gets two.
  8. Keeping Prescriptions in Order
    Open your pill bottles over a tray or baking sheet lined with dark colored felt. If you drop a pill, it won’t bounce on the floor and it will be easier to see.
  9. Going Out for a Meal
    When reaching for glassware, approach the glass from above, bringing your hand down to the rim, and then to the bottom to pick it up. Putting it down in a consistent place on the table will help you find it more easily.
  10. Going Out with a Friend
    A sighted guide is someone who has enough vision to help you get from one place to another safely. You will hold onto their upper arm with your hand so both of you maintain physical contact as you walk. When you’re approaching obstacles or changes in your path like doorways, stairs, or sidewalk curbs, it’s the sighted guide’s job to give you verbal and physical information to keep you aware of the surroundings.

While the LVF is geared toward older adults, the program is open to any individual who is experiencing sight loss or caring for someone who may be losing his or her vision. Adult children of seniors living with low vision are encouraged to take advantage of the online resources to assist their parents. Caregivers and professionals, especially those working with low vision support groups in local communities, are also encouraged to utilize the resources available through the LVF website.

In addition to downloadable recordings, the Web site offers links to free low vision webinars, Hadley distance education courses that are relevant to those with low vision, tips and resource lists. In the future, Hadley will provide free, “quick tip” videos through the Web site that complement the audio recordings as well as new monthly webinars.

“We are so excited to offer Low Vision Focus @ Hadley and enable this growing population to retain their independence and live with confidence,” says VP of Education and Training and head of Low Vision Focus @ Hadley, Doug Anzlovar.

For more information or questions, call 855-830-5355 or email lowvisionfocus@hadley.edu.

9/22/15


Sheryl BassSheryl Bass, MA, MSW
The Hadley School for the Blind

Vision Recap Of Previous Articles of Interest

Besides the comments that we get, one of the best parts of putting together this blog is the wonderful group of guests who share their expertise and personal stories. I want to thank all of the eye care professionals and friends that have contributed to make this blog a success.
Vision Recap
Here is a quick vision recap of some of the articles we had in the past that you may have missed.

Jullia A. Rosdahl, MD, PhDCoffee and Glaucoma and Taking Control of Glaucoma

David Liao, MD, PhDWhat Are A Macular Pucker and Macular Hole?

Kooshay MalekBeing A Blind Artist

Dan Roberts15 Things Doctors Might Like Us To Know

Jennifer VilleneuveLiving With KC Isn’t Easy

Daniel D. Esmaili, MDPosterior Vitreous Detachment

Donna ColeLiving With Dry Age-Related Macular Degeneration

Pouya N. Dayani, MDDiabetes And The Potential For Diabetic Retinopathy

Robin Heinz BratslavskyAdjustments Can Help With Depression

Judith DelgadoDrugs to Treat Dry AMD and Inflammation

Kate StreitHadley’s Online Education for the Blind and Visually Impaired

Catherine Warren, RNCan Keratoconus Progression Be Predicted?

Richard H. Roe, MD, MHSUveitis Explained

Sumit (Sam) Garg, MDCataract Surgery and Keratoconus

Howard J. Kaplan, MDSpotlight Text – A New Way to Read

Gerry TrickleImagination and KC

In addition to the topics above, here are few more articles that cover a variety of vision issues:

If you have any topics that you would like to read about, please let us know in the comments section below.

6/23/15


Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Selecting Your Best Vision Correction Options

Today technology has evolved to a point where patients either with normal refractive errors such as nearsightedness, farsightedness, astigmatism and presbyopia or those with ocular diseases that require specialized vision correction options such as those with keratoconus all have spectacular alternatives to maximize their visual performance. With the multitude of choices available, how does an individual make the decision which to take advantage of? Well let’s begin by saying that the input from your eye care professional is critically important. You need to be properly educated not only about the various options that are applicable to your individual situation but about the advantages and disadvantages of these options.eye glass fitting vision correction options

Normal Refractive Error Options

Let’s begin by discussing vision correction options available to those with normal refractive errors. Basically stated, these individuals have the ability to utilize spectacles, contact lenses or if they are appropriate candidates, consider the refractive surgical alternatives.

Glasses
Today spectacle lens technology has evolved to the point where exceptional vision quality can be achieved with lens designs that allow for the selection of almost any frame size or shape. Thin lens technologies have enabled those with high prescription powers to not only see amazingly well, but to wear glasses that remain quite thin and attractive even with some of the most extreme prescription powers. Your eye care professional can discuss the various lens material options that best work for your situation. New high index materials are not only thin but are very light weight. A concern for some however can be the significantly higher costs associated with these lens materials. For those who need multifocals, new digital and free form progressive addition lenses (PALs) have dramatically increased the success rates associated with adaptation to PALs.

Contact Lenses
Contact lens alternatives for those with normal refractive errors have also dramatically developed technologically over the past years. Today virtually every patient with normal refractive error is a candidate to wear contact lenses. Developments such as astigmatic contacts, multifocal contacts, and hybrid (rigid center / soft periphery) contact lens designs along with the introduction and the tremendous growth in the use of single use daily disposable contacts has made one form or another of contact lenses something to consider for almost everyone. Today’s CLs are healthier, more comfortable and provide better vision than ever before. CLs have the advantage of superior peripheral vision, more natural vision “sensation” and obvious advantages for demanding physical activities. With contemporary contact lens materials and designs we have successfully addressed issues that limited many people in the past such as concerns of poor comfort due to dryness, contact lens vision instability and contact lens induced complications associated with over-wear and over-use of lenses. Your eye doctor should always present contact lens options to you regardless if you ask or not. So often patients think that they can’t wear contacts, so it does become the responsibility of your doctor to inform and educate you about CL alternatives.
contact lens vision correction options
Combination of Glasses and Contact Lenses
So how do you decide if you should be a contact lens wearer or a glasses wearer? Who said you have to? The two vision correction options are not mutually exclusive; in fact they are quite synergistic. All contact lens wearers should have an excellent pair of glasses to use. Contacts may be more cosmetically acceptable to many, they may be much better for various physical activities such as sports, however there are many times when glasses may be preferred such as at the end of a long day of contact lens wear, first thing in the morning before inserting your CLs, or on those days you just don’t want to bother with your CLs or simply prefer the look of your glasses for some situations. Today even the person who predominantly wears glasses can consider part time contact lens wear. Single use daily disposable (DD) CLs are the perfect option for such an individual. DD CLs are now even available in astigmatism and multifocal designs!

Refractive Surgery
Refractive surgery is also developing and is more effective and safer today than ever before. An experienced and skilled eye doctor is in the best position to consult with you in order to determine if you are an excellent candidate for the various refractive surgical options available. Again, having refractive surgery does not always eliminate your need for glasses or contact lenses. Although that would be the optimal outcome, many patients still use glasses and contact lenses after having refractive surgery. Typically the glasses and contact lenses are far less strong and are used significantly less often than prior to surgery. Some patients need them due to complications of surgery while others need them when outcomes did not perfectly correct vision and of course refractive surgery does not stop eyes from changing over the years, so many patients who had successful refractive surgery may experience vision changes years after surgery that require the use of glasses, contacts or both.

Irregular Refractive Error Options

Specialty Contact Lenses
Next let’s talk about choices in vision correction for those with irregular corneas and other conditions that are termed “medically necessary” vision correction cases. Individuals with irregular corneas such as those with keratoconus or post LASIK or other refractive surgery induced ectasias often require contact lenses that in essence “mask” the irregularity of the cornea. In the past this equated with the fitting of rigid corneal contact lenses, however today many other alternatives can be considered such as the fitting of scleral large diameter gas permeable contacts, hybrid CLs designed for irregular corneas and even combination systems of soft lenses with corneal gas permeable lenses (called “tandem” or “piggyback” CL systems). These CL alternatives provide advantages such as improved comfort, improved eye health response by limiting contact lens to cornea bearing, and improved contact lens positioning and stability which positively impacts visual performance.

Combination of Contact Lenses With Glasses
It should be clearly stated that spectacle lens alternatives still can have a significant role in the treatment of individuals with irregular corneas. Often glasses can be prescribed that provide adequate vision if even for part time and limited applications. While less severe cases may perform quite well with glasses as their primary modality of vision correction. Your doctor may need to modify the power of your glasses prescription in order for you to adapt to wearing glasses, however even a modified prescription power can frequently allow for some degree of visual function and allow for the ability to reduce the number of contact lens wearing hours during the day.

Surgical Procedures
Application of certain surgical and medical procedures such as intra-corneal ring segments (Intacs TM) or corneal collagen cross linking (CXL) for corneal irregularity can often help these patients in various ways and may allow for perhaps a less complex contact lens application or easier adaptation and improved function with glasses. Management of these diseases and conditions is quite complex and requires the expertise of doctors with extensive experience. Your doctor, if appropriately skilled and experienced can provide you with all of the required information and education so that you both can jointly decide on the best vision correction options for you.

In conclusion, patients today have numerous options for their vision correction. These options each have advantages and disadvantages but in most cases can be utilized synergistically. The role that your eye care professional plays in consultation and education of the vision correction alternatives applicable to you cannot be over stated. Vision is a precious gift and you should experience the highest quality of visual performance possible.

2/26/15


Barry Eiden OD, FAAOS. Barry Eiden, OD, FAAO
Medical Director, North Suburban Vision Consultants, Ltd.
NSCV Blog: www.nsvc.com/blog
President and Founder, International Keratoconus Academy of Eye Care Professionals

February Is Low Vision Awareness Month

Help for People With Vision Loss

Here’s eye-opening news: Currently, 4.2 million Americans ages 40 and older are visually impaired. Of these, 3 million have low vision. By 2030, when the last baby boomers turn 65, the number of Americans who have visual impairments is projected to reach 7.2 million, with 5 million having low vision. For the millions of people who currently live or will live with low vision, the good news is there is help.
Low vision awareness
But first, what is low vision? Low vision is when even with regular glasses, contact lenses, medicine, or surgery, people have difficulty seeing, which makes everyday tasks difficult to do. Activities that used to be simple like reading the mail, shopping, cooking, and writing can become challenging.

Most people with low vision are age 65 or older. The leading causes of vision loss in older adults are age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma. Among younger people, vision loss is most often caused by inherited eye conditions, infectious and autoimmune eye diseases, or trauma. For people with low vision, maximizing their remaining sight is key to helping them continue to live safe, productive, and rewarding lives. The first step is to seek help.

“I encourage anyone with low vision to seek guidance about vision rehabilitation from a low vision specialist,” advises Paul A. Sieving, MD, PhD, director of the National Eye Institute (NEI), one of the National Institutes of Health (NIH) and the federal government’s principal agency for vision research.

What is a low vision specialist? A low vision specialist is an ophthalmologist or optometrist who works with people who have low vision. A low vision specialist can develop a vision rehabilitation plan that identifies strategies and assistive devices appropriate for the person’s particular needs. “A vision rehabilitation plan helps people reach their true visual potential when nothing more can be done from a medical or surgical standpoint,” explains Mark Wilkinson, O.D., a low vision specialist at the University of Iowa Hospitals and Clinics and chair of the low vision subcommittee for the National Eye Health Education Program (NEHEP).

Vision rehabilitation can include the following:

  • Training to use magnifying and adaptive devices
  • Teaching new daily living skills to remain safe and live independently
  • Developing strategies to navigate around the home and in public
  • Providing resources and support

There are also many resources available to help people with low vision. NEI offers a 20-page, large-print booklet, titled What You Should Know About Low Vision, and companion DVD, featuring inspiring stories of people living with low vision. This booklet and DVD, among other resources, are available at
www.nei.nih.gov/lowvision.

With the aging of the population, eye diseases and vision loss have become major public health concerns in the United States. NEI is committed to finding new ways to improve the lives of people living with visual impairment. Aside from making information and resources readily available, NEI has dedicated more than $24 million to research projects on low vision, including learning how the brain adapts to vision loss; strategies to improve vision rehabilitation; and the development of new technologies that help people with low vision to read, shop, and find their way in unfamiliar places. Research like this will help people with low vision to make the most of their remaining vision and maintain their independence and quality of life.

2/17/15

NEHEPsq75The National Eye Health Education Program (NEHEP) of the National Eye Institute (NEI), a part of NIH, offers a 20-page, large-print booklet, titled What You Should Know About Low Vision, and a series of videos featuring patient stories about living with low vision. These and other resources are available at http://www.nei.nih.gov/lowvision.

Visual Aids and Techniques When Traveling

I was 43 years old when I learned that I had an incurable disease of the retina that would cause permanent vision loss. I was devastated and could only think of how sad my life would be without being able to play basketball, ride my bicycle, travel to new destinations, and to enjoy the finer things in life. Fortunately, all of my preconceived ideas were wrong! I met a group of people with macular degeneration and they told me about all the fun things they did together. They told me about how they went horseback riding, bowled, golfed, rode tandem bicycles, and traveled across the United States together. The purpose of this article is to share with you many helpful tips and strategies to allow you to enjoy yourself when you travel and play outdoors. Here are some visual aids and techniques when traveling.
Visual aids  and techniques for traveling
Sunglasses and Filters
Sunglasses are one of the most helpful visual aids to improve your eye comfort and vision when traveling outdoors. There are many different color filters that are made of various materials to maximize your vision. Often, people purchase sunglasses that are too dark and they do not allow a person to see details most clearly. Amber and yellow filters are very helpful for people with macular degeneration and diabetic retinopathy while green and plum lenses are very comfortable for people who are in the direct bright sunlight. Another type of sunglass lens that is very helpful is polarized lenses. These lenses filter light from reflected surfaces, such as the water or a windshield. Thus, a polarized sunglass will be very helpful if you will be traveling on an ocean cruise or traveling in the car on a road trip.

Hats and Visors
Hats and visors are another excellent visual aid to reduce glare. Wearing a hat or visor with a wide brim made of a dark color will reduce glare caused by the bright sidewalk. Many hats and visors are shaped such that they also filter light coming from the sides.

Telescopes
Telescopic glasses are very helpful low vision aids that allow people to identify distant objects very clearly. A telescope consists of two lenses separated by space. They are available in different powers to provide different levels of magnification. The larger the telescope, the higher the magnification. Telescopes are available to be mounted in glasses or they may be held in your hand. By looking through a telescope or telescopic glasses, the world will be magnified, similar to looking through a pair of binoculars. Telescopes are very helpful for sight seeing, reading traffic signs, watching plays, sporting events, and for people watching. Consult with your low vision optometrist for a demonstration of these devices!

Magnifiers
Magnifiers are very helpful tools when traveling. They allow one to read menus, identify your currency, read bus schedules, and to also see the slot machines! Magnifiers are available in various shapes, sizes, and forms. Some are simple lenses that are held in your hand while others are placed in glasses to allow you to use your hands to perform other tasks. I will never forget the first time that I prescribed magnifying glasses to allow my patient to play Black Jack in Las Vegas. He came back from his vacation ad was so happy that he was able to play cards again!

Mobility Cane
A mobility cane is very important to take when you travel because it informs others that you have a vision problem and it allows people to assist you by moving out of the way as you walk. I recall how strongly I resisted the use of my long white cane. I did not feel that I needed it because I still had vision. However, when we walked on the Las Vegas strip, I could not enjoy the sights of the new hotels because I had my head tilted towards the sidewalk so that I could see where to walk. My wife told me, “Why don’t you try using your cane so that you can enjoy the scenery?” I reluctantly agreed and was so excited to be able to lift my head and look around at all the hotels and people. People moved out of our way as we walked and it made me feel as though I was Moses walking through the parted Red Sea!

Smart Phones
Another very helpful tool to use when traveling or performing activities away from your home is the use of the cell phone. Today, there are cell phones called Smart Phones. These phones are essentially a small computer that has the ability to magnify the print on the screen and they are also able to talk to you and understand your voice! I personally use the Apple iPhone 5 and this device is extremely helpful. I can ask it to give me directions to specific areas to walk and visit, or I can ask it where the nearest bank, restaurant, or hotel is. When my phone locates the available options, it says the options aloud. My phone is also helpful because it can take pictures of objects and tell me what they are. When shopping, my phone will scan the bar code and tell me what is in the package and it will also tell me the price. Lastly, my phone has the ability to identify the currency, colors of clothing, and it also can help me to obtain a taxi cab or a bus ride.

All in all, there are many tools and techniques that are available to allow people with low vision or blindness to perform enjoyable activities away from home and to travel. I never thought that I would be able to enjoy all the things that I now do as a person who is totally blind. To learn more about these low vision aids and strategies, contact your low vision agency.

2/5/15


Bill Takeshita - July 2011Bill Takeshita, OD, FAAO
Chief of Optometry
Center for the Partially Sighted

Spotlight Text – A New Way to Read

For People With Low Vision There Is Spotlight Text – A New Way To Read

Spotlight Text is a new e-reading app specifically designed to address the needs of patients with eye disorders. Dr. Howard J. Kaplan, a retina surgeon in the Hudson Valley, started developing the app five years ago. Dr. Kaplan states, “When the first Amazon Kindle came out, a light bulb went off. If books are now digital, you can make the text of the book adapt to the reader instead of forcing the reader to adapt to the text. My patients were extremely frustrated with low vision devices such as desktop readers. Most found them very difficult to use and affordable.” Working with low vision experts at the Lighthouse Guild International, various text presentation methods were evaluated. “The app is based on real visual science and was built with the input of the top low vision specialists in the country, “ says Dr. Kaplan.
spotlight text - a new way to read
The greatest difficulty in creating the app proved to be getting access to e-books. Initially Dr. Kaplan approached the major e-content providers such as Amazon, Google, and Barnes & Noble. All of them considered the low vision market too small to address. During the 5 years, Bookshare, a Silicon Valley nonprofit, began to expand exponentially. Bookshare is dedicated to creating an accessible library for the print disabled.

How Spotlight Text Works, and What Makes it Different
The app is seamlessly tied into the e-book library of Bookshare. The library currently has 300,000+ titles including all current and recent NY Times bestsellers. It has a very extensive collection of textbooks for K-12 children. E-book downloads are free and unlimited for children, and Vets. There is a minimal joining/maintenance fee for adults. All patients that have any visual deficit that prevents them reading standard print are eligible to join. A physician, optometrist, therapist, or even librarian has to certify a patient by checking a single box on the form and signing their name. Bookshare then does the rest by contacting the patient and giving them an account. Bookshare functions due to an exception in US copyright law that allows the free distribution of copyrighted material in formats that are unique for patients with visual disabilities. The books are coded in DAISY, which is a sound file format. The App takes these files and renders them back to written text.

The user interface is designed such that an 80-year-old technophobe or a five-year-old child can easily use it (Apple-like minimalism). The app also synchronizes with Bluetooth Braille readers that convert the text to Braille. It can be connected to the HDMI port of any TV for unlimited screen size (hardwire or wireless through Apple TV). As you will see when you demo the app, text is now dynamic: in both teleprompter and marquee modes the text will move so that ocular movements are minimized. Marquee mode was specifically designed and tested to work for end-stage Retinitis Pigmentosa patients and any patient with only a remaining very narrow central visual field. Using VoiceOver all books are now audible books.

Social Entrepreneurship
Special iTunes links are created for vision nonprofits. If a patient clicks on those links and purchases the Spotlight Text App, 50% of sales profits are donated to the organization, including the Discovery Eye Foundation or the American Academy of Ophthalmology Foundation. Prior to being placed on the AAO’s website the app was evaluated by its Low Vision Rehabilitation Committee. It is the only app that the American Academy of Ophthalmology has ever endorsed.

The Future
Dr. Kaplan hopes to return to the major providers of e-content and persuade them that low vision and blind users are a viable market for them.

“I believe universal accessibility is achievable, but it will take a coordinated and combined effort. Reading is such a vital part of all our lives, with e-books, everyone should be able to enjoy a good book.”

Howard J. Kaplan MDHoward J. Kaplan, MD
Retina Surgeon
Hudson Retina

1/15/15

For Book Lovers – Low Vision Magnifiers

11/13/14

The first of this month was Book Lover’s Day, and as an avid reader, I am willing to celebrate any day that is about reading. However, if you suffer from low vision due to age-related macular degeneration, cataracts, retinitis pigmentosa or other sight-threatening eye diseases, you may not be able enjoy reading as much as you used to.

There are several options to help you enjoy books again, including low vision magnifiers, e-books and tablets. We will provide you with a quick primer to help you select the best option for your lifestyle and budget. Today we will look at magnifiers and Tuesday we will explore e-readers and tablets.

Optelec ClearView low vision magnifiers
Optelec ClearView Magnifier

Low Vision Magnifiers

There are several general classifications for magnifiers –

Hand-held magnifiers – These are smaller and more portable, allowing you to read thins such as menus, price tags, prescription bottles and ingredients in addition to books. Some also come with built-in lighting that can help you see in low light situations. They can be as simple as a single glass lens to more advanced digital devices that can auto-focus, change text color and magnification or even let you snap a picture of what you are reading if steady hands are an issue. However, because of these are small enough to make them portable, the field of vision is small and reading books for any length of time might become tedious.

Stand magnifiers – These are really better for reading books, magazines and newspapers as the field of vision is larger, your hands will not get tired holding the device and the distance between the page and the magnifier will remain more constant, making reading easier. This is especially important if you have tremors. However, these require sitting at a desk or table to be used.

Magnifiers mounted on reading glasses – These are great for being “hands-free,” but they also limit your ability to see at varying distances, and are generally used for seeing things less than a foot from your nose.

Video magnifiers – These devices use a video camera (similar to the portable digital device listed above) that focuses on the page and then magnifies it for viewing on a screen or monitor. Text color/background, brightness, contrast and levels of magnification can be adjusted as needed. As with the stand magnifiers, the ones able to scan an entire page of a book need to be used at a desk or table. However, now there are some machines that will even read out loud to you!

To get an idea of the range of devices available, along with the wide range of prices, here are three websites to get you started – Enhanced Vision, Optelec and Humanware.

Because each person has a different vision issue, not one magnifier works for everyone. A person with central vision loss from age-related macular degeneration will have different needs from a person with peripheral vision loss from glaucoma. That is why we suggest that you consult with a low vision specialist to help guide you in selecting the correct device for your specific needs.

Check back on Tuesday, or subscribe to the DEF blog, to learn about e-reader and tablet options for people with low vision.

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Our Thanks to Guest Bloggers Continues

10/7/14

More Amazing Guest Bloggers

Last week I took the opportunity to thank our very first guest bloggers for helping us launch the Discovery Eye Foundation Blog. We are pleased that so many people appreciate the wide range of eye-related information from eye care professionals, as well as the stories from people that live with eye disease on a daily basis.
Thank you part 2
Here is a round-up of guest bloggers since June 2014 that shared their time, experience and/or expertise to provide you with the best eye-related information.

Sumit “Sam“ Garg, MDwhat you should know about cataracts

Randall V. Wong, MDfloaters, causes and treatments

Roy Kennedyhis personal experiences with the miniature telescope implant

Sandra Young, ODthe importance of getting vitamins and minerals from your food and not just supplements

Jeanette Hassemanliving with keratoconus

Greg Shanetheater for the blind

Caitlin Hernandezblind actress and playwright

Jullia A. Rosdahl, MD, PhDlasers for glaucoma and genetics and glaucoma

Maureen A. Duffy, CVRTways to reduce harmful effects of sun glare

Kooshay Malekwhat is it like to lose your vision and being a blind therapist

Jeffrey J. Walline, OD PhDchildren and contact lenses

Robert Mahoneychoosing a home care agency

Robert W. Lingua, MDnystagmus in children

Buddy Russell, FCLSA, COMTcommon pediatric eye diseases, treatment options for children and pediatric contact lenses

NIH (National Institute of Health)telemedicine for ROP diagnosis

Harriet A. Hall, MDevaluating online treatment claims

Patty Gadjewskithe life-changing effects of a telescopic implant

Michael A. Ward, MMSc, FAAOproper contact lens care and wearing contacts and using cosmetics

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation