Which Eye Care Specialist Do You Need?

It’s time to get your eyes checked – do you go to an ophthalmologist, optometrist or optician? Your optometrist sees the beginnings of age-related macular degeneration, but is sending you to see and ophthalmologist, why?
eye care specialist
One of the most confusing things about taking care of your eyes can be differentiating between an ophthalmologist, optometrist and optician. Each eye care specialist has a very important part to play in the health of your eyes and here is a quick synopsis of what each does so you can choose the best one for your vision issues and treatment.

These specialists are fully trained medical doctors that have completed the eight years of training beyond a bachelor’s degree. Their training has included a full spectrum of eye care, from prescribing glasses and contact lenses and giving eye injections, to carrying out intricate eye surgeries. Many doctors may also be involved eye research to better understand vision, improve eye disease treatments or potentially find a cure. They are easily identified by the MD following their name.

These medical professionals have completed a four-year program at an accredited school of optometry. They have been trained to prescribe and fit glasses and contact lenses, as well as diagnose and treat various eye diseases. They provide treatments through topical therapeutic agents and oral drugs, and are licensed to perform certain types of laser surgery, such as Lasik. They are easily identified by the OD following their name.

These eye care professionals are not licensed to perform eye exams, medical tests or treat patients. Their purpose is to take the prescription from the ophthalmologist or optometrist and work with you to determine which glasses or contact lenses work best for you. If you suffer from an eye disease like keratoconus, these specialists can make the difference between a relatively normal life, or one that is dictated short periods of vision because of contact lens pain. These eye care professionals may hold and associate optician degree or have apprenticed fore required number of hours.

While each one of these eye specialists has their own area of expertise, they can form a team whose only concerns are your eye health and the ability to see as clearly as possible.


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

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.


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

Living Well With Low Vision Online Courses

As of May 5th, 10 new audio lessons offering tips and techniques for living well with low vision are now available as part of the newly-launched Low Vision Focus @ Hadley (LVF). These low vision online courses offer practical knowledge to make life easier.
low vision online courses
Low vision is defined by having significant difficulty seeing even after one’s vision is corrected with eyeglasses, contact lenses, surgery or medicine. Some typical symptoms of low vision include dimness, haziness, and having difficulty recognizing faces, reading labels and safely moving around. Low vision can make everyday tasks like reading the mail, shopping, cooking and paying the bills difficult. 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. One out of every six older adults will experience age-related vision loss due to conditions such as macular degeneration, glaucoma or diabetes.

As the largest provider of distance education for people who are blind and visually impaired worldwide, The Hadley School for the Blind (www.hadley.edu) is building on its history and expertise with this new program. The LVF is designed to help those living with low vision maintain their independence by sharing practical ways to address daily living skills made difficult by vision loss. Most low vision assistance focuses on a device that is meant to correct the vision problem. The LVF, however, offers ways for older adults to educate themselves on their condition as well as learn adaptive techniques to continue the tasks of daily living. The LVF is unique in that it offers those living with low vision the opportunity to learn and take advantage of our resources from the comfort of their own homes, at a time that is convenient for them, with the benefit of one-on-one counseling and support, at no cost to them.

A newly-revised series of 10 audio lessons is the core component of the LVF. Each lesson is approximately 30 minutes long and is available on a CD that is mailed to the client. The CDs are free for the client to keep. When a new client comes to the LVF, he or she speaks with an intake coordinator to determine which lesson(s) best meet their needs based on their challenges with low vision. Clients will be limited in their requests to two lessons initially. Additional titles may be requested once the client has had the opportunity to listen to these initial lessons and determine future need. The audio lessons include:

Making the Kitchen User Friendly Getting Around in the House
Basic Tactile Marking Going Out with a Friend
Doing Simple Kitchen Tasks Keeping Prescriptions in Order
Low Vision Cooking Looking Your Best
Going Out for a Meal Simple Home Modifications

While the LVF is geared primarily toward seniors, adult children of seniors living with low vision are encouraged to take advantage of the resources offered by the LVF to aid their parents in the adjustment process. Additionally, while many of the people who are living with low vision are seniors, the program is open to any individual who is experiencing sight loss. Clients and professionals also are encouraged to utilize the programming of the LVF in either the development of new low vision support groups in local communities or to sustain existing support group networks.

In the future, Hadley will provide free, educational videos and webinars as part of the Low Vision Focus and the program will soon reference popular Hadley courses that may be of interest to individuals with low vision.

“We are so excited to offer the Low Vision Focus @ Hadley and enable this growing population to retain their independence and live with confidence,” says the dean of Educational Programs and Instruction and interim Director of the Low Vision Focus @ Hadley Doug Anzlovar.
For more information or to begin taking advantage of the LVF, please visit www.lowvisionfocus.org or call toll-free at 1-855-830-5355.


Kate Streit Hadley School online educationKate Streit
Media and Marketing Specialist
The Hadley School for the Blind

Do I Need Vision Insurance?

With the rising costs of health insurance, many people are looking for ways to reduce their costs. Since not all insurance packages include vision insurance, many people wonder, do I need vision insurance?
vision insurance

Standard Vision Insurance

Vision insurance is a type of health insurance that entitles you to specific eye care benefits such as routine eye exams and other procedures, as well as a specified dollar mount or discount for the purchase of eyeglasses and contact lenses. It only supplements regular health insurance and is designed to help reduce your costs for routine preventative eye care and eyewear.

You can get vision insurance as part of a group, such as your employer, an association, etc., through a government program such as Medicare or Medicaid, or as an individual. It is often a benefit linked to your regular HMO (health maintenance organization) or PPO (preferred provider organization) health insurance.

There are two primary vision insurance plans available:

  • Vision Benefits Package – provides free eye care services and eyewear within a fixed dollar amount for which you pay an annual premium or membership fee and a small co-pay. It may also include a deductible.
  • Discount Vision Plan – provides eye care and eyewear at a discounted rate after you pay an annual premium or membership fee.

Both insurance plans generally include:

  • Annual eye exams
  • Eyeglass frames (usually once every 24 months)
  • Eyeglass lenses (usually once every 24 months)
  • Contact lenses (usually once every 24 months)
  • Discounted rates for LASIK and PRK

Here is where you can check for a list of some vision insurance providers.

Medicare and Medicaid

Different kinds of vision care are included in the US government programs, Medicare and Medicaid. These programs are for qualifying American age 65 and older, individuals with specific disabilities and people with low income.

The Types of Medicare For Vision:

    • Medicare Part A (Hospital Insurance) –Medical eye problems that require a hospital emergency room attention, but routine eye exams are NOT covered.
    • Medicare Part B (Medical Insurance) – Visits to an eye doctor that are related to an eye disease, but routine eye exams are NOT covered.
    • Medicare Part D (Prescription Drug Coverage) – Will help pay for prescription medications for eye diseases.

If you have Medicare Parts A & B you are generally eligible for the following vision coverage, however, there is a deductible before Medicare will start to pay, at which point you will still be paying a percentage of the remaining costs.

  • Cataract surgery – covers many of the cost including a standard intraocular lens (IOL). If you chose a premium IOL to correct your eyesight and reduce your need for glasses, you must pay for this added cost out-of-pocket.
  • Eyewear after cataract surgery – one pair of standard eyeglasses OR contact lenses.
  • Glaucoma screening – an annual screening for people at high risk for glaucoma, including people with diabetes or a family history, and African-Americans whom are 50 or older.
  • Ocular prostheses – costs related to the replacement and maintenance of an artificial eye.

There is also Medicare Supplement Insurance (Medigap) which is sold by private insurance companies to supplement only Medicare Parts A & B. It is intended to cover your share of the costs of Medicare-covered services including coinsurance, co-payments and deductibles. For more details about Medicare plans and coverage check their website or call 800-633-4227.

Medicaid is the US health program that gives medical benefits to low-income people who may have no or inadequate medical insurance. A person eligible for Medicaid may be asked to make a co-payment at the time medical service is provided. Vision benefits for children under the age of 21 include eye exams, eyeglass frames and lenses. Each state determines how often these services are provided and some states offer similar vision services to adults. To learn more about Medicaid eligibility requirements and vision benefits call your state’s Medicaid agency or visit their website.
vision dial - vision insurance

Defined Contribution Health Plans

A way to lower your vison care costs is to take part in a defined contribution health plan (DCHP). You are given a menu of health care benefits to choose from where a portion of the fees you receive for health coverage come from money that is deducted from our paycheck before federal, state and social security taxes are calculated. Four types of DCHP are:

Cafeteria Plans – your employer takes a portion of your salary and deposits it into a non-taxable account for health care spending. The amount taken depends on the number and costs of the benefits you select.

Flexible Spending Accounts (FSA) – your employer takes a predetermined portion of your pre-tax salary and deposits it into health care account for you to pay medical expenses. But generally preventative care such as routine eye exams and are not reimbursable. Nor are eyeglasses and contact lenses reimbursable. You would need to verify with your employer. If you do not use all the money at the end of a 12 month period, the money goes back to your employer.

Health Reimbursement Arrangement (HRA) – this is similar to an FSA except you can use it for preventative care like eye exams and you do not lose the money if it isn’t spent within a certain time period as it can be carried from year to year.

Health Savings Account (HSA) – it can be employer-sponsored of you can set up one independently; however you must purchase a high-deductible health insurance plan to open an HSA and you cannot exceed the annual deductible of your health insurance plan. You cannot be enrolled in Medicare of be a depended on someone else’s tax return. You can use it for preventive care such as eye exams. You can learn more about HSAs by visiting the US Treasury’s website.

There are a variety of options when it comes to vision insurance. You just need to determine your needs and ask providers the correct questions.


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.

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.


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

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.


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.

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 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.


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


Hadley’s Online Education for the Blind and Visually Impaired


The Hadley School for the Blind (www.hadley.edu) is the world’s largest educator of people who are blind or visually impaired as well as the world’s largest Braille educator. The school’s curriculum has always been delivered completely through online education, meaning students can study from anywhere at any time. Hadley serves nearly 10,000 students in all 50 states and approximately 100 countries. Hadley serves adult students, age 14 and over. Our mission is to promote independent living through lifelong, distance education programs for individuals who are blind or visually impaired, their families and blindness service providers.
Hadley School
Hadley courses are tuition-free for people who are blind or visually impaired and their family members; there is modest tuition for professionals. Students study at their own pace and receive personalized, one-on-one instruction from their instructor by phone, email, virtual “office hours” or mail.

Students can take courses in four formats: large print, Braille, audio or online. Since we began offering courses in an online format in 2002 as part of our eHadley initiative, more than 13,000 students have completed one or more online courses. 89 of our approximately 100 courses are offered in an online format, and 20 new online courses were introduced in 2014. Most of our online courses also are now accessible on mobile devices, so that students can literally study on the go if they choose.

If you’re not familiar with blindness, you may be asking yourself how a blind person can take courses online. The answer is through adaptive technology, such as screen magnifiers or screen readers. A screen reader is a software application that converts text on a screen to speech. One of the most popular is called JAWS. If a student doesn’t know how to use a screen reader, Hadley has a series of courses to teach them how to use this technology!

While many students come to us to learn to read and write Braille, we offer much more than just Braille education. In addition to Braille, some of our most popular areas of study include access technology, independent living skills, employment skills and recreation. These courses fall within Hadley’s Adult Continuing Education Program, which represents the largest number of students at Hadley. Some examples of ACE courses include:

Independent Living Series: This series of two-lesson courses focuses on a variety of topics central to the tasks of daily living. When individuals lose their sight, it can be overwhelming. They must relearn key daily living skills, such as cooking, dressing themselves and getting around. These courses give our students the tools they need to retain their independence and lead productive lives. The individual course topics include: orientation and mobility basics; clothing care and dressing confidently; socializing and dining; and cooking.

Self-Esteem and Adjusting with Blindness: Whether a student was born visually impaired or lost vision later in life, this course will help them understand the adjustment to life’s demands. Maintaining self-esteem with the changes and adaptations that come with blindness are discussed in-depth and illustrated with quotes from many blind persons.

Human Eye 1 and 2: These courses explain the parts of the human eye, how it works and how corrective lenses work. They enable the student to describe the basic anatomy, routine examination procedures and some common conditions of the human eye. Hadley also offers courses on some of the specific conditions that can lead to vision impairment, including: macular degeneration, diabetes and glaucoma. These courses are designed to help students living with these conditions to better understand them and how to manage them.

Developing Your Technology Toolkit: Technology plays a significant role in how people interact with each other, and most will likely encounter some aspect of technology in their everyday life. This course presents a variety of prominent desktop and mobile solutions. It also discusses how adaptive technology solutions provide access to mainstream hardware and software. In addition, it focuses on proprietary, adaptive technology products designed to be used specifically by persons who are visually impaired.

Enjoying Bird Songs: Listening to birdsongs helps people reduce stress, improve cognition and memory, interact with nature and even have spiritual experiences. This course guides students through the many bird songs presented in Hadley student John Neville’s audio CD set Beginner’s Guide to Bird Songs of North America. This course helps students become able to appreciate nature and birdsongs, as well as reflect on their experiences with birdsong.

Also part of the ACE program is the Forsythe Center for Employment and Entrepreneurship (FCE), designed to address the 70 – 80% un- and underemployment rate among people who are blind or visually impaired. The FCE is not an academic, college-level business program, but instead was designed to provide the requisite computer training; relevant social security, tax, accounting, legal, marketing, management and communications information; and content specific to the needs and concerns of visually impaired individuals who want to launch and grown their own businesses. All FCE courses are online, and many are just one-lesson modules, which makes learning quick and easy. Some examples of modules include: The Marketing Plan, The Business Plan, Forms of Ownership and Networking Skills.

Since the 1930s, The Hadley School for the Blind also has offered a nationally-recognized, accredited High School Program, available to students with visual impairments age 14 and up who live in the United States. Students may transfer credits from courses taken at Hadley to their high school to graduate locally. Students may also earn their high school diploma directly through Hadley. Frustration with local schools not offering quality vision services or accessible formats, difficulties passing the state-required exit exam for graduation or inability to travel long distances have prevented many of our students from earning their diploma in the past, so the Hadley High School Program is a much-needed “second chance.”

Courses are supplemented by Seminars@Hadley, free 60 to 90-minute webinars that are available to the public. These seminars are designed to bring together our blind and visually impaired students from around the world to discuss various topics in a virtual conference room with a panel, moderator and guest speakers. Participants listen to the seminar from their computer and post questions electronically. They also ask questions and/or make comments using a microphone. Seminar topics are timely, practical and determined by what our students tell us they need. Some of our most popular seminars include: Learning to Put the “You” in YouTube, Simplifying Internet Searching and Crafting with Vision Loss. Some seminars are approved for Continuing Education Credits (CEUs).

Hadley also offer a series of instructional videos on YouTube called iFocus (www.youtube.com/hadleyschool). These videos explain how to use the vision accessibility features on iDevices (Apple products such as the iPhone and iPad). Each video focuses on a specific task on iDevices, such as sending a text message or creating a calendar event . There are now 25 videos in the series, and they have been viewed nearly 10,000 times!

For more information about Hadley or to enroll, visit our website at www.hadley.edu, call our Student Services Department at 800-526-9909 or send an email to student_services@hadley.edu.

Kate Streit Hadley SchoolKate Streit
Media and Marketing Specialist
The Hadley School for the Blind

Our First Three Months Of Eye Care


Discovery Eye Foundation Blog’s First Three Months

It is hard to believe, but this blog has been providing information and insights into eye disease, treatment options, personal experiences of living with vision loss, and other eye-related information for seven months.

All of this would not have been possible without the expertise of remarkable eye care professionals who took time out of their busy schedules to share information to help you cope with vision loss through a better understanding of your eye condition and practical tips. Since so much information was shared in the seven months, here is a look at the first three months, with the additional four months to be reviewed next Tuesday.
Thank You - first three months
I am very thankful to these caring eye professionals and those with vision loss who were willing to share their stories:

Marjan Farid, MDcorneal transplants and new hope for corneal scarring

Bill Takeshita, OD, FAAO, FCOVDproper lighting to get the most out of your vision and reduce eyestrain

Maureen A. Duffy, CVRTlow vision resources

M. Cristina Kenney, MD, PhDthe differences in the immune system of a person with age-related macular degeneration

Bezalel Schendowich, ODblinking and dealing with eyestrain

Jason Marsack, PhDusing wavefront technology with custom contact lenses

S. Barry Eiden, OD, FAAOcontact lens fitting for keratoconus

Arthur B. Epstein, OD, FAAOdry eye and tear dysfunction

Jeffrey Sonsino, OD, FAAOusing OCT to evaluate contact lenses

Lylas G. Mogk, MDCharles Bonnet Syndrome

Dean Lloyd, Esqliving with the Argus II

Gil Johnsonemployment for seniors with aging eyes

We would like to extend our thanks to these eye care professionals, and to you, the reader, for helping to make this blog a success. Please subscribe to the blog and share it with your family, friends and doctors.

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