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.
We all know that the holidays can be stressful with the many demands of shopping, baking, parties and the expectation that you should be filled with cheer and goodwill. This is all daunting under the best circumstances, but if you are also losing your vision to eye diseases such as glaucoma, age-related macular degeneration or diabetic retinopathy, the depression can increase.
6 Tips to Help With Holiday Stress
Being realistic, planning ahead and asking for help will let you deal with the stress and depression that may come with the holidays. Here are six tips that will help you deal with the pressures of the holidays, with additional tips for those with vision loss.
Begin by realizing you don’t have to be happy just because the holidays are here. You may have experienced a loss of someone close to you that makes celebrating the holidays hard.
With vision loss: You may miss seeing or putting up decorations; baking for friends and family; or seeing the joy and smiles of loved ones. You can’t force yourself to be cheerful because of the time of year.
While the common reaction to depression is stay home and isolate yourself, don’t, it will only make you feel worse and dwell on things you cannot change. Join friends when they ask you out, find community events to attend or volunteer. Sharing time with others can provide a welcome distraction and lift your spirits.
With vision loss: It is common to be uncomfortable with asking friends and family for a ride, but if they are attending the same party of community event, ask them if you can get a ride. They won’t mind a will be glad you are there. Worst case, call a taxi or use Uber.
Don’t expect perfection. You need to define for yourself what would make a great holiday and not let the media and retail stores tell you what the holidays should be. Also remember that your traditions will change as your family changes and grows. Look at this as an opportunity to be creative and start new traditions.
With vision loss: Scale your holiday to what is comfortable to you. If fewer decorations make it safer and easier for you to navigate around your home, then reduce the number of things that go up to a few larger items you can enjoy more easily – you can even “decorate” with holiday music.
Even traditions may need to change. Allow someone else to host the family or neighborhood celebrations. It is nice to pass the honor on and you won’t be so stressed and tired you can’t enjoy the festivities.
Plan ahead so you don’t feel the pressure. This refers to budgeting both time and money.
• Plan extra time for decorating, shopping, baking, wrapping presents, or any other activity you want to include. Rarely do things run smoothly, especially at holiday time.
• Decide how much money you can spend, and stick to it. To make money go further, give homemade gifts, start a gift exchange instead of shopping for everyone in your family or office, or make a donation to a charity in someone’s name.
With vision loss: The same concepts apply – you need to budget your time and money.
Don’t over extend yourself and learn to say no. If you don’t you may become resentful and overwhelmed. Friends and family will understand if you can’t do everything. If your guilt gets the better of you, ask the person making the request to help with the tasks. They will gain a new appreciation of what you do.
With vision loss: Don’t be afraid to let people know that you may not be able to do things as easily as you could in the past. No one, except you, know the limitations you have with your vision. It can be very uncomfortable for others if they think they are asking too much of you, and you could become resentful for being asked to do something beyond your capabilities.
Stay healthy. The best way to do this is to watch what you eat and drink, get plenty of sleep, continue any exercise routine you have and take time to relax.
• You will be tempted with lots of sweets and snacks. Try eating something healthy like cut veggies before you go to the party to curb your appetite. Remember to limit your alcohol because of the calories and the fact that it is a depressant.
• Sleep will keep you alert and better able to focus what you want to get done and will help keep you more positive.
• Exercise is a great way to help relieve the stress you feel, give you an extra burst of energy and help you clear your head.
• Taking 15-20 minutes to just listen to music, take a bath, go for a walk or read book can help you think more clearly and relax. You will actually get more done when you can “re-charge” yourself.
With vision loss: Everything listed above is good for good eye health. A good diet of brightly colored fruits and vegetables and exercise are very important. Being tired can affect how well you see, and stress has been known to have an adverse effect on a person’s vision.
Because of the busy holiday season, this month we will only be publishing once a week, on Tuesdays.
Low vision in aging adults varies as do the occupational therapy techniques that might help older adults in becoming more independent. Mr. P has glaucoma resulting in a narrowed field of view. He is light sensitive, and keeps his blinds closed, darkening the house. He is responsible for doing his laundry, yet his washer and dryer are in the basement, causing a safety concern. Mrs. K has macular degeneration with 20/400 visual acuity. She has severely reduced contrast sensitivity, and can no longer drive or recognize faces easily. She no longer gets to the senior center for regular exercise sessions, which is concerning to her and her OT. Ms. T was diagnosed with diabetic retinopathy. She has struggled for years to accurately see her glucometer and insulin. She has recently developed peripheral neuropathy, leading to wheelchair dependency. Each of these patients is likely to leave their home less often because of their low vision, eventually leading to a decline in lower extremity weakness, balance, endurance and confidence. The fear of falling leads to more isolation, which can cause even more lower extremity weakness, problems with balance, decreased endurance, and even depression. The irony is that this cycle, which began with caution and a fear of falling, lends itself to exactly that. . .a fall.
Why are low-vision aging adults at higher risk for falls?
According to the CDC, “Each year, millions of older people-those 65 and older-fall. In fact, one out of three older people fall each year, but less than half tell their doctor. Falling once doubles your chances of falling again.” The typical aging adult with low vision faces challenges that others do not. Difficulty seeing details combined with reduced contrast sensitivity leads to a decline in mobility and socialization.
So how do we help older adults with low vision lower their risk for falling? When considering safety within the home, persons with low vision must make it a priority to add lighting & contrast whenever possible. Consider all rooms of the house, including entrances, hallways and stairways.
Placement of night lights in hallways, stairway, etc.
Keep flashlights in accessible places throughout the home where night lights are not possible.
Instead of closing blinds, keep them open & wear appropriate colored filters to manage glare/light sensitivity.
Small battery operated stick-on lights or rope lighting is inexpensive, and easy to place on steps to light up a stairwell.
Line edge of steps, or stairway railing with brightly colored duct tape to increase visibility.
Make sure grab bars, tub benches, shower chair are high contrast, to be most visible.
Remove throw rugs, with the exception of those providing function, such as the one at the entrance and bathtub. Their purpose is for providing dry shoes and feet, but they should have a non-skid back and a high contrast color to “stand out.”
Reduce clutter in rooms to increase safety by removing items from floors, walkways and stairwells.
Consider investing in a Medical Alert System to provide added piece of mind, confidence, especially when living alone.
Persons with low vision can decrease their frequency of falls by staying social and walking in the community. Unfortunately, many low vision adults become more house bound when they can no longer drive. Locating sources of alternative transportation may be helpful. Seeing faces is difficult, making socializing a challenge, which can lead to depression. The following recommendations take into consideration the challenges of not seeing details or across the visual field normally, while improving lower body strength, endurance, coordination, confidence, and hopefully reducing the risk of a fall.
Encourage regular trips to the grocery stores and the mall to keep physically fit. Malls are safe environments to walk around because of wide, straight hallways. Use magnifiers to see price tag/label details, or take advantage of personal shoppers who assist with locating items.
Participate in regularly scheduled exercise sessions (videos, groups, etc). Sit/stand in the front row, ask instructor to provide clear verbal instruction, instead of only demonstration. Consider hiring a personal trainer in order to get 1:1 instructions for how to use exercise equipment. If watching a video, move closer to your largest TV screen. Home exercise equipment can be labeled with high contrast markings to increase visibility of its details.
Consider joining a senior center in the community. Some have low vision support groups.
Access driving alternatives, such as the Smart Bus, Senior Centers, Local Volunteer or Church groups. Consider using money previously spent for a car and its expenses to hire a private driver.
Use appropriate colored filters in bright outside conditions or darker inside environments (i.e. Amber outside in the sun; Yellow inside a dark restaurant or outside with overcast weather).
Consider using a walker or support cane when walking longer distances in the community or neighborhood. Many individuals decline using an assistive device, not realizing how active and fit it can make them. Rolling walkers are even available with seats, allowing for rest breaks wherever necessary.
While the fear of falling is great amongst all seniors, those with low vision need to consider adding strategies that specifically benefit them. Making changes within the home may be as simple as improving lighting and contrast. Remaining physically fit outside of the home may be done with shopping or exercise equipment, but either way staying active will improve confidence, the fear of falling, and hopefully decrease the chance of a fall. If you are unsure of what approach is best for you, consult with your ophthalmologist about scheduling a low vision eye exam and occupational therapy.
Reference:
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control-CDC 24/7: Saving Lives, Protecting People
Four years ago #GivingTuesday was started to use some of the focus on holiday shopping and direct donations to charities that had been providing services, information, education, research, etc. to benefit people throughout the year. It was a way for people to show appreciation and support for nonprofit organizations that had helped them or engaged in something they were passionate about.
Discovery Eye Foundation started this blog almost two years ago to provide consistently updated information on vision, eye health, nutrition and other eye-related information to people with eye diseases or those that wanted to keep their eyes healthy. DEF is a 501 (c)(3) nonprofit organization that has been supporting eye research since 1971. Hopefully, you have enjoyed reading this blog and found the information and comments useful.
In honor of #GivingTuesday, please show your support for this blog and DEF eye research by making a donation today!
Medical research funding from the US government, the medical device and pharmaceutical industries, biotech and foundations has dropped 0.8% per year, every year from 2007 to 2012. Even with the economic recovery, the funding of eye research from the NIH in 2014 decreased by 17% from 2012.
What makes this particularly disturbing is that the need for eye research is more important now than ever, as demonstrated by the infographic below.
This infographic by the National Institute of Health (NIH) is used with their permission.
Giving For Eye Research
The eye diseases in the above graphic are related to aging. The number of people being affected is more than doubling for each eye diseases, except for diabetic retinopathy which will increase by 47%, by 2050.
While we are more health conscious than in previous years, knowing the importance of exercise, healthy eating and not smoking, the US population is aging.
Aging baby boomers, the largest population group in US history, are creating a dramatic shift in the age composition of the U.S. population. It is projected that the entire senior population, including the pre-boomer silent generation, will reach 71.4 million people by 2029. This means that those people 65 and older will make up about 20%of the US population by 2029, up from almost 14% in 2012.
We need your help to find treatments and cures for these sight-threatening eye diseases.
December 1st will be the fourth year of #GivingTuesday. It is a global day of giving using combined power of social media and collaboration. Always the Tuesday following Thanksgiving, it has become as widely recognized as Black Friday and Cyber Monday and kicks off the philanthropic season, when many focus on their holiday and end-of-year giving.
We are asking that you support eye research through the Discovery Eye Foundation this philanthropic season with a gift on #GivingTuesday. It is easy to do; you can do it from the comfort of your home – just click here.
Also share this post with family and friends so they can also give the gift of sight this holiday season.
Thank you for reading our blog and for your support.
Smoking is the single largest preventable cause of eye disease.
On the third Thursday of November each year, smokers across the nation take part in the Great American Smokeout, sponsored by the American Cancer Society. This might be the ideal time for you to stop smoking and ACS has information and resources you may find helpful.
Here are some things you should know about smoking and your eyes.
Smoking at any age, even in your teens or twenties, increases your future risk for vision loss.
The more you smoke, the higher your risk for eye disease.
If you quit smoking, your risk for these eye diseases decreases considerably.
Smoking increases your risk for cardiovascular diseases that indirectly influence your eyes’ health.
Women who smoke during pregnancy increase their chance for a premature birth and a potentially blinding eye disease called retinopathy of prematurity (ROP).
A smoker is two times more likely to develop macular degeneration compared with a nonsmoker.
Smoking double your chance of forming cataracts and the risk continues to increase the more you smoke.
Smoking doubles your diabetes risk which can lead to the blinding eye disease, diabetic retinopathy.
Smokers are more than twice as likely to be affected by dry eye syndrome as a non-smoker.
Second-hand smoke also makes dry eye worse, especially for contact lens wearers and post-menopausal women.
If you smoke you can have a three-fold increase in the risk of developing AMD compared with people who have never smoked.
Smoking appears linked to the development of uveitis with smokers having more than twice the risk of non-smokers.
If you are looking to stop smoking you may also want to check out Smokefree.govwhich provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.
DEF Research Director Dr. M. Cristina Kenney’s research has shown that the mitochondrial DNA from different ethnic/racial populations may play a key role in determining that population’s resistance or susceptibility to disease (see previous article on 11/12/15 – Mitochondria and Age-Related Macular Degeneration). In order to study these effects, Kenney has developed the cybrid model using mitochondria from subjects of different ethnic/racial groups (Figure 1). The comparison of an individual’s mitochondria with that from other ethnic/racial groups (African, European, Asian or Ashkenazi Jewish) allows us to determine if their mitochondria determine that population’s susceptibility or resistance to disease and to response to drugs.
Figure 1 – Cybrids are cell lines with identical nuclei but the mitochondrial DNA from individuals of different ethnic/racial groups.
Personalized cybrids
Kenney’s cybrids are made with mitochondria from the blood taken from individual living donors. Looked at individually they are all really “personalized cybrids” because each cybrid test system has the mitochondria from the original donor and reflects the responses of that donor.
Using Cybrids to Study Age-Related Diseases
How is Kenney using these personalized cybrids?
Kenney is partnering with Dr. Pinchas Cohen, dean of the University of Southern California, Leonard Davis School of Gerontology, to explore how novel, small proteins produced from mitochondria might be used to treat a variety of age-related diseases such as age-related macular degeneration, Alzheimer’s, Parkinson’s, stroke and cholesterol. Cohen’s laboratory has discovered and characterized many of these new, small proteins called “mitochondrial derived peptides” (MDPs). His work has shown that these MDPs can protect brain cells from damage and early death, such as occurs in Alzheimer’s disease. Cohen and Kenney are now testing these MDPs in the K and H cybrids to assess their protective effects to stop retinal cell death, such as seen in AMD.
Kenney explains her approach: “Our cybrid system represents a very powerful technique. We are now using the Ashkenazi Jewish population as an excellent model to learn how the mitochondria, with their unique mtDNA, influence the risk factors for AMD. We plan to extend the study to investigate Ashkenazi Jewish people’s susceptibility to Alzheimer’s disease, heart disease and stroke. Eventually, we believe the findings for the K haplogroup mitochondrial DNA will be applicable to other groups, as well.”
Research on mitochondrial DNA shows promise for treating AMD
For the past few years, DEF Research Director Dr. M. Cristina Kenney has been researching the relationship of mitochondria and age-related macular degeneration (AMD). She found that damaged mitochondria from people with AMD send signals that can cause retinal cells to die at an increased rate, compared with people who had healthy mitochondria and no AMD. That research led to the exploration of stimulating mitochondria to support retinal cell health in an effort to retain or restore vision for people with AMD.
Mitochondria in Cells
Cells are the basic building blocks of all living things. The human body is composed of trillions of cells. They provide structure for the body, take in nutrients from food, convert those nutrients into energy and carry out specialized functions. Cells also contain the body’s hereditary material (DNA) and so they can make copies of themselves.
Mitochondria are tiny structures inside cells whose function is to produce energy, like a battery in a flashlight, to keep cells alive. Each cell contains hundreds to thousands of mitochondria, which are located in the fluid that surrounds the nucleus. Although most DNA is packaged in chromosomes within the nucleus of a cell (nuclear DNA), mitochondria also have a small amount of their own DNA, known as mitochondrial DNA or mtDNA.
Because only egg cells contribute mitochondria to a developing embryo, only females can pass on the mitochondrial DNA to their children.
Mitochondrial Haplogroups
The mtDNA can be classified into categories called haplogroups, which represent different ancient, geographically separated groups of people. For example, African-Americans and people of ancient African lineage have inherited L haplogroup mitochondria from their mothers no matter where they currently live.
Similarly, most Ashkenazi Jewish populations (primarily those Jews whose families originated in Eastern or Central Europe) possess mitochondria of the K haplogroup. People with this haplogroup of mtDNA seem to be susceptible to a variety of age-related diseases, including age-related macular degeneration (AMD).
The incidence of AMD varies a lot among different ethnic/racial populations. For example, in the United States, the likelihood of losing vision from AMD is very low for a person with an African maternal background but it is much higher in people of European descent. Similarly, in an Israeli eye clinic, of the people who had AMD, 96% were Jewish while only 4% were of Arab descent. This suggests that European mtDNA in retinal cells of Caucasians may be the reason they are more susceptible to AMD.
Figure 1
It has been recognized that AMD is a very complex disease with many factors involved (Figure 1). There are more than 30 genes associated with AMD, representing many different biological pathways. In addition, mitochondrial damage and specific mtDNA haplogroups have been associated with AMD. Finally, it is recognized that environmental factors, such as smoking and obesity, increase the risk to develop AMD.
Although millions of dollars and thousands of man-hours have been invested in finding the causes and treatments for AMD, we still do not understand how to prevent the most common form of AMD. One major difficulty has been that when we study a diverse group of individuals, each with hundreds of different nuclear and mitochondrial genes, it is very difficult to identify the causes and pathways involved with developing AMD and determining effective treatments. One drug may not help everyone and different people develop different types and severities of AMD.
Figure 2
Kenney’s approach to this dilemma has been to SIMPLIFY THE TESTING SYSTEM (Figure 2). In her research with different ethnic/racial groups, Kenney has found that the Ashkenazi Jewish population (K haplogroup) is an excellent group in which to study age-related diseases. This group has very well characterized nuclear and mitochondrial genes, the population tends to relatively homogenous and to marry within their community. Finally, the Ashkenazi Jewish population has longevity, which increases the likelihood that they will develop aging diseases, such as AMD.
Kenney’s laboratory has created a “cybrid” test system, which are cell lines with identical nuclei and nuclear DNA, but different mitochondrial DNA so that the differences in the cell behavior can be attributed to the different mitochondrial DNA (see the following cybrid story on 11/17/15). Using the cybrid system, Kenney has compared cell behavior of mitochondria from subjects with the K (Ashkenazi Jewish) haplogroups and the mitochondria from people of the H haplogroup (Figure 3), the most common European haplogroup.
Figure 3
There are:
Major differences in production of cholesterol and lipid molecules
Altered levels of inflammation
Differences in their responses to toxic effects of amyloid-? (a toxic protein associated with AMD and Alzheimer’s disease)
These differences are important contributors to AMD and other age-related diseases.
Significance of the Findings
Maternally inherited mitochondrial DNA can influence how a person’s cells respond to stress and this can contribute to age-related diseases. This is a completely new way of thinking about common aging diseases and offers new approaches to treatment and prevention of those diseases.
Future Studies
Kenney’s laboratory will continue to use the K haplogroup cybrid model to study the mitochondrial DNA, with the goal of blocking the harmful events that cause early retinal cell death, such as that seen in AMD. An additional advantage of cybrids is that they are unique to the donor whose blood was used to make them. Therefore with these “personalized cybrids,” Kenney can test the responses of the personalized cybrids to drugs that are currently being used for AMD (Lucentis™, Avastin™ and Eylea™). They can also be used to identify novel, new drugs that can protect the cells from early cellular death, a major event in the dry form of AMD. This research shows great promise in developing personalized treatments for AMD and other age-related diseases.
Susan DeRenmer, CFRE
