4 Super Greens for Better Sight

A healthy diet not only helps your heart, but also your eyes. Your diet should include lots of fruits and vegetables to provide you with a natural source of nutrients to help protect your sight. As wonderful as supplements are, eating the actual foods is always better. Some of the best vegetables for you are the dark, leafy greens that are rich in valuable vitamins and nutrients. These are the super greens for better sight.

With the US experiencing bitter, freezing temperatures on the East Coast, while the West Coast is having summer in February, with record-breaking hot temperatures, I thought it would be interesting to see how you could enjoy those super greens, no matter what the temperature is outside. Below is a quick look at four dark leafy greens that are a great addition to a healthy diet, watercress, arugula, spinach and kale. For each vegetable I have included a recipe that is served hot, along with one that is served cold.

Here is what you need to know about super greens for better sight.
super greens
WATERCRESS

Watercress is a cruciferous plant and part of the brassica family, like arugula and kale. It contains vitamins A, B6, B12, C, K, iron, magnesium, calcium, phosphorus, lutein and zeaxanthin. In fact, weight for weight, watercress contains more vitamin C than an orange, more calcium than milk, more iron than spinach and more folate than bananas. Watercress has the highest amount of nutrients for the smallest amount of calories.

The health benefits of watercress include boosting immunity, cancer & diabetes prevention, reducing cognitive decline, thyroid support, better cardiovascular health and stronger bones. As for your eyesight, it can help prevent or slow the onset of age-related macular degeneration and possibly cataracts.

Watercress is most commonly enjoyed fresh in salads, but can also be use in pastas, casseroles, soups and sauces. Choose watercress with deep green, crisp leaves, with no signs of wilting. Trim the stems, rinse the greens in cold water and dry. It is best if used immediately, but can be store for up to four days in the refrigerator.

Watercress Soup by William Anatooskin

Watercress and Grapefruit Salad by Martha Stewart
super greens
ARUGULA

Arugula is also known as a salad or garden rocket. It is a small low growing herb that is packed with vitamins, minerals and antioxidants. It is rich in folates, vitamin A, B-complex, C and K and has copper, iron, calcium, potassium, manganese and phosphorus.

The health benefits of arugula include a lowered risk of cancer, healthy bones, strengthened brain function, improved mineral absorption and it boosts the immune system. Because of being a source of carotenoids, it also helps to slow the progression of age-related macular degeneration.

Arugula is popular in salads, used with milder greens to add a peppery flavor. But it can also be used in pastas, casseroles, pizzas, soups and sauces. Choose arugula that is crisp with green young leaves. Avoid the flowered harvest as those leaves are tough and have a bitter taste. Wash leaves in a bowl of water, swishing thoroughly to get rid of all sand and soil. Drain and pat dry before storing in the vegetable bin of your refrigerator for no more than a few days.

Grilled Stuffed Swordfish by Stormy Scarlett

Pasta Salad with Goat Cheese and Arugula by Martha Stewart
super greens
SPINACH

Spinach is a very popular leafy green vegetable, with two common varieties cultivated for food; the savory-type with dark green crinkled leaves and the flat-leaf type with smooth surfaced leaves. Spinach contains vitamin A, B-complex, C and K, along with lutein, zeaxanthin beta-carotene, potassium manganese, magnesium, copper and zinc.

The nutrients in spinach help improve blood glucose control in diabetes, lower the risk of certain cancers, reduce blood pressure, increase bone health and help iron deficiency. The lutein, zeaxanthin and beta-carotene help to potentially prevent and slow the progression of age-related macular degeneration. Lutein also works to protect the eye from free radical damage by helping filter out damaging blue and ultraviolet light.

Spinach is a universally popular vegetable, used around the world in a variety of ways, including salads, soups, noodles, pies, casseroles, dips, sauces, etc. Look for leaves that are dark green in color, crisp and not dull or yellow and spotted. Wash thoroughly to remove sand and soil, dry, trim away tough stems and store in the refrigerator for up to a week.

Turkey-Spinach Meatballs from Bon Appètit

Spinach Salad with Dates from Bon Appètit
super greens
KALE

Kale is a member of the mustard and cabbage families and has more nutrients than spinach. Less than ½ cup has 333% of the recommended daily allowance (RDA) of vitamin A, 587% RDA of vitamin K and 200% RDA of vitamin C. This frilly-leafed vegetable also has vitamin B-complex, lutein, zeaxanthin, beta-carotene, copper, calcium, sodium, potassium, iron, manganese, and phosphorus.

The health benefits of kale include healthy muscles and skin, improved blood glucose control, lower colon and prostate cancer risk, better cardiovascular health, stronger bone health, reduced neuronal brain damage and support for red blood cell formation. The advantage for your eyes comes from the lutein, zeaxanthin, beta-carotene and vitamin A, all which work to support a healthy retina. They help protect against blue and ultraviolet light as well as the early onset and progression of age-related macular degeneration. Because of the positive impact on diabetes it also reduces the onset and progression of diabetic retinopathy.

Kale is very versatile and can be served in a variety of ways including salads, soups and casseroles. It can also be braised, broiled, sautéed and even made into kale chips by tossing them in extra-virgin olive oil and sprinkled with your choice of cumin, curry powder, chili powder, red pepper flakes or garlic powder and baking at 275 degrees for 15-30 minutes depending on how crisp you want them to be. When shopping for kale look for leaves that are crispy and crunchy with a brilliant dark blue-green color. Wash thoroughly to remove soil and sand, dry well, and remove all tough stems. It is extremely perishable, so use it as quickly as possible.

Kale and Chicken Casserole by Martha Stewart

Kale with Pomegranate Dressing and Ricotta Salata from Bon Appètit

All of these dark green leafy vegetables are not only healthy for you, but can be used in many ways to make it easy to incorporate them into your diet. Here are a few ideas:

  • Throw a small handful into your blender when making your favorite smoothie
  • Add them to your next omelet or egg scramble
  • Use them for making pesto or adding to pasta sauce
  • Sauté with a small amount of extra-virgin olive and season with freshly ground black pepper and freshly grated Parmesan cheese to serve at a topping for your baked potato
  • Add it to your wrap, sandwich or flatbread

2/17/16

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

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

Low Vision Aging Adults at Higher Risk for Falls

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.
risk for falls
risk for falls
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.

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  • Keep flashlights in accessible places throughout the home where night lights are not possible.

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  • Instead of closing blinds, keep them open & wear appropriate colored filters to manage glare/light sensitivity.

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  • Small battery operated stick-on lights or rope lighting is inexpensive, and easy to place on steps to light up a stairwell.

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  • Line edge of steps, or stairway railing with brightly colored duct tape to increase visibility.

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  • Make sure grab bars, tub benches, shower chair are high contrast, to be most visible.

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  • 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.”

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  • Reduce clutter in rooms to increase safety by removing items from floors, walkways and stairwells.

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  • 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.

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  • 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.

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  • Consider joining a senior center in the community. Some have low vision support groups.

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  • 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.

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  • 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).

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  • 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

12/3/15

Annette Babinski's headshot thumbnailAnnette M. Babinski, OTR/L CLVT
Henry Ford Health System
Vision Rehabilitation Center
 
 
 
 
 

Michelle Buck's headshot thumbnailMichelle Buck, MS, OTR/L CLVT
Henry Ford Health System
Vision Rehabilitation Center

#GivingTuesday – Giving For Eye Research

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.
giving for eye research
What makes this particularly disturbing is that the need for eye research is more important now than ever, as demonstrated by the infographic below.

Giving to eye research
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.

11/24/15

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

Smoking and Your Eyes

Smoking is the single largest preventable cause of eye disease.
smoking and your eyes
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.

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  • The more you smoke, the higher your risk for eye disease.

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  • If you quit smoking, your risk for these eye diseases decreases considerably.

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  • Smoking increases your risk for cardiovascular diseases that indirectly influence your eyes’ health.

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  • Women who smoke during pregnancy increase their chance for a premature birth and a potentially blinding eye disease called retinopathy of prematurity (ROP).

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  • A smoker is two times more likely to develop macular degeneration compared with a nonsmoker.

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  • Smoking double your chance of forming cataracts and the risk continues to increase the more you smoke.

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  • Smoking doubles your diabetes risk which can lead to the blinding eye disease, diabetic retinopathy.

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  • Smokers are more than twice as likely to be affected by dry eye syndrome as a non-smoker.

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  • Second-hand smoke also makes dry eye worse, especially for contact lens wearers and post-menopausal women.

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  • If you smoke you can have a three-fold increase in the risk of developing AMD compared with people who have never smoked.

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  • 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.gov which provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.

11/19/15

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

The Importance of An Eye Exam

Why You Need An Eye Exam

The end of the year is fast approaching – when was the last time you had an eye exam? Was it a comprehensive eye exam?
eye exam
To keep your eyes healthy and maintain your vision, the American Optometric Association (AOA) recommends a comprehensive eye exam every two years for adults ages 18 to 60, and annual exams for people age 61 and older. However, if you have a family history of eye disease (glaucoma, macular degeneration, etc.), diabetes or high blood pressure, or have had an eye injury or surgery, you should have a comprehensive exam every year, unless otherwise indicated by your doctor.
Also, adults who wear contact lenses should have annual eye exams.

An important part of the comprehensive eye exam is the dilated eye exam to look inside your eye. Drops are placed in each eye to widen the pupil and allow more light to enter the eye. This gives your doctor a clear view of important tissues at the back of the eye, including the retina, the macula, and the optic nerve. This allows for early diagnosis of sight-threatening eye diseases like age-related macular degeneration, diabetic retinopathy, glaucoma, etc.

To better understand the importance of the dilated eye exam, here is a video from the National Eye Institute (NE) that explains what to expect.

At the end of your comprehensive eye exam your doctor should raise any concerns he has with you. But it is up to you to be prepared to react and ask questions for peace of mind and to help save your vision.

Questions To Ask After Your Eye Exam

It is always important to know if anything about your eyes have changed since your last visit. If the doctor says no, then the only thing you need to know is when they want to see you again.

If the doctor says the have been some minor changes, you need to know what questions to ask, such as:

  • Is my condition stable, or can I lose more sight?
  • What new symptoms should I watch out for?
  • Is there anything I can do to improve or help my vision?
  • When is the next time you want to see me?

If the doctor sees a marked change in your vision or give you a diagnosis of eye disease, you would want to ask:

  • Are there treatments for my eye disease?
  • When should I start treatment and how long will it last?
  • What are the benefits of this treatment and how successful is it?
  • What are the risks and possible side effects associated with this treatment?
  • Are there any foods, medications, or activities I should avoid while I am undergoing this treatment?
  • If I need to take medication, what should I do if I miss a dose or have a reaction?
  • Are there any other treatments available?
  • Will I need more tests necessary later?
  • How often should I schedule follow-up visits? Should I be monitored on a regular basis?
  • Am I still safe to drive?

Your vision is a terrible thing to lose, but with proper diet, exercise and no smoking, along with regularly scheduled eye exams, you improve your chances of maintaining your sight.

11/5/15

 

Susan DeRemerSusan DeRemer, CFRE

Diabetic Eye Diseases

November is National Diabetes Month. Diabetes is a controllable condition that is growing in the US. In adults 20 and older more than one in 10 people have diabetes, while in seniors (65 and older) that number increases to more than one in four.

Diabetic Eye Diseases

One of the eye diseases that can result from diabetes is diabetic retinopathy, which will affect approximately 11 million people by 2030. Check the infographic below to learn more about diabetic eye diseases.

diabetic eye diseases

11/3/15

NEI LogoCourtesy of the National Eye Institute (NEI), a part of NIH.

Increased Awareness for Saving Vision

The following is a survey done by Essilor (a French company that produces ophthalmic lenses along with ophthalmic optical equipment) and a large marketing research firm in the UK, YouGov. While the focus in on people living in the UK, the results would probably be similar to the US population. Even with increased access to the Internet, many people are still not aware of the risks associated with eye disease and what they can do to help retain their vision. Increased awareness of informational resources are important for saving vision.
saving vision
There are a number of websites with easy to understand information about taking care of your vision that I have listed under Resources to Help Save Vision at the bottom of this article. And while there are eye diseases that are hereditary, you can slow the onset and progression by making good lifestyle choices about smoking, diet and exercise. Your eye care specialist is also an excellent source of information about what you can to do reduce your risk of vision loss, at any age.

Increased Awareness for Saving Vision

A YouGov poll conducted with Essilor reveals that most Britons are unaware of damage to their eyes by surrounding objects, activities, and devices. This widespread lack of awareness means fewer people seeking methods of prevention and avoidance, and for those that are aware of risks, most are not informed of existing preventative measures.

The poll has shown* that many British people remain uninformed about the various ways in which eyes are damaged by common daily factors, despite evidence that eye health is affected by blue light, UV rays (reflected from common surfaces), diet, obesity, and smoking.
Of the 2,096 people polled, the percentage of respondents aware of the link between known factors affecting and eye health were:

  • Poor diet – 59%
  • Obesity – 35%
  • Smoking tobacco – 36%
  • UV light, not just direct from the sun but reflected off shiny surfaces – 54%
  • Blue light from low energy lightbulbs and electronic screens – 29%

More than one in ten people were completely unaware that any of these factors could affect your eyesight at all.
saving vision
72% of respondents own or wear prescription glasses but only 28% knew that there were lenses available (for both prescription and non-prescription glasses) to protect against some of these factors; specifically, blue light from electronic devices and low energy light bulbs, and UV light from direct sunlight and reflective surfaces.

76% admitted they haven’t heard of E-SPF ratings – the grade given to lenses to show the level of protection they offer against UV.

Just 13% have lenses with protection from direct and reflected UV light, and only 2% have protection from blue light (from screens, devices, and low energy bulbs).

Poll results showed that younger people were most aware of the dangers of UV and blue light, yet least aware of how smoking tobacco and obesity can affect your eye health. Within economic sectors, middle to high income people are more aware of the effects of smoking & obesity on eyesight than those with low income –

  • 39% of people with middle to high income compared to 33% of people with low income are aware of the impact of smoking tobacco.
  • 38% of people with middle to high income compared to 31% of people with low income are aware of the impact of obesity.

Awareness of the impacts of smoking and obesity on eye health is significantly higher in Scotland (47% & 49% respectively) than anywhere else in the UK (35% & 33% in England and 40% & 38% in Wales).
Essilor’s Professional Relations Manager, Andy Hepworth, has commented: “The lack of awareness about these common risks to people’s eyes is concerning. Not only would many more glasses wearers be better protected, but also many people who do not wear glasses would likely take precautions too, if made aware of the dangers and the existence of non-prescription protective lenses.”

To see the full results of the poll, please visit the Essilor website.

For more information on the protection offered from blue light and UV through specialist lens coatings, for both prescriptions and non-prescription glasses, please see here for UV & Blue Light Protection options.

*All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2,096 adults. Fieldwork was undertaken between 21st and 24th August 2015. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Resources To Help Save Vision
All About Vision
Macular Degeneration Partnership
National Eye Institute (NEI)
Prevent Blindness

10/16/15


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

Vision Loss and Depression

On Tuesday, September 29, 2015, the National Eye Institute (NEI) hosted a Twitter chat on vision loss and depression. Here are some highlights of that discussion, along with some great resources to learn more about dealing with vision loss and depression.
vision loss and depression

  • Many studies show that people with vision loss or low vision are at risk for depression, although not everyone with vision loss gets depressed.

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  • A person with low vision is defined as someone who finds it difficult to do daily tasks even with regular glasses, contacts, medications or surgery.

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  • The number of Americans with low vision will increase over 70% by 2030. Broken down by ethnicity, African Americans with low vision will increase 93% and Hispanics with low vision will increase 190% during the same period. This is due to the rapidly aging Boomer population. 88% of Americans with low vision are age 65 and older.

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  • Symptoms of depression include persistent feelings of sadness, anxiety, irritability and fatigue. It is a common and serious illness that interferes with daily life. Each year, about 6.7% of American adults experience major depressive disorder. Women and men experience depression differently, with women 70% more likely to experience depression than men.

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  • People 65 and older are at particular risk for developing serious depression related to vision loss and yet it is often underdiagnosed and undertreated. Older adults may have other, less obvious symptoms of depression or they may not be willing to talk about their feelings. Many overlooked because sadness is not their main symptom. It is important to remember that while depression is a common problem among older adults, it is not a normal part of aging.

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  • An estimated 29-58% of those who suffer significant vision loss have major depressive disorder one year later. People with vision loss are 2x more likely to be depressed than someone without vision loss. Depression can be very disabling and may reduce the effectiveness of low vision rehabilitation interventions.

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  • A recent study confirmed age-related macular degeneration (AMD) is a big contributor to depression risk, as it accounts for about 45% of low vision cases.

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  • Older adults w/ vision loss are also 3X more likely to report difficulty in 1) walking, 2) managing medications, and 3) preparing meals. In fact about 39% of people with severe vision loss experience activities of daily living ADL limitations, compared to 7% of those with better vision. ADLs include eating, bathing, dressing, toileting, walking and continence.

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  • A link between depression and vision loss was also found in people as young as 20 according to a recent study. It looked at over 10,000 adults in the US and found they were approximately 2x more likely to be depressed.

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  • A decline in vision can also be associated with lower emotional, physical, and social functioning. To help those with low vision avoid depression it is important that they remain active and engaged in the world around them. And while people may become depressed because of vision loss, other causes of depression may also be present.

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  • An integrated approach to depression management in older adults with impaired vision may be the best course of action. Behavioral activation helps people recognize that loss of the activities they enjoyed that have led to depression and encourages them to find ways to re-engage with these activities. After 4 months, behavioral activation reduced the risk of depression by 50% compared to the control group. Behavioral activation can be used alone, or as part of psychotherapy called cognitive-behavioral therapy (CBT).

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  • Cognitive behavioral therapy (CBT) helps people with depression restructure negative thought patterns and to correct distorted thinking that is often part of depression. But it is important to remember that the best approach to treating depression is to personalize it for each individual.

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  • Often, the combination of pharmacotherapy and psychotherapy is a very effective option for depression treatment. Other time-limited psychotherapies, including interpersonal therapy (IPT) are effective in treating depression in people of all ages.

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  • Collaboration between eye care and mental health professionals can help people with vision loss improve their quality of life.

Resources
Understanding depression

How to live with low vision

Living with Low vision – How you can help webinar

Update on depression and AMD

Association of vison loss and depression in those over 20

Sadness impairs color perception

Rehab helps prevent depression from age-related vision loss

10/6/15

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

Using Andragogy to Help People with AMD

Adults and children do not learn in the same way. The concept of “andragogy” was widely introduced to the world of educational theory by Malcolm Knowles, PhD, in the latter part of the 20th century. He contrasted “pedagogy,” which is generally used to describe the method or practice of teaching — and comes from the Greek for “child learning” — with the practice of “andragogy,” which applies specifically to adult learning. While Knowles did not invent the term, he advanced the argument that andragogy should be very different from pedagogy.
Andragogy to Help People with AMD
Maureen Duffy, CVRT, LVT, an editor for Journal of Visual Impairment & Blindness, a writer and blog editor for VisionAware, and author of Making Life More Livable: Simple Adaptations for Living at Home After Vision Loss, relies heavily on andragogy in her work with vision-impaired adults. Loved ones — especially adult children of older people — have a tendency to push care and “help” on grown-ups as if they were children, she says. Not surprisingly, this method seldom works.

Using Andragogy to Help People with AMD

From her work as a certified vision-rehabilitation therapist (CVRT) and low-vision therapist (LVT), Duffy calls out three concepts of andragogy to keep in mind when trying to help an adult who is coping with vision loss:

1. Adults have life experience.
Children don’t have a lot of life experience. And while adults have an incredible amount of life experience, we don’t always treat them as if they do. They already know how to problem-solve. If they have been cooking for their entire lives, they don’t need to learn to learn how to cook all over again; they just need to make adaptations.

“We treat adults as if they have to forget everything they’ve learned, and try to teach them something new,” Duffy says. “That doesn’t usually work. I say, ‘Show me how you’ve always done this. There’s probably just a little adaptation you need to make, and you can keep doing things the way you’ve always done them.’ You can’t just go in, and tell someone you’re going to change everything they do. Just figure out an adaptation.”

2. Adults are reactive learners.
Children are ready to learn when they are told they are ready to learn: We send them to school, and they know it’s time to learn. Adults are ready to learn when they decide they need to know or do something to improve their daily lives — not before. You cannot make an adult learn until they are ready to learn. That’s a big difference.

“Adults tend not to say, ‘I’m going to learn this now because I might need it later.’ They say, ‘I have this problem right now; I need to learn this thing right now,’” Duffy says. “It’s common for family members to tell a person with macular degeneration, ‘You need to learn braille in preparation for when you go blind in the future.’ That’s not true. They can read larger and larger print for as long as they are able to do so. It creates additional anxiety to tell an adult they have to start now to prepare for when they can’t see. You can’t prepare for that. It’s a process, and you make changes as you go.”

Andragogy to Help People with AMD
3. Adults are self-directed.
Adults want to be independent and determine, for themselves, what it is they need to learn. And that won’t necessarily match what family members think or want.

“Adults will decide what they want to learn, usually based on a hierarchy of needs and what they really need to know now,” Duffy says. “That hierarchy starts with survival needs: making food, getting food, reading medications, etc. And the only way to know what an adult wants and needs to learn is to ask them.”

At the heart of andragogy, it seems, is respect for the fact that an adult is an adult — and should be treated as such. “Andragogy is more focused on teaching problem-solving skills, which can be used over and over again by the adult in a variety of situations,” Duffy says.

Another difference between the way children and adults learn is the need for adults to maintain a sense of autonomy, points out Judi Delgado, director of the Macular Degeneration Partnership (MDP). “People with AMD may need to adjust the way they do some things, but they can still do them,” she says. “It doesn’t help them if others try to take over or do things for them. It’s important to understand that the person is already losing so much; if loved ones try to take over their lives, it just adds to the loss of independence.”

9/10/15

 

Maureen Duffy, CVRTMaureen A. Duffy, CVRT, LVT
Social Media Specialist, visionaware.org
Associate Editor, Journal of Visual Impairment & Blindness
Adjunct Faculty, Salus University/College of Education and Rehabilitation