20 Tips For Cooking With Low Vision

10/21/14

People cook for different reasons. Some just so they can eat, others enjoy the creativity and find it relaxing and for some it is a activity they have fun doing with others. But cooking can become difficult and dangerous as you lose your vision. Here are some useful tips to help keep you safe and give you confidence to enjoy cooking with low vision.

Cooking with low vision
1. To avoid burns, place a pot or pan on the burner before turning it on and, turn the burner off before removing the pot or pan.

2. Turn pan handles inward from the stove or counter to avoid spills and burns.

3. Mark common or often used settings on appliances with bright nail polish, bright colored tape, or raised dots.

4. Purchase a microwave with a sensor reheat feature to automatically reheat food to the proper temperature.

5. Use long oven mitts to protect your hands and arms from hot surfaces.

6. Turn on the oven light while using it to remind you the oven is on.

7. Use a double spatula to help avoid spills when turning food.

8. Use a special measuring cup that enhances contrast.

9. Use a knife with an adjustable slicing guide.

10. Have light and dark cutting boards to be able to provide the most contrast depending on what you are slicing or chopping – such as black for slicing onions and white for chopping kale.

11. Use a large print, low-vision kitchen timer.

12. Use an automated coffee maker that makes a single cup of coffee or tea to eliminate the need to pour boiling liquids and risk burns.

13. Attach low-glare fluorescent lighting to the underside of cabinets to make it easier to see.

14. Outline the end of countertops with colored duct tape, or paint in a color that contrasts with the work surface. Also choose kitchenware that contrast with the countertop.

15. Organize shelves in a logical way, possibly alphabetically, with most use items easily accessible. Be sure to return items to where they were originally.

16. Use a color for the interior of cupboards that contrasts with your dishes to make them easier to see. Do not use clear glasses or dishes as they appear invisible.

17. If you have glaucoma and experience tunnel vision, remove cabinet doors or replace with sliding doors.

18. Place rubber bands around the milk carton to distinguish it from the orange juice carton. This also works well with distinguishing a can of chicken noodle soup from tomato, etc.

19. Avoid overflows by hooking a “liquid Level” indicator to your glass or cup that will play a tune when you are ¾” from the top.

20. For cold drinks you can also use your finger by placing the tip of it over the edge of the glass and stop pouring when you feel the liquid.

Once you have prepared your food, eating can also be a challenge, so here are five bonus tips.

1. Use dinner plates with a raised lip to avoid spills or pushing the food off while eating.

2. Avoid patterns on dinnerware.

3. Make sure your dishes contrast with the table or table linens.

4. Have a system for putting food on your plate such as meat at 6:00, vegetables at 3:00 and starches at 9:00.

5. Use a gooseneck lamp directly over you plate.

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development

Being A Blind Artist

10/14/14

One thing that was always nurtured in me as a child was art. My father was an architect, and my mother is an art-lover. I remember they would collect all my artwork from preschool and elementary school. I used to have trouble sleeping as a kid, so I started drawing on the wall next to my bed; it would comfort me until I fell asleep. Most parents would probably scold a kid for drawing on the wall, but my parents loved it! In fact, my father would bring his architect friends into the room to “see my daughter’s mural.” Art has always been one area where I don’t feel inadequate. Art is so subjective, and anything can be art, so there is no judgment, and it’s very liberating. I’ve done abstract painting, mosaic tile work, ceramics and, currently, sculpture.

Becoming a Blind Artist

When I became blind, maybe five or six years in, I started going to Braille Institute, and I rediscovered art as a blind person. I saw people there creating art, and I thought, “This is amazing.”
Kooshay scuplture - blind artist
I always wanted to learn how to sculpt, but every time I called art schools about classes, when I told them I’m blind, they told me I had to take private lessons. Fear came up, and they did not know where to put me. Finally, two years ago, I started taking private lessons. My first piece was a portrait of a man, and the school was so amazed, they not only offered to put me in the sculpting class, but they gave me a full scholarship.

My private-lesson teacher wasn’t even a sculptor; she was a painter, but she was so tickled by the idea of a blind person wanting to sculpt that she wanted to be involved. She was a true artist and wanted to try something new. It was a wonderful experience for both of us. My second teacher would blindfold herself to figure out how to teach me. She really went out of her way, and I learned some really great techniques. I started my current class, which is a figure-sculpting class, by sculpting shoes — I have a shoe fetish — but I starting getting jealous of everyone else sculpting figures. I can’t touch the naked models, so now I touch other people’s sculptures and use that as a study to make my own.

I love it. I love the feel of clay. I’m a very tactile person, and I love the sensation of it in my hands. It’s so malleable. I use my hands more than sighted people; I don’t really use tools. I need to feel the clay to shape it, and I think there’s more emotion involved for me. It’s me, the piece and nothing else. Maybe it’s because I can’t see it — it’s like a meditation for me. I get lost in my piece. There is so much emotion — that’s where I get my inspiration. It’s a way to fantasize or fulfill an emotion or need. For me, it’s more about the process — I don’t see the finished product. It’s a very fulfilling way of expressing myself that words can’t; it’s more about expressing what I feel.

Kooshay Malek - seeingKooshay Malek
Marriage and Family Therapist
Los Angeles

Lens Care If You Wear Contact Lenses and Use Cosmetics

9/23/14

In a continuation from his article on Proper Contact Lens Care, Mr. Ward, Director of the Emory Contact Lens Service, also offers tips if you wear contact lenses and use cosmetics. Several of these pointers apply even if you don’t wear contact lenses, but want to protect your eyes.you wear contact lenses and use cosmetics

The Bullet List of Contact Lens Care For Users Of Eye Area Cosmetics

    • If possible look for eye makeup specifically labeled for use by contact lens wearers; use premium products.
    • Apply eye area cosmetics after inserting contact lenses (this will help prevent cosmetic contamination of lens surfaces from handling of cosmetics).
    • Remove lenses before removing makeup.
    • Remove makeup daily with mild soap and water; do not use oil or petroleum based make up removers; specifically, avoid moisturizing bar soap and an eye makeup remover that contains mineral oil and cocoa butter.
    • Choose water based makeup; avoid any oil based, or ‘waterproof’ eye area products (oils will travel across the skin and contaminate the tear film).
    • Avoid ‘lash-extending’ mascaras with artificial fibers, and apply mascara only to the end of lashes; do not apply mascara to the base of the eyelash or on the eyelid margin.
    • Do not apply oil-based moisturizers on the eyelids (oils can spread on the skin).
    • Do not apply any makeup to the eyelid margin (shelf), between the eyelashes and the eyeball.
    • Apply face powders sparingly; use pressed powder instead of loose powder; try to stay away from the eye area as much as possible; avoid frosted.
    • Choose liquid or gel eye shadows rather than powders.
    • Use caution with hair styling sprays. If possible, spray aerosols with eyes closed and step back out of the mist before opening the eyes. These gel/wax/lacquer type sprays can significantly coat your contact lenses.
    • Replace eye makeup at least every three months; do not share cosmetics.
    • And, please note that an automobile’s rear view mirror is not intended for makeup application while driving.

    Michael Ward - proper contact lens careMichael A. Ward, MMSc, FAAO
    Director, Emory Contact Lens Service
    Emory University School of Medicine

Proper Contact Lens Care Provides Best Vision, Comfort and Ocular Health

9/18/14

Proper contact lens care is essential for the best contact lens wearing experience. Mr. Ward, Director of the Emory Contact Lens Service has shared some valuable information about taking care of your contact lens in the article below. On Tuesday join us for additional tips for people who wear contact lenses and wear cosmetics.contact lens case - proper contact lens care

Contact lenses provide alternatives to spectacles, and contact lens wearers report better peripheral vision, depth perception and overall vision quality. Contact lenses can correct near-sightedness, far-sightedness, astigmatism and even correct the need for reading glasses. They are also used to manage some ocular surface diseases.

Contact lenses fall into two basic material types: soft contact lenses (SCL) and rigid gas-permeable (GP) lenses. Soft lenses account for the great majority of the contact lens market. GP lenses require more precise fitting and are often used as specialty devices to correct high prescriptions and/or to manage various ocular disorders and may require longer lens-adaptation time. Regardless of lens type, careful attention to lens care instructions can provide good vision and life-long lens wearing comfort.
Proper lens care depends on the lens type, wearing schedule and other factors. Single-use or daily-disposable soft lenses are prescribed to be worn once and discarded. This is theoretically the safest lens wearing modality in that no lens cleaning, lens care or storage case is required for this modality. Other daily wear soft lenses may be replaced every 2 weeks, monthly or by other schedule. Any and all lenses that are removed each day must be cleaned and disinfected prior to their reuse. Your eye care practitioner should provide specific instructions relative to your lens wear and care needs. General lens care instructions and Dos and Don’ts are bullet-listed below.

A word of caution –
Contact lens wear is quite safe as long as proper lens and storage case care are followed. However, improper lens wear and care can put the lens wearer at risk for serious consequences. Sight-threatening microbial keratitis (corneal ulcer) is the most significant adverse event associated with contact lens wear and is largely preventable. The contact lens storage case is the most likely potential reservoir for contact lens related ocular infections. Therefore, lens storage case care should be high on the list of important lens wearing instructions. Contact lens cases are not meant to be family heirlooms; cases should be replaced regularly, at least every 1-3 months.

The Bullet List of Contact Lens Care Recommendations

  • Hand washing: Always wash your hands before handling contact lenses. Use mild, basic soap and avoid antibacterial, deodorant, fragranced or moisturizing liquid soaps (many liquid soaps have moisturizers that can contaminate your contacts from handling).
  • Cleaning, rinsing, and disinfecting: Digital cleaning (rubbing the lens with your finger in your palm) removes dirt and debris and prepares the lens surfaces for disinfection. Rub & rinse thoroughly, even if the product is labeled “No Rub”. Lens storage solutions contain chemicals that inhibit or kill potentially dangerous microorganisms while the lenses are soaked overnight.
    • Contact lenses should be cleaned when removed from the eye.
    • Do not re-use old solution or “top-off” the liquid in the lens storage case. Empty the storage case daily and always use fresh solution.
    • Do not use lens care products beyond their expiration dates. Discard opened bottles after 28 days.
    • Do not allow the tip of the solution bottle to come in contact with any surface, and keep the bottle tightly closed when not in use.
    • Do not transfer contact lens solution into smaller travel-size containers.
  • Keep your contact lens storage case clean (inside and out).
    • All lens storage cases should be emptied, rinsed, wiped, and air-dried between uses.
    • Keep the contact lens case clean and replace it regularly, every one to three months.
    • Do not use cracked or damaged lens storage cases.
    • Take care to remove residual solution from surfaces of lens case and solution bottles.

Other Dos and Don’ts

  • Do not wear your lenses during water activities (swimming, hot tubs, showering, etc).
  • Soft contact lenses should not be rinsed with or stored in water. Soft lenses will change size and shape if exposed to water.
  • Do not put your lenses in your mouth.
  • Do not use saline solution or re-wetting drops in an attempt to disinfect lenses. Neither is capable of disinfecting contact lenses.
  • Wear and replace contact lenses according to the prescribed schedule.
  • Follow the specific contact lens cleaning and storage guidelines from your eye care professional.
  • Do not change lens care products without first checking with your eye care practitioner.
  • Spare rigid (GP) lenses should be stored dry for long term storage { clean, rinse, dry}. New or dry-stored GP lenses should be re-cleaned and disinfected prior to lens wear.
  • Do not store soft lenses in the storage case for an extended period of time. “Spare” soft contact lenses should be new and stored in their original and unopened packaging.
  • Do not sleep in your contact lenses unless specifically approved to do so by your eye care practitioner.

For information from the Centers for Disease Control and Prevention, see:
www.cdc.gov/contactlenses/
www.cdc.gov/contactlenses/cdc-at-work.html

Michael Ward - proper contact lens careMichael A. Ward, MMSc, FAAO
Director, Emory Contact Lens Service
Emory University School of Medicine

 

How To Choose A Home Care Agency

7/31/14

When life changes due to vision loss, illness, accident or aging, it can be difficult to maintain your independence and personal care as you once did. Help with errands, grocery shopping, doctor’s appointments, personal care, medication reminders, meal preparation, laundry, housekeeping and more can relieve much of the stress you and your loved ones may be experiencing. Care provided by a qualified, professional home care agency can be the best option for many individuals and their families.
Caregiver for home care
But with so many aspects to consider, the task of selecting an agency to bring into your home can be daunting. So what should you look for and what questions should you ask when selecting a home care agency to provide services to you or your family?

Qualifications

  • Is the agency licensed by the state? Most states — but not all — require agencies to be licensed and reviewed regularly. Reviews may be available on request through your state health department. If your state is a non-licensure state (such as California), you will need to be more vigilant in screening potential agencies.
  • Does the agency meet federal requirements for health and safety with such things as OSHA, HIPAA, infection control, a disaster plan? If not, ask why.
  • What type of employee screening is done? To ensure caregivers are reliable and honest, drug and alcohol tests, extensive background checks, should be performed on all new hires and we are insured and bonded.
  • Are the caregivers experienced? The very best agencies hire experienced caregiver or have a Personal Care training program written by a Registered Nurse with extensive experience in home care and education.
  • Do the caregivers receive health, skill and competency testing? A good home care agency will test employees to assure their personal health, skills and capability. Standard testing should include competency testing, TB tests, pre-employment health screening and skills competency testing, and drug testing.

Quality of care

  • Does the agency value a caregiver bond? A great caregiver becomes part of the family, and a good company will recognize that and try to match you with one or more caregivers with a regular schedule to promote the development of this bond.
  • Does the agency provide training and continuing education? A quality home care company will provide an opportunity for continuing Personal Care training as well as specialized training in specialized areas such as dementia and Alzheimer care, chronic and acute illnesses, and best practices and procedures.
  • Is there supervision and unscheduled visits by the agency’s supervisor to evaluate the quality of home care? A good home care agency will provide supervisors or care coordinators who perform unscheduled supervision visits to help make sure that you are receiving the best care possible. The field nurse supervisor visit is also a good time to communicate any concerns you may find uncomfortable discussing with your caregiver.
  • As part of the agency’s quality assessment, do they have a client satisfaction survey system? For peace of mind you need an agency that has a process to know you are satisfied and keeps you and your family informed. Some agencies work with a third party to make calls to ensure your satisfaction with our caregivers and our agency. Caregivers should also be trained to alert family members regarding any changes or concerns regarding the client, in addition to responding to clients’ or family members’ concerns.
  • What happens if my caregiver does not show up? One of the most common problems that people have with the average home care agency is that the caregivers don’t show up. Choose an agency that has a system to handle the caregivers who cannot fill their shift such as incentives and/or pay bonuses for perfect attendance and have “on-call” caregivers.

Costs

  • How does the agency handle expenses and billing? Ask for literature explaining all services and fees, as well as detailed explanations of all the costs associated with home care.
  • Will agency fees be covered by health insurance or Medicare? Find out what arrangements are in place for specific health insurance plans. Although home care agencies do not bill Medicare there are many other insurances that will pay for service such as the Veteran’s Aid and Attendance, Long-term care insurance, Work Comp insurance and some traditional plans.

Understanding services

  • Will you receive a written care plan before service begins? The care plan should include details about medical equipment and specific care needs, contain input from your or your loved one’s doctor, and be updated frequently.
  • Will you receive a list of the rights and responsibilities of all parties involved? This is sometimes known as a client or patient’s bill of rights.
  • Will the agency work directly with you or your loved one, family members and health care providers? Look for a company that will coordinate your care with everyone involved.
  • When will service be provided? Is care available round-the-clock, if necessary? Care is provided to you as planned during your initial in-home visit from our Care Coordinator. The agency should be able to provide for 24 hour care either by shifts or a live in situation, if the setting is right.
  • What procedures are in place for emergencies? Ask how the agency or home health aide will deliver services in the event of a power failure or natural disaster. Your agency and caregivers should be prepared for emergencies and practice in ensure your and their safety.
  • How are problems addressed and resolved? Who can you or another family member contact with requests, questions or complaints? Ensure the agency provides you with contact information and that their phones are answered 24 hours every day!
  • When can services begin? A quality agency should work with you to create a schedule which will fit your needs and can be flexed if your family is in town or you go on vacation.

Monitor your home care services

After you’ve found a home care services provider, monitor the situation. If you’re concerned about the care or services provided, discuss it promptly with the agency. If necessary, involve your doctor or your loved one’s doctor as well.

Robert Mahoney - home careRobert Mahoney
Owner
First Light Home Care

Ways to Reduce the Harmful Effects of Sun Glare

During the height of summer sunshine (and heat!), it’s helpful to discuss the importance of eye protection, including ways to reduce the harmful effects of sun glare.

Fundamentally, we need light to see. Approximately 80% of all information we take in is received through the sense of sight. However, too much light – and the wrong kind of light – can create glare, which can affect our ability to take in information, analyze it, and make sense of our surroundings.

Facts about Sunlight

Every type of light has advantages and disadvantages, and sunlight is no exception:

Advantages:

• Sunlight is the best, most natural light for most daily living needs.
• Sunlight is continuous and full-spectrum: the sun’s energy at all wavelengths is equal and it contains all wavelengths of light (explained below).

Disadvantages:

• It is difficult to control the brightness and intensity of sunlight.
• Sunlight can create glare, which can be problematic for many people who have low vision.
• Sunlight is not always consistent or reliable, such as on cloudy or overcast days.

Visible Light and Light Rays

An important factor to consider is the measurement of visible light and light rays, beginning with the definition of a nanometer:

• A nanometer (nm) is the measurement of a wavelength of light.
• A wavelength is the distance between two successive wave crests or troughs:

Wavelength - glare

• A nanometer = 1/1,000,000,000 of a meter, or one-billionth of a meter. It’s very small!

The human visual system is not uniformly sensitive to all light rays. Visible light rays range from 400 nm (shorter, higher-energy wavelengths) ? 700 nm (longer, lower-energy wavelengths).
Visible Light Spectrum - glare
The visible light spectrum occupies just one portion of the electromagnetic spectrum, however:

• Below blue-violet (400 nm and below), is ultraviolet (UV) light.
• Above red (700 nm and above), is infrared (IR) light.
• Neither UV nor IR light is visible to the human eye.

Ultraviolet Light and Blue Light

Ultraviolet (UV) light has several components:

• Ultraviolet A, or UVA (320 nm to 400 nm): UVA rays age us.
• Ultraviolet B, or UVB (290 nm to 320 nm): UVB rays burn us.
• Ultraviolet C, or UVC (100 nm to 290 nm): UVC rays are filtered by the atmosphere before they reach us.

Blue light rays (400 nm to 470 nm) are adjacent to the invisible band of UV light rays:

• There is increasing evidence that blue light is harmful to the eye and can amplify damage to retinal cells.
• You can read more about the effects of blue light at Artificial Lighting and the Blue Light Hazard at Prevent Blindness.

A new study from the National Eye Institute confirms that sunlight can increase the risk of cataracts and establishes a link between ultraviolet (UV) rays and oxidative stress, the harmful chemical reactions that occur when cells consume oxygen and other fuels to produce energy.

Sunlight and Glare

Glare is light that does not help to create a clear image on the retina; instead, it has an adverse effect on visual comfort and clarity. Glare is sunlight that hinders instead of helps. There are two primary types of glare.

Disability glare

• Disability (or veiling) glare is sunlight that interferes with the clarity of a visual image and reduces contrast.
• Sources of disability glare include reflective surfaces (chrome fixtures, computer monitors, highly polished floors) and windows that are not covered with curtains or shades.

Discomfort glare

• Discomfort glare is sunlight that causes headaches and eye pain. It does not interfere with the clarity of a visual image.
• Sources of disability glare include the morning and evening positions of the sun; snow and ice; and large bodies of water, (including swimming pools).

Controlling Glare

You can protect your eyes from harmful sunlight and minimize the effects of glare by using a brimmed hat or visor in combination with absorptive lenses.

• Absorptive lenses are sunglasses that filter out ultraviolet and infrared light, reduce glare, and increase contrast. They are recommended for people who have low vision and are also helpful for people with regular vision.
• Lens colors include yellow, pink, plum, amber, green, gray, and brown. Ultra-dark lenses are not the only choice for sun protection.
• Lens tints in yellow or amber are recommended for controlling blue light.
NoIR Medical Technologies: NoIR (No Infra-Red) filters absorb UVA/UVB radiation and also offer IR light protection.
Solar Shields: Solar Shields absorb UVA/UVB radiation and are available in prescription lenses.
• You can find absorptive lenses at a specialty products store, an “aids and appliances store” at an agency for the visually impaired, or a low vision practice in your area. Before you purchase, it’s always best to try on several different tints and styles to determine what works best for you.

More Recommendations

• Always wear sunglasses outside, and make sure they conform to current UVA/UVB standards.
• Be aware that UV and blue light are still present even when it is cloudy or overcast.
• Make sure that children and older family members are always protected with UVA/UVB-blocking sunglasses and brimmed hats or visors.

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

Caitlin Hernandez – Blind Actress and Playwright

7/8/14

Being a blind actress is many things: challenging and rewarding, cathartic and uplifting, fun and freeing. What most people don’t realize is that blindness, in and of itself, requires us to be actors every day. Of course, this is true of anyone and everyone, blind or not. We all wear masks, conceal truths, profess to feel things we don’t. But with a trait like blindness– something obvious and visible, which douses us daily in an eternal, inextinguishable spotlight — the play-acting invariably becomes more complex. Striving, constantly, to put others at ease, regardless of our own state-of-being, is an exhausting side-effect of blindness which few people recognize. In some ways, blind people are more accustomed to the pressures of acting than many sighted person will ever be.
Caitlin - blind actress
If I could grant anyone with special needs one wish, it would be the chance to be part of a company like CRE Outreach. For me, CRE’s magic comes in two forms. First, there’s the singular sensitivity of the sighted members of CRE: the directors, the assistants, the sighted actors who join us on certain projects, the audience members who have attended so many of our shows that they’ve learned about blindness by osmosis. Back home, as I catch my breath between answering the public’s questions and negotiating the logistics of graduate school as the only totally blind student in my program, I replay each little L.A. moment. The guiding hands and detailed explanations, so much more beneficial than the ever-present, ineffectual pointing, gesturing, and “over theres” which the rest of the world uses in abundance. The implementation of sound cues–taps on chairs, doorways, and obstacles in our paths–which become second-nature to those who know us best. The easy way we walk together. The empathy that only develops when a sighted person makes the choice to truly live blindness alongside us, even when it’s hard. And, always, always, the way they’re able to open their eyes wide enough to let us see, too.
Caitlin at piano - blind actress
Alongside our sighted compatriots, our “honorary blind people,” as we affectionately call those of the CRE contingent who can see, we’re a team of blind actors. The blind cast members are different ages and backgrounds; we have different levels of vision, different pasts, different families, different lives, different dreams. But being visually impaired binds us inextricably, regardless of our stories. We’ve all lived through those ups and downs of blindness that can sometimes feel so overwhelmingly difficult to share or explain.

CRE casts never leave shows and move on. Contact remains constant, through phone calls and texts and e-mails, voice-chatting and video-chatting and Braille letters, playing and replaying treasured recordings of the laughs, the triumphs, the moments of growth and change. It’s about so much more than putting on a show. When the curtains part on opening night, our plays almost feel like bonuses: beautiful things we were able to produce as a team, chiefly because we’re so deeply invested in this family we’ve created along the way.

Caitlin Headshot copy revCaitlin Hernandez
CRE Outreach
Actress and Playwright

Food for Thought . . .

6/26/14

Can dinner really be delicious medicine for our eyes?

Recent studies have shown compelling evidence that specific nutrients support eye health.* When a vitamin or mineral is given as a supplement, are there the supporting micronutrients and enzymes required for optimal utilization of that supplement by our bodies? Is a nutrient more bioavailable and/or more beneficial to our health as a foodstuff than as a supplement? Are there unintended effects from supplements that are not present when the nutrient is derived from a food source?**

Visionary Kitchen - nutrients
Despite the many thought provoking questions, I personally take supplements as I feel it is difficult to acquire the nutrients strictly through food. Dietary preferences and requirements influence our everyday food choices as well as the quality of food available at our local grocery stores. Thoughtfully designed, well-sourced supplements have been shown to enhance eye health and general well being.
Here are some key nutritional principles which should be kept in mind to maximize the nutrient availability to our eyes and bodies from the foods that we eat:

1. Bioavailability: Vitamins A, D, E and K are fat soluble; the vitamin B-complex and vitamin C are water soluble. Dietary fats aid in the transport of fat soluble vitamins. Of particular importance to eye health are the fat soluble carotenoids in the vitamin A family, lutein and zeaxanthin. Carotenoids are the red, orange and yellow pigments found in fruit and vegetables such as kale, spinach, corn, apricots and orange bell peppers. To maximize their nutritional benefit, combine foods rich in carotenoids with a healthy source of fat such as olive oil, avocados or walnuts. Egg yolk contains the most bioavailable source of lutein and zeaxanthin and is preferentially deposited in the macula.

2. Nutrient Synergy: Nutrient synergy is the interaction of two or more nutrients that work together to achieve a greater effect than a single nutrient alone could. Foods have a vast array of micronutrients. We know that spinach contains a high level of lutein; however, we don’t know precisely how all the nutrients in spinach work together to promote eye health. Epidemiological studies show people who eat spinach have a lower risk for developing Age-related Macular Degeneration (AMD). Levels of lutein and zeaxanthin in the macula can be measured and low levels are a predictor for the risk of developing AMD.

3. Growing and Feeding Practices: The growing and feeding practices of the agriculture industry affect the nutrient profile and nutrient density of our food. Grass-fed versus corn-based animal husbandry, and wild versus farm-raised fish, alters the fatty acid profile. The amount of omega-3 fatty acids found in eggs varies depending upon the chicken’s diet. Ketchup from organically grown tomatoes contains nearly 50% more lycopene than from conventionally grown tomatoes. Choose quality ingredients whenever possible.

4. Cooking Techniques: Steaming, sautéing or pureeing will break down the plant cell walls increasing the body’s access to the lutein found in dark leafy greens. Cooking tomatoes will increase the availability of lycopene. Heat, however, diminishes the amount of vitamin C present. To maximize lutein and vitamin C, consume both fresh and cooked vegetable sources. Excessive heat and lengthy cooking times diminish vitamin content (mineral content will remain intact, however).

5. Whole Foods: Whole foods have benefits such as soluble and insoluble fiber which help to regulate blood sugar. Foods high in fiber have been shown to decrease total cholesterol, triglycerides and VLDL levels. Fiber supports gut health which is integral to nutrient absorption.

6. Select Eye Nutrient Dense Foods: Studies have highlighted lutein+zeaxanthin, the omega-3 fatty acids balanced with omega-6 fatty acids, the vitamin A family, the antioxidant vitamins C and E, as well as the mineral zinc. There a number of other nutrients that play a role in eye health including B vitamins, selenium and other plant based antioxidants. Knowing the food sources of these important nutrients will help you to make better food choices for eye health.

How does this sound for dinner tonight? Grilled wild salmon on a bed of lightly sautéed spinach with caramelized onions!

* AREDS 1, 2; LAST: Lutein Antioxidant Supplement Trial; ZVF: Zeaxanthin and Visual Function
** CARET: Carotene and Retinal Efficacy Trial

author-portraitSandra Young, OD
Author of the award winning Visionary Kitchen: A Cookbook for Eye Health
www.visionarykitchen.com

Books About Age-Related Macular Degeneration

6/24/14

Judi Delgado, the executive director of the Macular Degeneration Partnership, is often asked to recommend books about age-related macular degeneration (AMD). People who have been newly diagnosed, along with their family members, are interested to learn about what they can do to save their sight, how the eye disease might progress, and personal experiences from others that have the disease. Here is a list of books about age-related macular degeneration that Judi has put together, including authors, links to Amazon, and the available formats for each title.books about age-related macular degeneration

Books About Age-Related Macular Degeneration

By Doctors:

Macular Degeneration: The Complete Guide to Saving and Maximizing Your Sight
by Lylas G. Mogk and Marja Mogk
Paperback, Nook and Kindle

Macular Degeneration: From Diagnosis to Treatment
by David S. Boyer MD, Homayoun Tabandeh MD
Paperback, Nook and Kindle

By Patients:

The First Year: Age-Related Macular Degeneration:  An Essential Guide for the Newly Diagnosed
by Daniel L. Roberts
Paperback, Large Print and Kindle

Out of Sight, Not Out of Mind: Personal and Professional Perspectives on Age-Related Macular Degeneration
by Lindy Bergman, The Chicago Lighthouse, Jennifer E. Miller
Paperback, Nook and Kindle

Living With Macular Degeneration: What Your Doctors Cannot Tell You
by Edgar C Craddick, Benjamin Joel Michaelis
Paperback, Large Print and Kindle

Twilight: Losing Sight, Gaining Insight
by Henry Grunwald
Hardcover, Paperback, Audio Cassette, Audible, Nook and Kindle

Sunset…A Macular Journey
by F. Leroy Garrabrant
Paperback

Macular Disease: Practical Strategies for Living with Vision Loss
by Peggy R. Wolfe
Paperback, Large Print

Overcoming Macular Degeneration: A Guide to Seeing Beyond the Clouds
By Yale Solomon MD, J.D. Solomon
Paperback and Kindle

Macular Degeneration: Living Positively with Vision Loss
by Betty Wason, James J. McMillan
Hardcover and Paperback

We hope you will find this list useful and share it with people you know dealing with AMD. Also, if you know any books you think others might enjoy, please list them in our comments section.

Judi Delgado - age-related macular degenerationJudith Delgado
Executive Director
Macular Degeneration Partnership
A Program of Discovery Eye Foundation

Unleash the Power of Age

5/29/14

Employment Challenges Faced by Older Persons with Visual Impairments


Growth in Number of Older Persons with Vision Loss
May is designated as “Older Americans Month” and last year’s theme “Unleash the Power of Age” seemed an appropriate title for this article with the number of baby boomers who are coming down the pike. In fact, according to the U. S. Bureau of Labor Statistics, the annual growth rate of “boomers” (those 55 and older) is projected to be 4.1 percent, 4 times the rate of growth of the overall labor force. Indeed, the Governmental Accountability Office estimates that by 2015 (just next year!!), older workers will comprise one-fifth of the nation’s workforce.
man at computer
At the same time, the number of older persons with vision loss are growing dramatically due to age-related eye conditions such as macular degeneration . The 2011 National Health Interview Survey (NHIS) Preliminary Report indicated that an estimated 21.2 million adult Americans (or more than 10% of all adult Americans) reported they either “have trouble” seeing, even when wearing glasses or contact lenses, or that they are blind or unable to see at all. The survey also indicated that 12.2% of Americans 65 to 74 years of age and 15.2% of Americans 75 years of age report having loss of vision. These estimates only include the non-institutionalized civilian population.

Economic Burden of Vision Loss and Aging
According to Prevent Blindness, disorders of the eye and resulting vision loss result in a major economic burden to society, for all ages, but most dramatically with people 65 years of age and older: 77.27 billion of direct and indirect costs . Loss of productivity is estimated to be almost $25 billion for the 65 plus population.

Older People Want to Continue to Work
The loss of productivity costs are of particular concern given the fact that older people, including those with vision loss, want to continue to work. In fact, older persons are staying in the labor market beyond the usual retirement age. This is due to many reasons: people are living longer and often are in good health; because of the downturn in the economy, some need to work beyond the usual retirement age to meet to supplement diminished retirement funds; and some are looking for social engagement through the workplace.

Assets Versus Perceptions
Experienced workers who are older offer many assets to employers such as: an understanding of the expectations of employers; respect for co-workers and supervisors; loyalty; and skills and knowledge based on prior work experience. However, a major dichotomy is occurring in our society regarding older workers: “…companies are struggling with the large numbers of older workers who are retiring, and that the brain drain is a matter of concern to many…While the loss of experienced staff is a challenge that all companies must address, technology has improved the workplace and the work environment by enabling workers of all ages to complete work from other locations…Evidence shows that ageism, stereotypes, and misinformation about mature persons continue to be issues across all segments of society, including the workplace. … studies revealed that the positive perceptions characteristic of older workers held by managers include their experience, knowledge, work habits, attitudes, commitment to quality, loyalty, punctuality, even-temperedness, and respect for authority. These same studies also reveal some negative perceptions held by managers about the mature worker: inflexibility, unwillingness or inability to adapt to new technology, lack of aggression, resistance to change, complacency….. While the results of these findings may appear confusing or contradictory, they clearly focus on the precise and delicate balance between positive and negative perceptions that, depending on the industry or work environment, may affect a manager’s decision to hire, retain or advance an older worker.”

Kathy Martinez, Assistant Secretary of the Office of Disability Employment Policy at the Department of Labor, feels that this dichotomy, as it relates to people with disabilities, will not really change until disability becomes more of an environmental issue than a personal issue and that workplace flexibility is critical in terms of time, place, and task. (“Public Policy and Disability: A Conversation about Impact”, Disability Management Employment Coalition conference, April 1, 2014).

Challenges of Obtaining and Retaining a Job for Older Persons with Vision Loss
In addition to the negative perceptions noted above, older persons who experience vision loss, have additional challenges: learning to live with vision loss, dealing with the workplace to retain or obtain a job, working with a disability including having to learn new skills such as speech access for a computer, getting transportation to and from work (if they keep or land a job), dealing with co-workers and even managers who often don’t know what to say or do. Those persons with low vision or no vision whose medical condition is stabilized and with appropriate reasonable accommodations as assured by the Americans with Disability Act (ADA), can continue to be productive members of the workforce thereby contributing to the profitability of the business and to their quality of life.

An informal review of the latest available data submitted by public vocational rehabilitation agencies indicates the following: In 2011, there were 9609 blind and visually impaired individuals who obtained jobs through the vocational rehabilitation agencies; of these 505 (or 5%), were 65 years of age and older. We truly need to “unleash” the power of age in this country!

Resources
These resources listed can help older individuals with vision loss, employers, and professionals working with individuals with vision loss. The American Foundation for the Blind (AFB) hosts a family of web sites with information that can help older persons with adjusting to and living with vision loss, information on how to find and apply for jobs, adaptations to the work environment and assistive technology and workplace accommodations, and mentors who are blind or visually impaired and are willing to assist others with career choices. These sites can help individuals interested in working or retaining employment as well as employers seeking to know what to do. AFB has a directory of services for each state, which includes state vocational rehabilitation agencies charged with helping people with vision loss with the adjustment and career needs.

AFB Links
Information related to living with vision loss:
Visionaware.org/gettingstarted
Information about working:
Visionaware.org/work
AFB.org/careerconnect
Data base on how to find public and private agencies:
AFB.org/directory
Online courses including “Employment of Older Persons”, technology, etc. (for professionals):
Elearn.afb.org

Other Resources
Department of Labor funded Job Accommodations Network
http://askjan.org/
JAN provides consultation to employers and job seekers about the wide range of accommodations which can help to select the appropriate technology and job restructuring accommodations.
Department of Labor Office of Disability Policy
http://www.dol.gov/odep/topics/OlderWorkers.htm
Section on research and reports on employment of older workers.

Gil JohnsonGil Johnson
Contributing author to VisionAware ™
American Foundation for the Blind