Vision Recap Of Previous Articles of Interest

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

Jullia A. Rosdahl, MD, PhD – Coffee and Glaucoma and Taking Control of Glaucoma

David Liao, MD, PhD – What Are A Macular Pucker and Macular Hole?

Kooshay Malek – Being A Blind Artist

Dan Roberts – 15 Things Doctors Might Like Us To Know

Jennifer Villeneuve – Living With KC Isn’t Easy

Daniel D. Esmaili, MD – Posterior Vitreous Detachment

Donna Cole – Living With Dry Age-Related Macular Degeneration

Pouya N. Dayani, MD – Diabetes And The Potential For Diabetic Retinopathy

Robin Heinz Bratslavsky – Adjustments Can Help With Depression

Judith Delgado – Drugs to Treat Dry AMD and Inflammation

Kate Streit – Hadley’s Online Education for the Blind and Visually Impaired

Catherine Warren, RN – Can Keratoconus Progression Be Predicted?

Richard H. Roe, MD, MHS – Uveitis Explained

Sumit (Sam) Garg, MD – Cataract Surgery and Keratoconus

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

Gerry Trickle – Imagination and KC

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

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

6/23/15


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

Coping With Retinitis Pigmentosa

Tribulations, Travels and Tennis Balls

Linda Becker stopped playing tennis at night because she couldn’t see the balls coming at her. “Coincidentally, I saw something about night blindness on TV, so I went to my optometrist,” Becker says. He confirmed she had night blindness and sent her for more testing. An ophthalmologist told her: “I’m sorry, but you have retinis pigmentosa, and you’ll be blind some day.”
Linda Becker - coping with retinitis pigmentosa
“As a young mother, I couldn’t wrap my head around that,” Becker says. So she entered a decade of denial until she started to sideswipe other cars while driving. “I drove into my development one day, and there was a thump over the hood of my car. I thought, ‘Oh my god, what did I do? Did I kill somebody?’ I pulled over, and a police officer who happened to be driving behind me came over to my window. I was devastated. I said, ‘What have I done?’ He told me a jogger who wasn’t paying attention had tripped over the hood of my car. But I knew if I could have seen better, I would have stopped. That was the day I put my car keys down.”

Coping with Retinitis Pigmentosa

Encouraged by her kids to get a guide dog, Becker called Guide Dogs for the Blind (GDB). She learned she needed orientation and mobility (O&M) skills, including knowing how to walk with a white cane, before she could be considered for a dog.

“I called the Braille Institute, and it was daunting, to say the least: Thinking about walking with a white cane, having people know I’m blind and feeling disabled. Going through that whole transition — I didn’t want to even face it,” she recalls. “But I went, and I took classes, until I knew it was time for me to have a guide dog. I’ve always been a dog person, and I’d rather use my dog as a mobility tool than a cane. Plus, I wanted the companionship.”

She successfully completed the GDB requirement of walking one mile to and from her home with the cane. She then completed two weeks of on-site training at GDB’s campus in Oregon, where she was paired with Lyla, a yellow English Lab.

Becker started teaching classes at the Braille Institute and helping others navigate their vision-loss transition. She teaches a 14-week sensory-awareness class. “It helps develop and educate your other senses when you start losing your sight,” she says. “It humbles me. I have no sight now. My transition of going to the Braille Institute, learning to use a white cane, then learning to have a guide dog, taught me a whole lot about myself and feeling very independent. I was able to speak about guide dogs and speak about blindness — and be a teacher.”

She became an outreach ambassador for the Braille Institute, facilitating low-vision support groups throughout Orange County, Calif. She also went to work for GDB as an alumni-outreach representative, putting together workshops and helping people learn about the “guide-dog lifestyle.”

Now 66 years old, Becker finds the most enjoyment in traveling. “Being with a guide dog and in the blindness community took me places,” she says. “I was asked to be a keynote speaker here or an ambassador there. I’d never done that type of thing before, and I’d never traveled much. I just kept hopping on airplanes with my guide dog and going to hotels and trying to figure things out. I ask questions and collect tips, so I can share with others how easy it can be to travel with or without usable sight. It is really exciting, and I’m really driven to go different places.”

Since Lyla’s retirement, Becker travels regularly with her guide dog, Anchorage, a yellow lab. “He gives me courage,” she says. The pair is currently planning a trip to Australia and New Zealand. Becker is no longer daunted by learning new skills, exploring new places or even flying tennis balls — Anchorage is quite happy to deal with those when he is off-duty.

For more on traveling with guide dogs, including Becker’s adventures with Lyla and Anchorage, read “Traveling Tails”.

5/26/15


LH1_RESCANLauren Hauptman
Lauren Hauptman INK

Living Well With Low Vision Online Courses

As of May 5th, 10 new audio lessons offering tips and techniques for living well with low vision are now available as part of the newly-launched Low Vision Focus @ Hadley (LVF). These low vision online courses offer practical knowledge to make life easier.
low vision online courses
Low vision is defined by having significant difficulty seeing even after one’s vision is corrected with eyeglasses, contact lenses, surgery or medicine. Some typical symptoms of low vision include dimness, haziness, and having difficulty recognizing faces, reading labels and safely moving around. Low vision can make everyday tasks like reading the mail, shopping, cooking and paying the bills difficult. According to 2010 research by the National Eye Institute, the number of Americans with low vision will continue to grow dramatically, from 2.9 million in 2010, to 5 million in 2030, to 8.9 million in 2050, as our population ages. One out of every six older adults will experience age-related vision loss due to conditions such as macular degeneration, glaucoma or diabetes.

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

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

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

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

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

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

5/21/15


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

Must Love Dogs

Traveling with Guide Dogs

Adam Lawrence was diagnosed with retinitis pigmentosa (RP) when he was 17, but the disease did not have a profound effect on his life until his early 40s. “I sometimes had trouble with bright sunlight during the day, but I dealt with it by wearing dark sunglasses. Then one morning, I woke up, and it was like I was staring through a haze of pepper,” he says.

traveling with guide dogs
Adam with his guide dog, Escort

Lawrence gave up his job in the banking industry, as he could no longer see the contracts he needed to review. “I had to stop working and driving, and I had to figure out how to adapt,” he recalls. “I was great at organization, so my job became running the house, while my wife went to work. I got a scanner and a JAWS (Job Access With Speech) screen-reader for my computer, and I learned to read Braille.”

Lawrence is now legally blind, and his RP had another profound affect on his life about seven years ago, when he and his wife encountered Guide Dogs of America (GDA) at a fundraising event.

“I didn’t plan to get a guide dog, but they had a chocolate Lab puppy on the table” he says with a smile. “They put my hand on the puppy, and there was no turning back.”

Lawrence went through an interview and then an intensive 28-day on-site orientation program at GDA’s school in Sylmar, Calif. He was paired with a black and tan Labrador named Escort — also known as “the greatest dog in the world.”

With Escort, Lawrence feels a sureness and freedom he never experienced with other mobility tools. “When I walk with a cane, I don’t feel as confident, and I’m much slower. He gives me confidence, mobility and ability.”

Now in their sixth year as a team, Lawrence and Escort are virtually inseparable. They even shop together: “A person in the market takes our list, then Escort and I follow them around the store.”

They also travel extensively and have been everywhere from Mexico to New England to Colorado, where they went rock-climbing. “On the way down, Escort chose the more difficult path for himself, and left the easier path for me. He’s amazing,” Lawrence says.

Lawrence is quick to point out that “Escort is not a GPS. I have to plan and know where we are going. He’s there to keep me safe; he’s not there to figure out where to go — that’s my job.”

For more on traveling with guide dogs, including Lawrence’s adventures with Escort, read “Traveling Tails”, an article from our most recent e-newsletter.

5/19/15


LH1_RESCANLauren Hauptman
Lauren Hauptman INK

Traveling With Low Or No Vision

What Good is Sitting Alone in Your Room?

Traveling with low or no vision

There is a whole world out there to discover — regardless of whether you can see it all with your eyes. No one will tell you traveling with low or no vision does not present challenges, but there are precious few that cannot be overcome with planning, creativity and patience.
Traveling with low or no vision
A plethora of for-profit and nonprofit companies exist to help you navigate the complexities of traveling with a vision disability — from technology and websites, to travel agents and tour operators. And don’t overlook helpful — and free! — resources such as your friends and family, assistance pets and even complete strangers.

Travel Tools
Everyday tools become even more essential when you are traveling in unfamiliar surroundings. A mobility cane (consider a small travel version) will let you find your way more easily — and notify others of your vision issues. This is especially helpful for two reasons: Strangers are less likely to get in your way and more likely to help if you ask for it. In a recent DEF blog post (“Visual Aids and Techniques When Traveling”

Linda Becker, who has retinitis pigmentosa (RP) and travels primarily with her guide dog, is planning her next trip to Australia and New Zealand with Mind’s Eye Travel, a company that specializes in creating tours especially for people who are blind or visually impaired, as well as providing sighted guides. There are many such companies that will assist you with all facets of travel, from immigration documents to reservations to tour guides. Traveleyes offers discounts to sighted travelers in exchange for helping guide non-sighted travelers during group vacations around the world. DisabledTravelers.com is a good resource for companies that specialize in travel for people with accessibility issues. It includes reviews and recommendations on everything from airlines and cruises, to travel agents and hotels.

Plan, Prep, Pack
Ask any experienced low-vision traveler, and they will tell you planning, planning and more planning is the key to successful travel. Not only will it make your trip go more smoothly, it will give you peace of mind, as well as the ability to relax and enjoy yourself. The fewer surprises, the more confident and comfortable you will feel. And if something does goes awry, it is easier “go with the flow,” because everything else has been planned.

Right at the top of the list with planning is, well, making a list. Prepare a list of all the items you will need, then double it. That means if you wear contact lenses, pack at least one extra pair, as well as cleaning solutions. Same goes for glasses and sunglasses. Make sure you have plenty of the medications and other supplies you use on a day-to-day basis. Most seasoned travelers suggest you have multiples of all these stashed in different bags: your carry-on, your suitcase and a handbag of some kind that never leaves your side. This way, if one bag gets lost, you still have another one or two. Sample sizes may become your best friend!

Carolyn Hammett, an accomplished photographer and world traveler who has keratoconus (KC), advises: “Be prepared; having backups makes you more comfortable. Be ready to change contact lenses in public restroom if you need to. Have one of everything you need, vision-wise, with you at all times.” To learn more about Hammett and see what she packs for a two-week trip, see “Through a Lens with One Eye Blind,” a story from our recent e-newsletter focused on travel experiences and tips.

“Leave extra time, notify airlines or others in advance that you may need assistance, and don’t be afraid to ask for help,” says Adam Lawrence, who also has RP and travels regularly with his guide dog. (Read more about traveling with guide dogs in “Traveling Tails”, from an article in our recent e-newsletter.

Speaking of help, don’t forget the helper sitting next to you right now, whether it’s a spouse, a friend or a guide dog. Traveling alone can be vexing for people with full vision, so it’s natural for those with low vision to feel even more anxiety.

Dame Judi Dench, who has age-related macular degeneration (AMD), recently told Radio Times she no longer travels alone. “I need someone to say, ‘Look out, there’s a step here!’ or else I fall all over the place like a mad, drunk lady,” she said.

“Don’t travel by yourself the first time — go with someone you trust, and let them know how much help you want,” Hammett says. “I’ve gotten to the point where I tell my husband, ‘Don’t tell me anything until I screw up.’”

With planning, preparation and practice, you may get to a point where you feel comfortable traveling alone. You will only know your limitations if you try to stretch them.

“Just try,” Hammett says. “Do it once to find out if you can.”

Additional Resources

Access-Able Travel Source’s “Travel Tips for People Who are Blind or Visually Impaired”

Society for Accessible Travel & Hospitality

Transportation Security Administration’s “Passengers Who Are Blind or Have Low Vision”

5/14/15

LH1_RESCANLauren Hauptman
Lauren Hauptman INK

Famous People with Vision Loss – Part II

Here is part two of our look at famous people with vision loss. The focus this time is the creative minds of artists, actors and musicians.

Artists

Georgia O’Keeffe (1887-1986) – Best known for her paintings of enlarged flowers, New York skyscrapers, and New Mexico landscapes, she was recognized as the “Mother of American modernism”. In 1972, O’Keeffe’s eyesight was compromised by age-related macular degeneration (AMD), leading to the loss of central vision and leaving her with only peripheral vision. She stopped oil painting without assistance in 1972, but continued working in pencil and charcoal until 1984.

Claude Monet (1840-1926) – A French impressionist painter who had cataracts that blurred his vision and caused a severe loss of color perception. After complaining about his cataracts for ten years, he had cataract surgery in 1923. Those paintings before the surgery have more of a reddish tone, while those painted before his cataracts and after the surgery show more blue tones.

Edgar Degas (1834-1917) – A French artist known for his paintings, sculptures, prints, and drawings. He had a chronic and progressive retinal disease that made him sensitive to light and caused him to lose his central vision. Frustrated by these limitations he switched to oil pastels because less precision was needed. He finally resorted to sculpting to be able to utilize his sense of touch and feeling in order to continue to create art.

Actors

Johnny Depp (1963-) – Known for his many movie roles, Depp doesn’t let his vision loss stop his career. Besides correcting his blurred vision, the tinted lenses of the glasses he wears also help with Meares-Irien ‘visual stress’ syndrome, which causes dizziness, discomfort and eye pain. He is also nearly blind in his left eye.

Issac Lidsky (1979-) – A child actor known for his part in the Saved by the Bell: The New Class TV series, he was diagnosed with retinitis pigmentosa (RP) at 13 and was completely blind by 25 years of age. He changed the course of his career, becoming a lawyer. He was a law clerk for Justices Sandra Day O’Connor and Ruth Bader Ginsburg in 2008-09, making him the the first blind US Supreme Court clerk.

Jon Weller (1975-) – A TV actor who has performed on many shows, he is best known for his recurring role of toxicologist Henry Andrews on CSI: Crime Scene Investigation. He has been diagnosed with RP.

Dame Judith Dench (1934-) – A actress has had a long career in theater and film, receiving many awards including ten BAFTAs, six Olivier Awards, two Screen Actors Guild Awards, two Golden Globes, an Academy Award, and a Tony Award. She is well-known for the part of M in the James Bond series of films. In 2012 She announced that she has age-related macular degeneration (AMD), but has no intentions of slowing down. Scripts are now provided to her in a larger font.

Musicians

Ray Charles (1930-2004) – He was born with congenital glaucoma which resulted in blindness by the age of 7. This American singer, songwriter, musician and composer, received multiple Grammys, was inducted into the Rock and Roll Hall of Fame and a Kennedy Centers Honoree.

Stevie Wonder (1950-) – He is a singer-songwriter, multi-instrumentalist and record producer who signed with Motown Records at the age of 12. He has won 25 Grammys and received the Grammy Lifetime Achievement Award. He is blind due to retinopathy of prematurity due to excessive oxygen in his incubator when he was born.

Andrea Bocelli (1958-) – An Italian classical tenor, he was born with congenital glaucoma, but lost his vision at the age of 12 following a soccer accident in which he was hit in the head. He started playing piano when he was six, also learning the saxophone and flute. Bocelli has recorded fourteen solo studio albums, of both pop and classical music, three greatest hits albums, and nine complete operas, selling over 75 million records worldwide, making him one of the best-selling music artists of all time.

Ella Fitzgerald (1917-1996) – An American jazz singer often referred to as the First Lady of Song. She also appeared on TV and in movies. She won 14 Grammy Awards, National Medal of Arts and the Presidential Medal of Freedom. She was diagnosed later in life with diabetic retinopathy due to her advanced diabetes, which also cost her both legs.

Do you know of any creative famous people You could add to this list? Please share them below in the comments.

4/30/15

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

Famous People with Vision Loss – Part I

With all the recent news about Rosanne Barr’s vision loss due to age-related macular degeneration (AMD) and glaucoma, I thought it would be interesting to see other famous people with vision loss who didn’t let it stop their impact on the world around them. Today’s post will focus on writers, politicians, business and military leaders, scientists. Thursday we will explore artists, actors and musicians.

Authors

Harper Lee (1926-) – Best known for her 1960 Pulitzer Prize winning book To Kill a Mockingbird, she has been diagnosed with AMD. Her second novel, Go Set a Watchman, which was actually written before To Kill a Mockingbird, will be published this July.

John Milton (1608-1674) – English poet who wrote the poem Paradise Lost, among others, and became blind at the age of 43.

Alice Walker (1944-) – American author and activist who wrote The Color Purple which won the Pulitzer Prize and the National Book Award in 1983. She was blinded in one eye as a child when shot with a BB gun.

Joseph Pulitzer (1847-1911) – American newspaper publisher who established the prestigious journalism award, the Pulitzer Prize. He became blind at the age of 42 due to a retinal detachment.

James Thurber (1894-1961) – American humorist who switched his attention from sports to writing when his brother shot him in the eye with an arrow while recreating the legend of William Tell shooting the apple off his son’s head.

James Joyce (1882-1941) – Irish novelist and poet who had numerous eye surgeries for various conditions starting with iritis.

Stephen King (1947-) – American author of contemporary horror, supernatural fiction, suspense, science fiction, and fantasy. He has been diagnosed with AMD.

Leaders

Horatio Nelson (1758-1805) – British naval admiral lost an eye as a young seaman. He was said to have used this to his advantage by raising his telescope to his blind and then claim not to see the flags of surrender being raised by enemy ships.

Thomas Gore (1870-1949) – Blinded as a child, he became the first senator from Oklahoma and the first blind member of the US Senate.

Steve Wynn (1942-) – A well-known business leader having helped build up Las Vegas, and the owner of The Wynn and The Encore resorts, he was diagnosed with retinitis pigmentosa in 1971 and declared legally blind in 2010.

David Alexander Paterson (1954-) – He was the first African American Governor of New York and the second legally blind governor of any state, after Bob Riley of Arkansas. Paterson became blind at the age of three months when an ear infection spread to his optic nerve.

Willie Brown (1934-) – He spent over 30 years in the California State Assembly and served as the first African American Mayor of San Francisco for eight years. He has retinitis pigmentosa.

Hellen Keller (1880-1968) – She was an American activist, lecturer and author. She was the first deaf/blind person to graduate from college. At the age of 19 months she came down with infection that left her deaf and blind. She inspired the Lions Clubs International to become “knight of the blind,” leading them to focus their community service efforts toward vision-related causes.

Science & Medicine

Dr. Jacob Bolotin (1888-1961) – Was the first congenitally blind person to receive a medical license. This Chicago physician’s specialties were diseases of the heart and lungs.

John Glenn (1921-) – He was the first man to orbit the earth in 1963 on the Friendship 7 mission. He suffers from glaucoma.

Joseph Plateau (1801-1883) – Belgian physicist who invented an early stroboscopic device, the phenakistiscope, in 1836 that allowed still images to create an animated effect. It eventually led to the development of cinema. He performed an experiment in which he gazed directly into the sun for 25 seconds, leading to his eventual blindness.

Join us next Tuesday for part two.

4/28/15

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

Driving and Age-Related Macular Degeneration

Driving and Age-Related Macular Degeneration

The issue of driving and age-related macular degeneration is a particularly sensitive one for seniors losing their vision. Driving means independence and most people want to hold on to their cars as long as possible. When is it time to stop?
Driving and Age-related Macular Degeneration
A research survey by the Massachusetts Institute of Technology (MIT) Age-Lab and The Hartford Financial Services Group involved 3,824 drivers over age 50, asking them how and why they limited their driving.

The study found that two-thirds of the drivers self-regulated their activities in the car, restricting their driving for certain condition. Time of day was a common factor, with some people choosing to stay home at night or dusk. Bad weather conditions and heavy traffic were other conditions. Over time, drivers developed conscious strategies to compensate for failing vision, slower reflexes and stiffer joints.

Statistically, older drivers are actually very safe drivers, although over age 75, the accident rate per mile increases. The study found that health and medical conditions contributed far more to driving restrictions than age alone.

About ten percent of the nation’s drivers are over 65. However, by 2030, when one in five Americans are over age 65, this percentage will skyrocket. Consider that 23-40% of people over age 65 have macular degeneration – that ís a lot of drivers with a potential visual impairment.

Making the Decision

If your macular degeneration is causing a problem when you drive, you are most likely aware of it. Or, perhaps a friend or family member has pointed it out to you. Does this mean you should immediately stop driving? Not necessarily.

What you should do immediately is ask yourself some critical questions. How are you functioning when you drive during the day? What about dusk, dawn and cloudy days? Bright sunlight? At night?

Here are six important questions:

  1. Do you have difficulties reading clearly and rapidly all the instruments on a carís dashboard?
  2. Do you have difficulties reading road signs, or if you are currently driving, do you notice and understand the signs in time to react to them with comfort?
  3. Do other cars on the road appear to “pop” into and out of your field of vision unexpectedly?
  4. While on the road, do you drive well below the speed limit and slower than most cars around you?
  5. Do you have difficulties positioning yourself on the road, with respect to other cars, lane markers, curves, sidewalks, parking spaces, etc.?
  6. Do you find yourself feeling confused and/or disoriented on the road?

If you answered yes to any of the above questions, you may want to suspend your driving until you consult a specialist. If your answers indicate that you may have a problem under certain conditions (i.e., dim light or night) you may want to suspend your driving under those conditions until you consult a specialist further.

This questionnaire is from an excellent book, “Driving With Confidence, A Practical Guide to Driving With Low Vision” by Eli Peli and Doron Peli. Dr. Eli Peli is a Senior Scientist at the Schepens Eye Research Institute and Professor of Ophthalmology at Harvard Medical School. Their book contains a practical program to help you maximize your chances of retaining your driving privileges. It also provides a detailed description of driving vision regulations in every state as does the AAA website.

Other Useful Resources

AARP Driver Safety Program – Largest classroom driver refresher course specially designed for motorists age 50 and older. It is intended to help older drivers improve their skills while teaching them to avoid accidents and traffic violations.

AAA Safety Foundation for Traffic – Tips on driving and resources for other transportation options.

Summary

There are many ways to stay safe and maintain your independence. Just be attentive to your own abilities and find out all you can about your options.

4/21/15


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

How to Help a Blind or Visually Impaired Person with Mobility

You as a Guide
As the spouse, partner or friend of a person that has low or no vision, it is hard to know when to step and help. You don’t want to offend them by jumping in and making them feel incapable, nor do you want to stand by and have them stumble along, possibly hurting themselves.
blind or visually impaired person with mobility
Here are few pointers to help a blind or visually impaired person with mobility so you can be supportive and considerate.

  • First and most importantly, never assume the person wants or needs your help. Always ask first and never force the person to accept your help.
  • If your offer of help is accepted, ask if the person would like you on their right or left, then the tap them with your appropriate elbow so the person needing help can grasp slightly above the elbow.
  • Relax and walk at a comfortable, consistent pace, about a half step ahead.
  • When navigating obstacles, guiding signals, along with verbal cues, are helpful. Examples:
    Curb – brief pause and state “we are approaching a curb and it is slanted upwards.”
    Narrow door or passage – you enter first moving your guiding arm behind the small of your back and let them know you are moving through a doorway or narrow space and which direction the door opens so they can move to the appropriate side.
  • Stairs – stop at the edge of the first step and let the other person know if the steps are up or down, where the railing is (make sure it is on the side of their free hand), and if there is anything special about the steps (they are uneven, very steep, have an overly wide tread, etc.). If there are just a few steps let them know, “you will take 4 steps down.” The will follow one step behind you, with one hand on the handrail and the other holding your arm. Pause after completing the stairs.
  • Escalators and revolving doors – Use similar guiding cues as you do for the stairs. Let them know when to step onto the escalator and when to get ready to get off. If the person you are guiding is uncomfortable with escalators or revolving doors, use the elevator and regular doors which all buildings are required to have.
  • Chair – when approaching a chair, place the hand of the person being guided on the back or side of the chair, letting them know which direction the chair is facing.
  • Never leave a person who is blind or visually impaired in “free space.” Make sure they are in contact with a wall, railing or some other stable object until you return.

If They Use a Guide Dog
Guide dogs are invaluable to people that are blind or partially sighted. They allow their owners a sense of independence. But how should you respond to a guide dog who is working?blind or visually impaired person with mobility

  • Never distract the dog from its duty, so don’t pet the dog without asking.
  • Before asking a questions of a person handling a dog, allow them to complete the task at hand.
  • Remain calm when you approach, never teasing or speaking to the dog.
  • Do not offer the dog food or other treats. They are fed on a schedule and follow a specific diet to keep them healthy. Deviations from their routine can disrupt their regular and ad relieving schedules, seriously inconveniencing their handlers.
  • Do not offer toys to a guide dog. Though they are treated as pets when they are not in their harnesses, they are only allowed specific toys. In their harness they don’t play with toys.
  • Do not call out to the guide dog or obstruct its path, as it can break the dog’s concentration which could prove to be dangerous to its handler.
  • In some cases the person with low or no vision may prefer to take your arm above the elbow and allow their dog to heel instead of lead. Follow the same instructions as in the first part of this blog. When approaching stairs, ask how the person how they wish to proceed, as they will be holding your arm with one hand and the guide dog with the other, making it impossible to grasp a handrail.

Giving Directions To Someone Who is Blind or Visually Impaired
If a person is on their own with a guide dog or white cane, giving complete accurate directions is necessary. While you may be used to pointing or saying “it is over there,” or “go around the next corner,” if you can’t see you have no idea where “there” is or the “next corner.”

  • Always refer to a specific direction from the perspective of the person you are advising. Your right is their left.
  • Indicate the approximate distance in addition to the direction.
  • Give the approximate number of streets to cross to reach the destination. Even if you are off a block or two, it gives the person an idea of when to stop and ask for further instructions if needed.
  • If possible, provide information about landmarks on the way. Remember that sounds, scents and ground textures can be landmarks. You can hear an escalator, smell the scent of fresh brewed coffee and feel the difference between grass and a sidewalk.

4/16/15


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

Selecting Your Best Vision Correction Options

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

Normal Refractive Error Options

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

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

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

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

Irregular Refractive Error Options

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

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

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

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

2/26/15


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