February Is Low Vision Awareness Month

Help for People With Vision Loss

Here’s eye-opening news: Currently, 4.2 million Americans ages 40 and older are visually impaired. Of these, 3 million have low vision. By 2030, when the last baby boomers turn 65, the number of Americans who have visual impairments is projected to reach 7.2 million, with 5 million having low vision. For the millions of people who currently live or will live with low vision, the good news is there is help.

But first, what is low vision? Low vision is when even with regular glasses, contact lenses, medicine, or surgery, people have difficulty seeing, which makes everyday tasks difficult to do. Activities that used to be simple like reading the mail, shopping, cooking, and writing can become challenging.

Most people with low vision are age 65 or older. The leading causes of vision loss in older adults are age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma. Among younger people, vision loss is most often caused by inherited eye conditions, infectious and autoimmune eye diseases, or trauma. For people with low vision, maximizing their remaining sight is key to helping them continue to live safe, productive, and rewarding lives. The first step is to seek help.

“I encourage anyone with low vision to seek guidance about vision rehabilitation from a low vision specialist,” advises Paul A. Sieving, MD, PhD, director of the National Eye Institute (NEI), one of the National Institutes of Health (NIH) and the federal government’s principal agency for vision research.

What is a low vision specialist? A low vision specialist is an ophthalmologist or optometrist who works with people who have low vision. A low vision specialist can develop a vision rehabilitation plan that identifies strategies and assistive devices appropriate for the person’s particular needs. “A vision rehabilitation plan helps people reach their true visual potential when nothing more can be done from a medical or surgical standpoint,” explains Mark Wilkinson, O.D., a low vision specialist at the University of Iowa Hospitals and Clinics and chair of the low vision subcommittee for the National Eye Health Education Program (NEHEP).

Vision rehabilitation can include the following:

Training to use magnifying and adaptive devices
Teaching new daily living skills to remain safe and live independently
Developing strategies to navigate around the home and in public
Providing resources and support

There are also many resources available to help people with low vision. NEI offers a 20-page, large-print booklet, titled What You Should Know About Low Vision, and companion DVD, featuring inspiring stories of people living with low vision. This booklet and DVD, among other resources, are available at
www.nei.nih.gov/lowvision.

With the aging of the population, eye diseases and vision loss have become major public health concerns in the United States. NEI is committed to finding new ways to improve the lives of people living with visual impairment. Aside from making information and resources readily available, NEI has dedicated more than $24 million to research projects on low vision, including learning how the brain adapts to vision loss; strategies to improve vision rehabilitation; and the development of new technologies that help people with low vision to read, shop, and find their way in unfamiliar places. Research like this will help people with low vision to make the most of their remaining vision and maintain their independence and quality of life.

2/17/15

The National Eye Health Education Program (NEHEP) of the National Eye Institute (NEI), a part of NIH, offers a 20-page, large-print booklet, titled What You Should Know About Low Vision, and a series of videos featuring patient stories about living with low vision. These and other resources are available at http://www.nei.nih.gov/lowvision.

Visual Aids and Techniques When Traveling

I was 43 years old when I learned that I had an incurable disease of the retina that would cause permanent vision loss. I was devastated and could only think of how sad my life would be without being able to play basketball, ride my bicycle, travel to new destinations, and to enjoy the finer things in life. Fortunately, all of my preconceived ideas were wrong! I met a group of people with macular degeneration and they told me about all the fun things they did together. They told me about how they went horseback riding, bowled, golfed, rode tandem bicycles, and traveled across the United States together. The purpose of this article is to share with you many helpful tips and strategies to allow you to enjoy yourself when you travel and play outdoors. Here are some visual aids and techniques when traveling.

Sunglasses and Filters
Sunglasses are one of the most helpful visual aids to improve your eye comfort and vision when traveling outdoors. There are many different color filters that are made of various materials to maximize your vision. Often, people purchase sunglasses that are too dark and they do not allow a person to see details most clearly. Amber and yellow filters are very helpful for people with macular degeneration and diabetic retinopathy while green and plum lenses are very comfortable for people who are in the direct bright sunlight. Another type of sunglass lens that is very helpful is polarized lenses. These lenses filter light from reflected surfaces, such as the water or a windshield. Thus, a polarized sunglass will be very helpful if you will be traveling on an ocean cruise or traveling in the car on a road trip.

Hats and Visors
Hats and visors are another excellent visual aid to reduce glare. Wearing a hat or visor with a wide brim made of a dark color will reduce glare caused by the bright sidewalk. Many hats and visors are shaped such that they also filter light coming from the sides.

Telescopes
Telescopic glasses are very helpful low vision aids that allow people to identify distant objects very clearly. A telescope consists of two lenses separated by space. They are available in different powers to provide different levels of magnification. The larger the telescope, the higher the magnification. Telescopes are available to be mounted in glasses or they may be held in your hand. By looking through a telescope or telescopic glasses, the world will be magnified, similar to looking through a pair of binoculars. Telescopes are very helpful for sight seeing, reading traffic signs, watching plays, sporting events, and for people watching. Consult with your low vision optometrist for a demonstration of these devices!

Magnifiers
Magnifiers are very helpful tools when traveling. They allow one to read menus, identify your currency, read bus schedules, and to also see the slot machines! Magnifiers are available in various shapes, sizes, and forms. Some are simple lenses that are held in your hand while others are placed in glasses to allow you to use your hands to perform other tasks. I will never forget the first time that I prescribed magnifying glasses to allow my patient to play Black Jack in Las Vegas. He came back from his vacation ad was so happy that he was able to play cards again!

Mobility Cane
A mobility cane is very important to take when you travel because it informs others that you have a vision problem and it allows people to assist you by moving out of the way as you walk. I recall how strongly I resisted the use of my long white cane. I did not feel that I needed it because I still had vision. However, when we walked on the Las Vegas strip, I could not enjoy the sights of the new hotels because I had my head tilted towards the sidewalk so that I could see where to walk. My wife told me, “Why don’t you try using your cane so that you can enjoy the scenery?” I reluctantly agreed and was so excited to be able to lift my head and look around at all the hotels and people. People moved out of our way as we walked and it made me feel as though I was Moses walking through the parted Red Sea!

Smart Phones
Another very helpful tool to use when traveling or performing activities away from your home is the use of the cell phone. Today, there are cell phones called Smart Phones. These phones are essentially a small computer that has the ability to magnify the print on the screen and they are also able to talk to you and understand your voice! I personally use the Apple iPhone 5 and this device is extremely helpful. I can ask it to give me directions to specific areas to walk and visit, or I can ask it where the nearest bank, restaurant, or hotel is. When my phone locates the available options, it says the options aloud. My phone is also helpful because it can take pictures of objects and tell me what they are. When shopping, my phone will scan the bar code and tell me what is in the package and it will also tell me the price. Lastly, my phone has the ability to identify the currency, colors of clothing, and it also can help me to obtain a taxi cab or a bus ride.

All in all, there are many tools and techniques that are available to allow people with low vision or blindness to perform enjoyable activities away from home and to travel. I never thought that I would be able to enjoy all the things that I now do as a person who is totally blind. To learn more about these low vision aids and strategies, contact your low vision agency.

2/5/15

Bill Takeshita, OD, FAAO
Chief of Optometry
Center for the Partially Sighted

Imagination and KC

Imagination is a powerful thing. It can take you to great heights or take you into a downward spiral. I know. It’s done both to me. Thirty years ago I was diagnosed with keratoconus (KC) in both eyes. Then, I wasn’t sure what it was all about and my imagination took over spinning out all kinds of scenarios. Was I going to go totally blind? Would I be able to continue working? Would I still be able to drive? Was I scared then? Yes!

Imagination and KC
Over the years I’ve been through many of the ups and downs KC’ers face – uncomfortable lenses, vision changes, cornea abrasions, the piggyback system and pushing the limits of lens wear-time. The KC in my left eye deteriorated and a cornea transplant was the only option left. In the early 80s, my surgeon performed the transplant while listening to tracks from Michael Jackson’s album, Thriller. The transplant gave me the vision I needed stay in the workforce. I travelled for business, spent hours in front of a computer, belonged to a bowling league, walked on a glacier, climbed a fraction of the Great Wall, shed inhibitions in an acting class, answered crisis hotline calls, took “artsy” out-of-focus photos and gazed into the innocent, perfect eyes of my grandsons.

Everything wasn’t all rosy. There were highs and lows throughout those years because my other eye with KC kept going downhill before it stabilized. I still encountered all those difficulties KC contact lens wearers face when lenses are critical to functioning. But, I never let KC take over my life. Sometimes after I tried something new, I had to concede that vision challenges lessened the enjoyment and I labeled it “not for me” and moved on to something else.

I’m retired now and am sixty-nine. Now, my transplant cornea has filamentary keratitis and chronic dry eye so wearing a RGP lens is out. I’m at 20/200 in that eye but am still thankful for the good vision years. My other eye fluctuates between 20/50-60 with a RGP lens but comfortable wear-time is down to 3-4 hrs. Old anxieties have resurfaced. I live alone. Is driving my golf cart over? What am I going to do? “Explore your options,” my inner voiced commanded. So, I tackled the worst-case scenario first – what if I can’t wear any kind of lenses even scleral? I researched tools and services available to those with all kinds of vision problems. I visited the Southeastern Guide Dog Campus in Palmetto, FL in the US and learned all about Seeing Eye guide dogs. They’re amazing! My doctor started conversations about scleral lenses but that got put on hold.

Why? I was in the middle of a huge project. My imagination was taking me to great heights in this project. I was at the critical stages of writing a novel. It required my full attention. Fitting sessions and lens adjustment time would derail my momentum or even force me to take a detour off my route to my destination of having my novel catalogued in Books in Print. I didn’t need high functional vision to imagine scenes and characters. What I did need was a soft contact to act as a bandage to alleviate the pain of filamentary keratitis in my left eye. The soft lens worked! I published Juror 1389 – Dorsie Raines Renninger! Did vision challenges hinder me? Yes, at times. But, I pushed on and worked with what vision I had. I adapted – I bumped up MS Word font size way beyond 200%. I set an alarm clock to signal a stop after two hours of screen time. I removed my RGP lens and took eye-soothing breaks. I used various colors of paper for my research subjects so I could find notes easily. Thera® Tears were constant buddies. And, I asked for help! I formed a 1389 project team with good vision. They read. They highlighted mistakes to correct. I’m 100% certain any reader of Juror 1389 would never guess the author had vision challenges. Why would they? It’s of no importance to them. They’re only interested in what my imagination produced – a good story, a good read.

My message to all KCers is this – KC is a life altering condition not a life threatening condition. Don’t let keratoconus threaten your life or how you live it. Make these two words your mantra – Accept and Adapt. Make peace with what vision you have or will have. Accept it. Move on. Move towards being the best you can be in spite how out-of-focus the world looks to you. Life is not perfectly focused for anyone! Adapt – seek out tools and invent ways to change how you do things. Discover “what works” for you. Learn to ask for help. And remember, imagination is powerful. It has crisp, clear vision. It’s always there. Use it to visualize anything you want or what kind of life you want to live.

1/22/15

Gerry Trickle
Author, web content and greeting card verse writer
She is now working on her next novel – learn more at: www.gttrickle.com

Spotlight Text – A New Way to Read

For People With Low Vision There Is Spotlight Text – A New Way To Read

Spotlight Text is a new e-reading app specifically designed to address the needs of patients with eye disorders. Dr. Howard J. Kaplan, a retina surgeon in the Hudson Valley, started developing the app five years ago. Dr. Kaplan states, “When the first Amazon Kindle came out, a light bulb went off. If books are now digital, you can make the text of the book adapt to the reader instead of forcing the reader to adapt to the text. My patients were extremely frustrated with low vision devices such as desktop readers. Most found them very difficult to use and affordable.” Working with low vision experts at the Lighthouse Guild International, various text presentation methods were evaluated. “The app is based on real visual science and was built with the input of the top low vision specialists in the country, “ says Dr. Kaplan.

The greatest difficulty in creating the app proved to be getting access to e-books. Initially Dr. Kaplan approached the major e-content providers such as Amazon, Google, and Barnes & Noble. All of them considered the low vision market too small to address. During the 5 years, Bookshare, a Silicon Valley nonprofit, began to expand exponentially. Bookshare is dedicated to creating an accessible library for the print disabled.

How Spotlight Text Works, and What Makes it Different
The app is seamlessly tied into the e-book library of Bookshare. The library currently has 300,000+ titles including all current and recent NY Times bestsellers. It has a very extensive collection of textbooks for K-12 children. E-book downloads are free and unlimited for children, and Vets. There is a minimal joining/maintenance fee for adults. All patients that have any visual deficit that prevents them reading standard print are eligible to join. A physician, optometrist, therapist, or even librarian has to certify a patient by checking a single box on the form and signing their name. Bookshare then does the rest by contacting the patient and giving them an account. Bookshare functions due to an exception in US copyright law that allows the free distribution of copyrighted material in formats that are unique for patients with visual disabilities. The books are coded in DAISY, which is a sound file format. The App takes these files and renders them back to written text.

The user interface is designed such that an 80-year-old technophobe or a five-year-old child can easily use it (Apple-like minimalism). The app also synchronizes with Bluetooth Braille readers that convert the text to Braille. It can be connected to the HDMI port of any TV for unlimited screen size (hardwire or wireless through Apple TV). As you will see when you demo the app, text is now dynamic: in both teleprompter and marquee modes the text will move so that ocular movements are minimized. Marquee mode was specifically designed and tested to work for end-stage Retinitis Pigmentosa patients and any patient with only a remaining very narrow central visual field. Using VoiceOver all books are now audible books.

Social Entrepreneurship
Special iTunes links are created for vision nonprofits. If a patient clicks on those links and purchases the Spotlight Text App, 50% of sales profits are donated to the organization, including the Discovery Eye Foundation or the American Academy of Ophthalmology Foundation. Prior to being placed on the AAO’s website the app was evaluated by its Low Vision Rehabilitation Committee. It is the only app that the American Academy of Ophthalmology has ever endorsed.

The Future
Dr. Kaplan hopes to return to the major providers of e-content and persuade them that low vision and blind users are a viable market for them.

“I believe universal accessibility is achievable, but it will take a coordinated and combined effort. Reading is such a vital part of all our lives, with e-books, everyone should be able to enjoy a good book.”

Howard J. Kaplan, MD
Retina Surgeon
Hudson Retina

1/15/15

Hadley’s Online Education for the Blind and Visually Impaired

12/4/14

The Hadley School for the Blind (www.hadley.edu) is the world’s largest educator of people who are blind or visually impaired as well as the world’s largest Braille educator. The school’s curriculum has always been delivered completely through online education, meaning students can study from anywhere at any time. Hadley serves nearly 10,000 students in all 50 states and approximately 100 countries. Hadley serves adult students, age 14 and over. Our mission is to promote independent living through lifelong, distance education programs for individuals who are blind or visually impaired, their families and blindness service providers.

Hadley courses are tuition-free for people who are blind or visually impaired and their family members; there is modest tuition for professionals. Students study at their own pace and receive personalized, one-on-one instruction from their instructor by phone, email, virtual “office hours” or mail.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Adjustments Can Help With Depression

11/25/14

Eye disease can lead to isolation and depression. But making some adjustments can help with the depression. Robin Heinz Bratslavsky (pictured below with her oldest son) was diagnosed with keratoconus (KC) 20 years ago at age 25. Now a mother of two who works from home as a freelance editor. She participates in NKCF’s KC-Link.

When I was diagnosed with KC, I was an editor at a major women’s magazine. The diagnosis didn’t mean much to me at the time. Things changed when I was fitted with RGPs. I had limited wear time and pain, and I started to feel anxious about my career. There were times I had to leave work early and drive to my eye specialist — several times a week. As a young editor in a highly competitive field, I was concerned these absences would interfere with my ability to move up at the magazine.

When I had my first child, my husband and I decided I would stay home with him and work on a freelance basis. I’ve been doing this for 14 years now. Through a series of corneal abrasions, infections and lens-tolerance issues, I have had to rely heavily on my husband and family and friends to drive me and my children when my eyes would not cooperate. I have had moments of extreme despair, because I am not used to being so dependent. My husband works incredibly long hours, and he used to travel a lot. I was always worried I would not be able to drive my children in an emergency.

As my KC has progressed, I have moments in which my normally well-controlled clinical depression manifests, and I feel helpless because of my vision limitations. My sons are both avid soccer players, and I miss a lot of their on-field accomplishments, because I simply cannot see well enough.

At this point, I wear Kerasoft lenses, and I have had Intacs placed in my right eye. My vision, corrected, is about 20/30, but that can vary from day to day. After 20 years, it appears my KC is stabilizing, so I have a pair of emergency glasses; they get me to approximately 20/60, so I can’t drive, but I can function somewhat around my house to give my eyes a break. I’ve been living with KC for a long time; it’s a manageable disease — as long as you are willing to make some adjustments.

Robin Heinz Bratslavsky
Keratoconus Advocate

For Book Lovers – Low Vision Magnifiers

11/13/14

The first of this month was Book Lover’s Day, and as an avid reader, I am willing to celebrate any day that is about reading. However, if you suffer from low vision due to age-related macular degeneration, cataracts, retinitis pigmentosa or other sight-threatening eye diseases, you may not be able enjoy reading as much as you used to.

There are several options to help you enjoy books again, including low vision magnifiers, e-books and tablets. We will provide you with a quick primer to help you select the best option for your lifestyle and budget. Today we will look at magnifiers and Tuesday we will explore e-readers and tablets.

Low Vision Magnifiers

There are several general classifications for magnifiers –

• Hand-held magnifiers – These are smaller and more portable, allowing you to read thins such as menus, price tags, prescription bottles and ingredients in addition to books. Some also come with built-in lighting that can help you see in low light situations. They can be as simple as a single glass lens to more advanced digital devices that can auto-focus, change text color and magnification or even let you snap a picture of what you are reading if steady hands are an issue. However, because of these are small enough to make them portable, the field of vision is small and reading books for any length of time might become tedious.

• Stand magnifiers – These are really better for reading books, magazines and newspapers as the field of vision is larger, your hands will not get tired holding the device and the distance between the page and the magnifier will remain more constant, making reading easier. This is especially important if you have tremors. However, these require sitting at a desk or table to be used.

• Magnifiers mounted on reading glasses – These are great for being “hands-free,” but they also limit your ability to see at varying distances, and are generally used for seeing things less than a foot from your nose.

• Video magnifiers – These devices use a video camera (similar to the portable digital device listed above) that focuses on the page and then magnifies it for viewing on a screen or monitor. Text color/background, brightness, contrast and levels of magnification can be adjusted as needed. As with the stand magnifiers, the ones able to scan an entire page of a book need to be used at a desk or table. However, now there are some machines that will even read out loud to you!

To get an idea of the range of devices available, along with the wide range of prices, here are three websites to get you started – Enhanced Vision, Optelec and Humanware.

Because each person has a different vision issue, not one magnifier works for everyone. A person with central vision loss from age-related macular degeneration will have different needs from a person with peripheral vision loss from glaucoma. That is why we suggest that you consult with a low vision specialist to help guide you in selecting the correct device for your specific needs.

Check back on Tuesday, or subscribe to the DEF blog, to learn about e-reader and tablet options for people with low vision.

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Night Blindness

10/28/14

As the number of daylight hours decrease and daylight savings time is about to end, many of us feel that the days are getting much shorter. If you suffer from night blindness, your days are shorter, because getting around or driving at night, are sometimes impossible.

Night blindness is a condition that makes it difficult for a person to see in low-light situations or at night. Some types are treatable, while others are not. You will need to consult your eye doctor to determine the underlying cause of your night blindness to determine what can or cannot be done.

There are several things that could cause night blindness:
•Cataracts
•Genetic eye disease
•Vitamin A deficiency
•Diabetes
•Aging eye
•Sunlight exposure

Here is a brief look at each.
Cataracts – This is when the lens of the eye becomes gradually becomes clouded, reducing vision. Besides reducing vision at night you may also experience halos around lights. This is a treatable condition requiring cataract surgery and replacing your clouded lens with a clear artificial lens. Your vision should improve considerably.

Genetic Eye Disease – Both retinitis pigmentosa or Usher syndrome are progressive genetic eye diseases where the rods that regulate light, and cones that control color perception and detail die. Progressive night blindness is one of the first visual symptoms of these two diseases. Currently there is no treatment for them as there is no way to treat or replace the dying rods.

Vitamin A Deficiency – While rare in the US, it can be a result of other diseases or conditions such as Crohn’s disease, celiac disease, cystic fibrosis or problems with the pancreas. Options to help with the deficiency include vitamin supplements suggested by your doctor, or increasing your intake of orange, yellow or green leafy vegetables.

Diabetes – People with diabetes are at higher risk for night vision problems because of the damage to the blood vessels and nerves in the resulting in diabetic retinopathy. Not only can it cause poor night vision, it may also take longer to see normally after coming indoors from bright light outside. There is no cure, but controlling blood sugar levels with medicine and diet can help prevent developing retinopathy or help slow the progression.

Aging Eye – As we age several things happen to our eyes. Our iris, which regulates the amount of light going into the eye, gets weaker and less responsive. This can make adapting from light to dark more difficult and slower. Our pupils shrink slightly allowing less light into the eye. The lens of the eye becomes cloudier, as explained above in cataracts, limiting the amount of light into the eye. We also have fewer rods for light perception. Aside from cataract surgery there is no treatment for age-related night blindness. However, eating a diet rich in fruits and vegetables and low in saturated fat is the best way to slow the progression. Here is more information on how the aging eye is affected.

Sunlight Exposure – If your night vision seems temporarily worse after a trip to the beach or a day on the ski slopes, it probably is. Sustained bright sunlight can impair your vision, especially if you fail to wear sunglasses or goggles.

Night blindness due to genetic conditions or aging cannot be prevented. However if you protect your eyes from extreme sunlight, eat a healthy diet, and monitor blood sugar levels if needed, you can reduce your chances for night blindness.

As we head into the holiday season, you should know that some great sources of vitamin A include sweet potatoes, butternut squash and … pumpkins!

Susan DeRemer, CFRE
Vice President of Development

Living With KC Isn’t Easy

10/23/14

The Discovery Eye Foundation Fall 2014 e-newsletter focused on depression and eye disease. At the time we asked for people that were willing to share their stories. Jennifer Villeneuve is one of the many that responded. She is 26 years old and lives in Ontario, Canada. A participant in KC-Link, she talks about the emotional toll keratoconus has taken on her life and living with KC.

At age 13, I was diagnosed with keratoconus and given RGP lenses, with which I struggled intensely. ?I became very quiet, and my bubbly personality disappeared. The lenses often got irritated and made my eyes water and turn red, which made me look like I was crying. My doctor didn’t really give me much information on the disease. He just told me my corneas were the shape of footballs instead of circles.

I couldn’t be a normal teenager. I often squinted and had red eyes, which made me very self-conscious. I couldn’t wear makeup or have a free-for-all teenage life. I had to worry about my lenses and what people saw when they looked at me. Some people knew about my KC, but not many. I was just that quiet person who squinted. Because of this, my self-esteem got very low. All in all, my high-school life was hell.

Every time I went to the doctor, he said my pain is normal, the discomfort is typical, and I needed to get used to it. I was also diagnosed with two learning disabilities, in addition to my vision impairment. Throughout high school, I had major anxiety and depression, though I never wanted to admit it. A close teacher even spoke to my mom about the anxiety and low self-esteem. I got through high school, still with the depression being untreated — and still with the same doctor who never even sent me for a topography scan. Each time I went in, it was, “Yup your eyes the same; see ya.”

In college, I was diagnosed with depression and anxiety and was finally getting treated. ?I also went to the University of Ottawa Eye Institute of The Ottawa Hospital in Ontario, Canada. They did topographic scans; my KC had gotten significantly worse. My contacts’ sizing changed twice that year. Again, I couldn’t be normal. College students go out partying, but not me. I stayed in my room by myself. I worried whether I could see enough to go out. What if I drank too much and lost a lens? It wasn’t worth the risk, especially given how expensive they are. In college, I got great help and acceptance. My teachers all knew about my KC, and I was set up with the Centre for Students with Disabilities at Algonquin College in Ottawa. They were my backbone and my support.

After my two years in college, I moved on to my career working with children. At each job, I had to explain why I always had a mirror and my contact stuff. At first, I was ashamed and almost embarrassed, explaining why I squinted and that I may not be able to read a kids’ book if the writing is too small. Not only did I get accepted by coworkers, but also by the kids. They knew my eyes were red from my contacts or that my tears meant something was in my eye. I began working in with special-needs children, which was incredible but also challenging — especially in ensuring my eyes were at their best.

At this same time, my vision had gotten worse. I went for corneal crosslinking (CXL) in one eye. I had to take? time off from work, which caused a lot of stress. Unfortunately, there were complications from the CXL. I had a scar in the same eye that caused the crosslinking to be difficult and not as successful. When it came time to do my other eye, I was hesitant, but I needed it. It worked, and the disease slowed down.

A year or so later, the disease had a spike and caused my eye to rub on a lens and make a blister. I had laser surgery to get rid of that and the scar, too. Because KC isn’t covered by insurance in Ontario, I had to pay for every lens, every $11 bottle of solution and countless eye drops. It was expensive, and money was a struggle. I still struggle with the costs of things.

I also have to worry about eye infections. Since I work with kids, they are easy to get, but if I get an eye infection, I can’t wear my contacts, which means no driving, which means no working, which means no money. Things can snowball so quickly.

My vision is up and down. My lenses don’t last as long in my eyes as they used to, and my nighttime vision can be scary. I have to be extra-vigilant. Again, I can’t be normal or go somewhere unfamiliar at night. I’m always concerned. My lens fitter recently recommended scleral lenses, but I can’t afford them. I barely could afford the $2,000 for the CXL.

Living with KC isn’t easy. I can’t help but wonder how long I’ll have the vision I have now. Am I going to be blind in a few years? If I have children, will they have this, or will I even be able to see them? Will I find a guy who would want someone with the possibility of losing vision? I have to stop myself from thinking ahead, or the anxiety gets the best of me.

Jennifer Villeneuve
Keratoconus Advocate

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.

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 DeRemer, CFRE
Vice President of Development

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