Increased Awareness for Saving Vision

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

Increased Awareness for Saving Vision

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

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

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

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

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

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

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

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

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

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

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

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

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

10/16/15


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

Business Opportunity for Blind Adults

Food for Thought – Business Opportunity for Blind Adults

For those not in the know, the acronym sounds like a popular sandwich. However, for Louisville, KY resident, George Bouquet, The Hadley School for the Blind’s and the National Association of Blind Merchants’ joint“BEPLT” program (Business Enterprise Program Licensee Training) is more like a dream come true.

George Bouquet - Business Opportunity for Blind
George Bouquet

Hadley is the largest provider of distance education for people who are blind and visually impaired worldwide and the BEPLT program is part of the school’s Forsythe Center for Employment (FCE) and Entrepreneurship. Under the Randolph-Sheppard Act, legally blind adults are given first right of refusal on operating state and federal government vending facilities including cafeterias, snack bars, convenience stores, micro markets, and vending machines and rest stop vending areas nationwide. In February 2014, Hadley’s FCE partnered with the National Association of Blind Merchants (NABM) and the National Federation of the Blind Entrepreneurs’ Initiative (NFBEI) to bring the academic portion of training to would-be blind vendors. Individual state Business Enterprise Programs provide the hands-on component of the blind vendor training. Bouquet is Hadley’s first graduate from the school’s new BEPLT program.

Born with both Pierre Robin Syndrome, which often results in a smaller-than-normal lower jaw, a cleft palate, a tongue that falls back in the throat, and difficulty breathing, as well as Stickler Syndrome, which causes hearing loss, eye abnormalities and joint problems, Bouquet has struggled with health issues throughout his 54 years. Although he was born without eye lenses, he was not born blind. Rather, his vision worsened over time. Bouquet worked in several food service positions since high school and had wanted to become a Randolph-Sheppard vendor even before he would have qualified as legally blind!

There are only so many blind vendor licensee training slots available and many more people compete for them than such programs can accommodate. The first time Bouquet applied to receive the training was in February 2014. Unfortunately, he was not accepted into a program. However, he was fortunate to gain some blind vendor experience by working under friends who already held the license. In early 2015, Bouquet’s counselor told him of another opportunity to apply for vendor training. This time he was accepted and Bouquet began Hadley’s BEPLT program in April 2015. Bouquet was so motivated to graduate from the program that he completed approximately two modules (one-lesson online courses) per week. Hadley’s BEPLT students complete a 10-module program and then take their state’s physical training component. After passing both elements, graduates are eligible to bid for the opportunity to become a blind vendor in their community.
George Bouquet - Business Opportunity for Blind
“The [Hadley BEPLT] program offers a lot of useful information. It will really help anyone wanting to undertake vending,” he said. Bouquet then acknowledged that the material about food borne illnesses helped him to realize the tremendous responsibility he would be accepting by running a government food service area. “As a manager, you need to decide what you are willing to delegate to other people,” he added.

For Bouquet, becoming a blind vendor allows him to hire and train his 25 year-old unemployed son, who inherited most of his visual and hearing problems. This training is Bouquet’s first step toward creating a legacy of financial independence.

10/13/15

Sheryl BassSheryl Bass, MA, MSW
The Hadley School for the Blind

Vision Loss and Depression

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

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

    •  

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

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

    •  

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

    •  

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

    •  

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

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

    •  

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

    •  

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

    •  

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

    •  

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

    •  

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

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

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

Resources
Understanding depression

How to live with low vision

Living with Low vision – How you can help webinar

Update on depression and AMD

Association of vison loss and depression in those over 20

Sadness impairs color perception

Rehab helps prevent depression from age-related vision loss

10/6/15

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

Which Eye Care Specialist Do You Need?

It’s time to get your eyes checked – do you go to an ophthalmologist, optometrist or optician? Your optometrist sees the beginnings of age-related macular degeneration, but is sending you to see and ophthalmologist, why?

One of the most confusing things about taking care of your eyes can be differentiating between an ophthalmologist, optometrist and optician. Each eye care specialist has a very important part to play in the health of your eyes and here is a quick synopsis of what each does so you can choose the best one for your vision issues and treatment.

Ophthalmologist
These specialists are fully trained medical doctors that have completed the eight years of training beyond a bachelor’s degree. Their training has included a full spectrum of eye care, from prescribing glasses and contact lenses and giving eye injections, to carrying out intricate eye surgeries. Many doctors may also be involved eye research to better understand vision, improve eye disease treatments or potentially find a cure. They are easily identified by the MD following their name.

Optometrist
These medical professionals have completed a four-year program at an accredited school of optometry. They have been trained to prescribe and fit glasses and contact lenses, as well as diagnose and treat various eye diseases. They provide treatments through topical therapeutic agents and oral drugs, and are licensed to perform certain types of laser surgery, such as Lasik. They are easily identified by the OD following their name.

Optician
These eye care professionals are not licensed to perform eye exams, medical tests or treat patients. Their purpose is to take the prescription from the ophthalmologist or optometrist and work with you to determine which glasses or contact lenses work best for you. If you suffer from an eye disease like keratoconus, these specialists can make the difference between a relatively normal life, or one that is dictated short periods of vision because of contact lens pain. These eye care professionals may hold and associate optician degree or have apprenticed fore required number of hours.

While each one of these eye specialists has their own area of expertise, they can form a team whose only concerns are your eye health and the ability to see as clearly as possible.

8/11/15

 

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

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

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

Do I Need Vision Insurance?

With the rising costs of health insurance, many people are looking for ways to reduce their costs. Since not all insurance packages include vision insurance, many people wonder, do I need vision insurance?
vision insurance

Standard Vision Insurance

Vision insurance is a type of health insurance that entitles you to specific eye care benefits such as routine eye exams and other procedures, as well as a specified dollar mount or discount for the purchase of eyeglasses and contact lenses. It only supplements regular health insurance and is designed to help reduce your costs for routine preventative eye care and eyewear.

You can get vision insurance as part of a group, such as your employer, an association, etc., through a government program such as Medicare or Medicaid, or as an individual. It is often a benefit linked to your regular HMO (health maintenance organization) or PPO (preferred provider organization) health insurance.

There are two primary vision insurance plans available:

  • Vision Benefits Package – provides free eye care services and eyewear within a fixed dollar amount for which you pay an annual premium or membership fee and a small co-pay. It may also include a deductible.
  • Discount Vision Plan – provides eye care and eyewear at a discounted rate after you pay an annual premium or membership fee.

Both insurance plans generally include:

  • Annual eye exams
  • Eyeglass frames (usually once every 24 months)
  • Eyeglass lenses (usually once every 24 months)
  • Contact lenses (usually once every 24 months)
  • Discounted rates for LASIK and PRK

Here is where you can check for a list of some vision insurance providers.

Medicare and Medicaid

Different kinds of vision care are included in the US government programs, Medicare and Medicaid. These programs are for qualifying American age 65 and older, individuals with specific disabilities and people with low income.

The Types of Medicare For Vision:

    • Medicare Part A (Hospital Insurance) –Medical eye problems that require a hospital emergency room attention, but routine eye exams are NOT covered.
    • Medicare Part B (Medical Insurance) – Visits to an eye doctor that are related to an eye disease, but routine eye exams are NOT covered.
    • Medicare Part D (Prescription Drug Coverage) – Will help pay for prescription medications for eye diseases.

If you have Medicare Parts A & B you are generally eligible for the following vision coverage, however, there is a deductible before Medicare will start to pay, at which point you will still be paying a percentage of the remaining costs.

  • Cataract surgery – covers many of the cost including a standard intraocular lens (IOL). If you chose a premium IOL to correct your eyesight and reduce your need for glasses, you must pay for this added cost out-of-pocket.
  • Eyewear after cataract surgery – one pair of standard eyeglasses OR contact lenses.
  • Glaucoma screening – an annual screening for people at high risk for glaucoma, including people with diabetes or a family history, and African-Americans whom are 50 or older.
  • Ocular prostheses – costs related to the replacement and maintenance of an artificial eye.

There is also Medicare Supplement Insurance (Medigap) which is sold by private insurance companies to supplement only Medicare Parts A & B. It is intended to cover your share of the costs of Medicare-covered services including coinsurance, co-payments and deductibles. For more details about Medicare plans and coverage check their website or call 800-633-4227.

Medicaid is the US health program that gives medical benefits to low-income people who may have no or inadequate medical insurance. A person eligible for Medicaid may be asked to make a co-payment at the time medical service is provided. Vision benefits for children under the age of 21 include eye exams, eyeglass frames and lenses. Each state determines how often these services are provided and some states offer similar vision services to adults. To learn more about Medicaid eligibility requirements and vision benefits call your state’s Medicaid agency or visit their website.
vision dial - vision insurance

Defined Contribution Health Plans

A way to lower your vison care costs is to take part in a defined contribution health plan (DCHP). You are given a menu of health care benefits to choose from where a portion of the fees you receive for health coverage come from money that is deducted from our paycheck before federal, state and social security taxes are calculated. Four types of DCHP are:

Cafeteria Plans – your employer takes a portion of your salary and deposits it into a non-taxable account for health care spending. The amount taken depends on the number and costs of the benefits you select.

Flexible Spending Accounts (FSA) – your employer takes a predetermined portion of your pre-tax salary and deposits it into health care account for you to pay medical expenses. But generally preventative care such as routine eye exams and are not reimbursable. Nor are eyeglasses and contact lenses reimbursable. You would need to verify with your employer. If you do not use all the money at the end of a 12 month period, the money goes back to your employer.

Health Reimbursement Arrangement (HRA) – this is similar to an FSA except you can use it for preventative care like eye exams and you do not lose the money if it isn’t spent within a certain time period as it can be carried from year to year.

Health Savings Account (HSA) – it can be employer-sponsored of you can set up one independently; however you must purchase a high-deductible health insurance plan to open an HSA and you cannot exceed the annual deductible of your health insurance plan. You cannot be enrolled in Medicare of be a depended on someone else’s tax return. You can use it for preventive care such as eye exams. You can learn more about HSAs by visiting the US Treasury’s website.

There are a variety of options when it comes to vision insurance. You just need to determine your needs and ask providers the correct questions.

4/14/15


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

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.
Low vision awareness
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

NEHEPsq75The 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.
Visual aids and techniques for 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 - July 2011Bill Takeshita, OD, FAAO
Chief of Optometry
Center for the Partially Sighted