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.
spotlight text - a new way to read
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 MDHoward 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 School
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 Hadley SchoolKate Streit
Media and Marketing Specialist
The Hadley School for the Blind

Our First Three Months Of Eye Care

9/30/14

Discovery Eye Foundation Blog’s First Three Months

It is hard to believe, but this blog has been providing information and insights into eye disease, treatment options, personal experiences of living with vision loss, and other eye-related information for seven months.

All of this would not have been possible without the expertise of remarkable eye care professionals who took time out of their busy schedules to share information to help you cope with vision loss through a better understanding of your eye condition and practical tips. Since so much information was shared in the seven months, here is a look at the first three months, with the additional four months to be reviewed next Tuesday.
Thank You - first three months
I am very thankful to these caring eye professionals and those with vision loss who were willing to share their stories:

Marjan Farid, MD – corneal transplants and new hope for corneal scarring

Bill Takeshita, OD, FAAO, FCOVD – proper lighting to get the most out of your vision and reduce eyestrain

Maureen A. Duffy, CVRT – low vision resources

M. Cristina Kenney, MD, PhD – the differences in the immune system of a person with age-related macular degeneration

Bezalel Schendowich, OD – blinking and dealing with eyestrain

Jason Marsack, PhD – using wavefront technology with custom contact lenses

S. Barry Eiden, OD, FAAO – contact lens fitting for keratoconus

Arthur B. Epstein, OD, FAAO – dry eye and tear dysfunction

Jeffrey Sonsino, OD, FAAO – using OCT to evaluate contact lenses

Lylas G. Mogk, MD – Charles Bonnet Syndrome

Dean Lloyd, Esq – living with the Argus II

Gil Johnson – employment for seniors with aging eyes

We would like to extend our thanks to these eye care professionals, and to you, the reader, for helping to make this blog a success. Please subscribe to the blog and share it with your family, friends and doctors.

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

Seeing the whole picture: My life after a telescope implant

9/11/14

I’ve lived with my family in Schenectady, NY (outside of Albany) for more than 50 years and I love my home because it’s within walking distance of my grocery store, bank and church. But ten years ago, my vision was severely impacted because of age-related macular degeneration.

Patty and Linda - telescope implant
Patty (on right) and friend Linda have some fun

My children had to help me so much because I just couldn’t see. For example, they had to drive me to the doctor and on errands. I needed help shopping because I couldn’t read labels. After a while, it was very depressing. I started to avoid social situations, like at family parties and church events, because I was embarrassed that I couldn’t recognize faces any longer. I felt terrible about this. I sat and cried every now and then.

But then my doctor told me about a treatment I wasn’t yet aware of called the telescope implant. The device is very small (the size of a pea), and it is implanted in one eye to restore vision. My doctor explained that it works like a real telescope in that it magnifies images, which reduces the blind spot that blocked my straight-ahead vision. The other eye does not get an implant because you need to keep some peripheral vision to help with orientation and balance. This sounded like science fiction! But I wanted to see if it could help me and decided to take a chance on the procedure.

I worked with an entire team of specialists, which were part of a treatment program called CentraSight. My retina doctor, cornea surgeon, low vision optometrist and a low vision occupational therapist all counseled me about what to expect from the outpatient procedure, particularly afterwards. For example, I learned there was a significant amount of occupational therapy required to adjust and become proficient at using my new vision. I also was warned that my sight would not be like it was in my youth, I wouldn’t be able to do everything I used to nor would I be able to see, differently, the minute I opened my eyes.

I had my surgery in February 2013. The cost for the telescope implant and visits associated with the treatment program were covered by Medicare, which was very helpful.

Thinking back, I was nervous on surgery day, but shortly after the procedure, I was back with my family and going out to dinner. The most amazing part is that I was able to see my daughter’s face almost immediately, despite not expecting to see anything right away. It was such a gift! After the surgery, I worked with the low vision specialists for about three months. The exercises varied because you use different techniques to see things when you are standing, sitting or moving around.

It’s been more than a year since my surgery and I am very happy, mostly because I can do so much more now that I can see better. I can read, sew, do canning and work in my garden. I can see the crosswalks, which lets me walk to the grocery store safely. But most importantly, I can see my family and friends. I’m enjoying spending time with the people I care about. I would recommend that people learn more about the telescope implant. There are CentraSight teams all over the country. When you call 877-99-SIGHT or visit www.CentraSight.com a trained CentraSight Information Specialist will point you to the team closest to your home and can even help schedule the appointments for you. The telescope implant isn’t for everyone, but it can make such a difference in your life.

Patty Gadjewski - telescope implantPatty Gadjewski
Schenectady, NY

Evaluating Treatment Claims

9/03/14

The following article on evaluating treatment claims is from the Science-Based Medicine blog is being used with their permission. Since Discovery Eye Foundation provided the inspiration for Dr. Hall, we thought you might enjoy it as well.
Black board evaluating treatment options
I recently wrote about the claim that acupuncture can improve vision in patients with macular degeneration. In response, I received this e-mail:

“At Discovery Eye Foundation we have an education and outreach program for people with age-related macular degeneration, the Macular Degeneration Partnership. We are constantly getting calls from people who have heard of a new “cure” or a way to stop their vision loss. It is always hard to interject reality into the conversation and hear the hope leave their voice, replaced by frustration or despair.”

The e-mail suggested I write an article providing guidelines for consumers to help them evaluate the validity of treatment claims for themselves. On SBM we are constantly stressing the need to apply critical thinking to what you read, and the many pitfalls to be avoided. I’ll try to synthesize some of the principles into a handy list of questions.

What kind of evidence is there?

• If the claim is based on nothing but testimonials, STOP RIGHT THERE. You can forget about it, or at least file it away until there is better evidence. Anecdotes are not evidence; they only serve to suggest promising avenues of research. Science is the only reliable way to determine if a treatment is safe and effective.

• Is the claim based on a gold standard randomized, placebo-controlled, peer-reviewed study or some lesser kind of evidence like case reports? Was it published in a reputable mainstream medical journal? (If you’re not sure how reputable the journal is, you can look it up on tables of “journal impact factors.”

• Keep in mind that half of all studies are wrong. There are many factors that can lead to error. Preliminary or pilot studies that are positive are frequently followed by better, larger studies that are negative. We can never rely on one study without confirmation.

• Was it a meaningful clinical study in humans?

In vitrolab studies and animal studies may not be applicable to humans; if promising, they must be confirmed in good human studies. If it was a human study, did it show meaningful outcomes that made a real difference, like a reduction in heart attacks, or did it just show an improvement in lab values or risk factors?

• Were there 10 subjects or 300? Large studies are more trustworthy than small ones. The fewer dropouts, the better.

• Did it use an appropriate placebo control that subjects really couldn’t distinguish from the active treatment?

• Have other studies found similar results? Are there any studies that show the opposite? You can search PubMed and look for them.

Who is making the claim?

  • Is it someone who is likely to be biased?
  • Is it someone who provides the treatment or sells the product?
  • Is it someone with expert medical knowledge or someone like the schoolteacher who claimed she had invented a cure for the common cold?
  • Does the person have a good reputation, or a track record of making questionable statements?
  • Is it someone who quotes or associates with unreliable sources like Mercola.com, the Weston Price Foundation, or the Health Ranger? Quackwatch has a useful list of non-recommended sources of health advice.

Where was the claim reported?

Real medical breakthroughs would be headline news. It’s not likely you would first hear about a cure for diabetes on an afternoon talk show or a Facebook page. Has your doctor heard of it? Are mainstream doctors recommending it? Is it covered on professional medical websites like the American Academy of Pediatrics or disease-focused websites like the American Diabetes Association? Is it sold only through multilevel marketing schemes?

What kind of language is being used?

Is it a sober factual report with caveats, or is it full of hype and buzzwords like “miracle,” “natural,” “known to the ancients,” “quantum,” “amazing,” “revolutionary”? If it really worked, advertising gimmicks wouldn’t be needed to sell it.

Does Gwyneth Paltrow swear it worked for her?

Testimonials can be very passionate but they are notoriously unreliable. Getting better when you use a treatment doesn’t necessarily mean you got better because of the treatment. Symptoms can fluctuate, diseases can resolve without treatment, and placebos can fool people. Perceptions can be wrong (think of optical illusions), the meaning of true perceptions can be misinterpreted, and memories can be inaccurate. Every snake oil salesman has reams of testimonials, and through the centuries there were testimonials galore for bloodletting to balance the humors. People frequently come to believe bogus remedies have worked for them. Barry Beyerstein wrote a classic article about that; it’s essential reading.

Does it make sense?

Is there a plausible mechanism of action? If someone claimed that standing on your head and whistling Dixie would cure diabetes, I think you would be skeptical. If it claims to work by a mechanism incompatible with known scientific principles, the level of evidence would have to be extraordinary for it to outweigh all the evidence those scientific principles are based on. Homeopathy’s claim that water can cure by remembering long-gone molecules, even after the water has been dripped onto a sugar pill and allowed to evaporate, would require extraordinary evidence indeed. If it’s a new antibiotic that is related to an old one, an ordinary level of evidence would suffice.

Is there a double standard?

Are they asking you to accept a “natural” or “alternative” treatment on the basis of the kind of evidence that you wouldn’t want the FDA to accept for allowing marketing of a prescription drug? There is only one science and only one standard of evidence.

Does it sound too good to be true?

Then it probably is too good to be true. Does it promise to cure a hitherto-incurable disease? Does it promise you can eat all you want and still lose weight? Does it promise there are no side effects of any kind? Does it remind you of the spiel of a used car salesman or a TV infomercial? Caveat emptor.

Who disagrees and why?

This is the most important question you can ask. It is rare for 100% of people to agree on anything. If you can find someone who disagrees, you can examine the reasons given for both opinions, and it will usually become obvious which side makes more sense. If you can’t find anyone who disagrees, it might be because it’s too new or because no scientist has taken it seriously enough to bother writing about it. In that case, withhold judgment and keep checking until someone does disagree.

Hope springs eternal, but true hope is better than false hope

If you are a desperate patient, it’s only natural to grasp at any straw of hope; but when the evidence is insufficient, the reasonable approach is to withhold judgment and wait for better evidence. You might think, “If it works, I don’t want to wait” but history teaches us that the great majority of these things don’t pan out. It might not do any harm, but then again it might; there might be adverse effects that haven’t been identified yet, it might raise false hopes only to dash them, and if nothing else it might waste time and money or interfere with getting more appropriate care. When you take an inadequately-tested medicine, you are essentially offering yourself as a guinea pig in a haphazard uncontrolled experiment that doesn’t even keep records. Of course, that’s your privilege; but I hope you would do it with your eyes open, with a realistic understanding of the state of the evidence.

Harriet Hall, MDHarriet A. Hall, MD
Retired US Air Force Physician
Editor of Science-Based Medicine Blog
Author of SkepDoc column in Skeptic Magazine

Ways to Reduce the Harmful Effects of Sun Glare

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

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

Facts about Sunlight

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

Advantages:

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

Disadvantages:

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

Visible Light and Light Rays

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

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

Wavelength - glare

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

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

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

Ultraviolet Light and Blue Light

Ultraviolet (UV) light has several components:

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

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

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

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

Sunlight and Glare

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

Disability glare

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

Discomfort glare

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

Controlling Glare

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

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

More Recommendations

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

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

Theater Company Gives Blind Actors Confidence

7/3/14

In this two-part blog post, you will learn more about an amazing program at CRE Outreach, which uses theater to engage and improve confidence among the blind participants, which is how the program started, later helping at-risk youth and military veterans. In the second post on Tuesday, one of the blind actors, Caitlin, will share her experiences as a member of the CRE Outreach troop and what it has meant to her.
theater - blind actors
When twelve visually impaired kids, ranging in age from eight to thirteen, are busy creating characters for their original play, silence is a rarity. Here, in the safe space of an acting class where everyone is visually impaired. I glance around the circle to see whose turn it is to suggest a character … and then I understand the silence. Eric is ten years old, totally blind, and autistic. He’s almost completely nonverbal. If he has ideas, which I often sense that he does, we never hear them.

It’s highly unlikely that Eric’s going to speak, or share, or rise from his hunched, self-protective crouch among the other students. I prompt him anyway. “Eric, it’s your turn. Do you have an idea for a character?”

Without warning, he lights up. A burst of energy seems to lift him right out of his hunched position, and with more clarity and volume than I’ve ever heard from him before, he declares, “I want to be a human telephone!”

Eric went on to be the lead in our show and now interacts socially with other kids. Acting has helped him build up his confidence and find his voice. And he isn’t alone.

CRE Outreach aims to transform lives one show at a time. From inception to performance, these actors play a major role in all aspects of the production. Inclusivity is the cornerstone of CRE Outreach. Our productions are based on authentic stories and rarely-heard messages, conveyed by the very people who should be sharing them.

CRE Outreach works with three different populations–at-risk youth, military veterans, and the visually impaired–using theater as an empowerment tool. For all participants, stepping into another character allows them to forget about themselves for a while. They feel new emotions, take on new experiences, and live a life which they don’t have the opportunity to live every day.

For blind actors, visual impairment is their common thread, but it’s their will to define their disability which truly binds them. To cement that bond, we introduce each new blind actor to our theater group with an exercise called “The Run.” One by one, each visually impaired actor races from one side of the stage to the other: an experience that they have never had before. Learning to use sound cues, along with textured mats on the floor, the actors break through their fears of movement and learn to navigate the stage independently. They learn to trust themselves and each other. As they run, they realize that the unknown isn’t half as scary as you’d think, when you have a family all around you.

Greg Shane - blind actorsGreg Shane
CRE Outreach
Co-Founder

Books About Age-Related Macular Degeneration

6/24/14

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

Books About Age-Related Macular Degeneration

By Doctors:

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

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

By Patients:

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

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

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

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

Sunset…A Macular Journey
by F. Leroy Garrabrant
Paperback

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

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

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

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

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

Unleash the Power of Age

5/29/14

Employment Challenges Faced by Older Persons with Visual Impairments


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

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

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

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

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

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

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

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

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

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

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

May is Healthy Vision Month

When it comes to our health, we may visit our doctors and nurses regularly to make sure our bodies are healthy. But what about our eyes? They’re not always top of mind, but they’re just as important! HVM Logo-02 May is Healthy Vision Month, an observance coordinated by the National Eye Institute to empower Americans to make their eye health a priority and educate them about steps they can take to protect their vision. What do those steps include?

Get a dilated eye exam. When it comes to common vision problems, many people don’t realize their vision could be improved with glasses or contact lenses. In addition, many common eye diseases have no symptoms. A dilated eye exam is the only way to detect these diseases in their early stages.

Live a healthy lifestyle. Almost everything we do affects our eyes. To keep our vision healthy, it is important to:

    • Eat healthy foods, especially dark leafy greens such as spinach and kale and fish high in omega-3 fatty acids, including salmon, halibut, and tuna.
    • Maintain a healthy weight. Being overweight or obese can increase your risk of developing diabetes and other systemic conditions, which can lead to vision loss.
    • Don’t smoke. It’s as bad for your eyes as it is for the rest of your body.
    • Manage chronic conditions. Many conditions, including diabetes, hypertension, and multiple sclerosis, can greatly impact vision and result in inflammation of the optic nerve, diabetic retinopathy, glaucoma, and even blindness.

Know your family history. Eye health can be hereditary, so it’s important to talk to your family members about their eye health history. Knowing your family history will help you determine whether you are at higher risk for developing an eye disease.

Use protective eye wear. Eye injuries can happen at work, while playing sports, and when doing chores around the house. Prevent those injuries from happening by wearing protective eyewear! Look for safety glasses, goggles, safety shields, or eye guards made of polycarbonate, which is 10 times stronger than other plastics.

Wear sunglasses. The sun’s rays can damage your eyes, so make sure to wear your shades! When purchasing sunglasses, look for ones that block out 99 to 100 percent of both UVA and UVB radiation.

Celebrate Healthy Vision Month by taking these steps today! Then encourage your family and friends to make their vision a priority by helping NEI spread the word. Here are some ideas:

We hope you’ll join in the celebration! And don’t forget to protect your eyes today to see well for a lifetime.

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