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Help with Age-Related Vision Loss

FACTS & TIPS

by Scott Hearing, O.D.

Currently, there are over 12 million people in the United States who have low vision, and this number will continue to grow as the population ages. In this article, we will look at the major causes of low vision, and the resources available to harness the remaining vision to gain (or regain) function and independence in your life.
Along with every part of the human body, the eyes and vision system change with age. The four most common low vision conditions facing the older adult population are:
1. Cataracts: The word “cataract” comes from the Latin word for waterfall, and the condition causes a clouding of the crystalline lens. Fortunately, in most cases, cataracts can be easily removed by replacing the crystalline lens with a silicone or plastic type of implantable lens. Cataract surgery is the most successful surgery in the world. Early symptoms of cataracts may include headlights looking like stars at night, dull colors, and a generally diminished vision.

2. Glaucoma: Glaucoma is a condition where the pressure inside your eye slowly causes the optic nerve to die, causinga loss of peripheral vision. Glaucoma is more common among African Americans and can be prevented in many cases by using drops and lasers.

3. Diabetic Retinopathy: Diabetic retinopathy is a disease where the retina does not get enough oxygen. As a result, it either slowly dies or creates new fragile blood vessels which can hemorrhage and cause vision loss. The type of vision loss associated with diabetic retinopathy is like tiny little holes throughout your vision. diabetic retinopathy can be treated with a laser if caught early.

4. Macular Degeneration: The most common cause of age related vision loss is macular degeneration. It is much more prevalent in a white population, particularly those with light blue eyes, and not as common among those with darker eyes or darker skin. Macular Degeneration causes a loss or blurriness of central vision. There is no effective treatment for this condition. Macular Degeneration can possibly be prevented by using antioxidant vitamins, using special sun protective lenses known as melanin and, of course, an annual eye health examination.

There is no “quick fix” to low vision, so you will need to learn in many cases how to live your lives with impaired visual acuity. The impact of vision loss “hits you right between the eyes.” Joe Fontenot, M.D. a low vision specialist in Alabama says, “If the heart stops, life stops. The loss of sight does not mean death.”
Most of the conditions mentioned above do not cause total vision loss and with the proper attitude and low vision devices, you can restore some visual function to regain much of your visual independence. . Throughout the diagnosis and treatment process, it is important to have a good doctor/patient relationship. This is foundational to the healing process. A good low vision specialist can help assist you to regain the functional aspects of your vision that are missing.

There is no one magical device that can help you compensate for your vision loss. The average successful patient has multiple tools in his low vision toolbox. Low vision devices range in many forms from special lights, to special glasses and telescopes, to special magnifiers, to electronic video magnification systems, and head mounted vision technology. These devices are compensatory items which can allow you to perform tasks such as reading and doing crossword puzzles with your remaining sight.

Enhanced Vision, based in California, provides affordable low vision tools. They have the latest generation of more traditional products, like Closed Circuit Televisions (CCTVs) / desktop video magnifiers, as well as powerful portable devices like the JORDY (Joint Optical Reflective Display) a sleek pair of glasses which weighs about 9 oz.. The JORDY uses a self-contained miniature digital video camera to magnify objects up to 30x. You can visit Enhanced Vision at www.enhancedvision.com or contact them directly at 1-800-440-9476 to learn more.

Tom Perski, a leader in the low vision field who is also vision impaired stated “There is no magic or quick fix, but low vision technology is a slowly improving field that will be with you the rest of your life to help maintain your quality of life as much as possible.”
To get you back on the right track it is vital that you receive care from a low vision specialist and, if possible from a multidisciplinary rehabilitation team. This may include your primary medical provider, ophthalmologist or optometrist, low vision therapist or low vision occupational therapist, and any local services and/or support groups that help to overcome the challenges of vision loss.

“ARM” Yourself with Knowledge about Low Vision.
Acuity. The low vision specialist can run vision tests, including acuity, to assess your vision.

The Snellen Acuity Chart is the most typical test, differentiated by the big “E” at the top of the chart. Unfortunately, Snellen acuity is not necessarily a meaningful predictor of how well you will function with low vision. Other tests are much more important such as contrast sensitivity (how well you see white letters or objects on black background, or the reverse), visual field (how much of the side vision is still intact), and whether one is glare sensitive, outside or inside.

In many cases special filtered lenses and lighting can also help you see better. A very simple and special light, called GE Reveal, can be obtained at Wal-Mart. It has a color correcting, comfortable, pink color that many of my patients find helpful.

Refraction. Many of the patients that come in my office are not properly refracted—in other words, their reading has been hindered by an inappropriate glasses prescription. Prescriptions are crucial and must be done by a competent low vision specialist, as reading with the wrong glasses can lead to further complications.

Magnification. Know that magnification is not enough. Special techniques in using peripheral vision instead of your central vision, or using contrast enhancing lenses for backgrounds and glare control are extremely important steps to take in order to improve poor vision.

F-A-C-T-S about Low Vision Rehabilitation.
The “F” in “Facts”stands for faith, family, and friends. Isaac Goodpaster who has Macular Degeneration stated, “Faith and strong friendships have given me the encouragement to never give up and always press on no matter what.”

The “A” stands for attitude. Your attitude determines your altitude. While it is natural in the beginning to have depression and to grieve over the loss of your vision, ultimately at some point in time, your attitude, willingness and desire determine your ability to cope with vision loss.

The “C” stands for courage, confidence and commitment. You must have the courage to try new things. You must be committed. Winston Churchill is quoted as saying on how to win World War II when they were losing so badly, his answer was “Never, never give up.” Patients who have a “never quit” attitude always overcome their vision loss to succeed greatness. Also, you must have the confidence to believe that you can do things that may seem difficult or impossible at first.

“T” is a willingness to try to new things. One of my low vision patients says he will never give up fishing; he’ll just keep on getting bigger lures. You also have to take risks. When others say that you cannot do something, I say “If you don’t try, you will never know if you can do it or not.”

“S” stands for a sense of humor. We must maintain our sense of humor. One of my low vision patients took a bite out of a cork coaster, thinking it was cookie. His daughter said, “Dad, that’s a coaster.” Her dad said, “Thank goodness, I thought your cooking was going to pot.”

Now that you have the FACTS: faith, attitude, courage, a willingness to try new things, and a sense of humor, do not give up. Define your goals and needs and understand your low vision problems. Speak with low vision eye doctor. Get proper assistance. Follow through with recommendations, and spread the word that help is available for people who have low vision by sharing your success with others.

George Hall, low vision instructor, states, “At first, I considered my macular degeneration as a curse, but now I know it is a blessing, I have the opportunity to help others.”

If you or a loved one have low vision I encourage you to become familiar with how to get assistance from your eye care professional and specifically ask about devices to assist in regaining independence—as life does not have to be missed.

The author, Scott Hearing, O.D. is the Director of the Low Vision Clinic at the Stuart Eye Institute in Stuart, Florida. Dr. Hearing has been practicing low vision for nearly 20 years. His current areas of interest include the development of high technology head mounted low vision systems. Dr. Hearing has recently been appointed to the position of Adjunct Professor of Ophthalmology at the West Virginia University School of Medicine. He can be reached at www.drhearing.net or mrhearing@cs.com.