Help with Age-Related Vision
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
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
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
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