The internet isn’t just for kids

As elderly adults become more computer savvy, some vision risks may arise.

Photo courtesy of http://www.listproducer.com

Do you remember the excitement of receiving mail from your grandma with a crisp $5 dollar bill stuffed inside? With the recent explosion of computer use in the age 65 and up crowd, I wonder if my children will get to experience that or if they might receive an email with an e-gift card for Amazon instead.

Currently 74.8 percent of households in the United States have internet access and a remarkable 53 percent of persons 65 years old and up make use of the technology. Even social media is changing with seniors comprising 25 percent of all users. As a result, more seniors than ever before will be using their vision to perform tasks like emailing and making online purchases. While this is clearly a benefit, as seniors can do business in the comfort of their own homes and even order groceries online, there are some inherent pitfalls when it comes to their vision. As we know, patients over 40 tend to have greater difficulty with all near tasks and as the years go by, this only gets worse. Also, conditions such as cataracts and macular degeneration are much more prevalent in this population making most visual tasks more difficult. Finally, dry eyes are more common as we age and since we blink less when using a computer, this to can lead to discomfort and fatigue.

So, what can we do to make computer use more comfortable for seniors?

• Make sure the computer font is at an appropriate size
• See an optometrist for an up to date glasses prescription and to check for eye disease
• Consider glasses that are specifically made for computer use with protection from glare
• Use lubricating drops (artificial tears) and take frequent breaks
• Do not forget to stand up occasionally and stretch your legs

Additionally, more of the 65 and older crowd is starting to use smart phones (14.5 percent!).   While many smart phones and tablet computers have zoom text, I encourage them to make a purchase with their vision in mind. So, for phones, a phablet like the new iphone plus or the galaxy note makes sense and will be less frustrating to use.

So, while my kids may be fruitlessly waiting by the mailbox, they do get to talk to grandma via skype and facetime which is amazing. What a great time to be a senior!

~ David C. Ardaya, O.D.
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

Vitamins for vision

Did you know that adding powerful antioxidants to your diet could improve your eye health?

Photo courtesy of Perfect-Diet.net

It is true, adding certain nutrients to your diet every day, either through foods or supplements, can help save your vision. Researchers have linked nutrients such as lutein/zeaxanthin, vitamin C, vitamin E, and zinc to reducing the risk of certain eye diseases, including macular degeneration and cataract formation.

Here are some facts about these vision-saving nutrients:

• Lutein and zeaxanthin reduce the risk of age-related vision problems, including age-related macular degeneration and cataracts. These important nutrients are found in green leafy vegetables, such as kale, spinach and turnip greens, as well as other foods, such as eggs.
• Vitamin C (ascorbic acid) is an antioxidant found in fruits and vegetables. You can find it in fruits like oranges, kiwi, and strawberries, as well as vegetables like broccoli, mustard greens, and peppers. Scientific evidence suggests vitamin C lowers the risk of developing cataracts, and when taken in combination with other essential nutrients, can slow the progression of age-related macular degeneration and visual acuity loss.
• Vitamin E in its most biologically active form is a powerful antioxidant. It can be found in nuts, like almonds, peanuts and pine nuts, dried apricots, sunflower seeds, fortified cereals and sweet potatoes. It is thought to protect cells of the eyes from damage caused by unstable molecules called free radicals, which break down healthy tissue.
• Essential fatty acids are a necessary part of the human diet. They maintain the integrity of the nervous system, fuel cells and boost the immune system. Two omega-3 fatty acids have been shown to be important for proper visual development and retinal function.
• Zinc is an essential trace mineral or ‘helper molecule’. It plays a vital role in bringing vitamin A from the liver to the retina in order to produce melanin, a protective pigment in the eyes. Zinc is highly concentrated in the eye, mostly in the retina and choroid, the vascular tissue layer lying under the retina.

Now we know that incorporating vitamins in our diet can provide protection from eye diseases that arrive later in life. No matter your age, be proactive in your health. Strive to include as many colors of fruits and vegetables as possible!

~ Melissa Barnett, OD, FAAO
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

You’re losing your vision and there’s nothing more to be done

It’s devastating to hear that you’re losing your vision. Worse yet is being told, “There’s nothing more to be done.” Unfortunately, millions of Americans are given this sad news every year, and although medical treatment may not restore one’s vision, low vision rehabilitation can often help to increase visual function.

What is low vision rehabilitation?

Low vision rehabilitation refers to a field of optometry that focuses on making use of the remaining vision that you have. Often when patients lose vision, they do not become entirely blind, but rather lose only portions of their vision. For example, a patient with macular degeneration will lose their central vision whereas a patient who has suffered a stroke might lose all vision on their right visual field. If you or someone you know is suffering from low vision, it’s best to refer them to a low vision optometrist who can spend time uncovering the specific needs of the patient, and subsequently provide a thorough evaluation to determine what aids are best suited to meet those needs. To read more on low vision rehabilitation, click here.

Photo Courtesy of Optelec

Beyond having a low vision evaluation, there are a number of tips I often give my patients, which play an equally important role in improving vision function:

1. Increase lighting and use task lights: Lighting is crucial to seeing better. Even those of us who do not suffer from eye diseases know that we see better with brighter lighting. Patients who have eye diseases often have reduced contrast sensitivity, which means they have more difficulty seeing lighter colored objects. Increasing lighting will help with this. I often advise patients to read under a desk lamp and to replace any non-working light bulbs. Consider flashlights throughout the home for shining into pantries or closets that are more dimly lit. Dark hallways may need lighting for night trips to the restroom. Portable flashlights are also helpful for menus (magnifiers with illumination are even better). You may need to experiment with various color lights to determine which gives best illumination without causing too much glare.

2. Increase contrast: As mentioned earlier, poor contrast sensitivity will affect one’s ability to see lighter colored objects. A method for improving this

Photo Courtesy of ies.org

is to pair dark colored objects alongside lighter colored ones. For example, when plating meals, consider serving greens and beef on a white plate, and potatoes, rice and fish on a dark plate. Also, place a dark rug against lighter colored floors at the bottom of stairs to indicate the last of the steps. Write or print in dark bold markers on white paper and increase contrast.

3. Increase size: This option is self-explanatory. The larger it is, the easier it would be to see, and the closer you are to an object, the larger it will be. Therefore, if viewing television is difficult, sit closer or invest in a larger television. Some of my patients sit as close as to 2 feet away from the television. Optics plays a tricky part in the distance change though, so you may need your optometrist to help with glasses for a particular viewing distance. Increase computer monitor sizes or increase screen magnification. Some of my patients prefer two monitors, one to display the magnified image and the other to scroll around. For printed materials, increase the size of fonts and limit visual disturbance by avoiding irrelevant images and words. Your bank can also help by providing large print checks.

4. Make use of your tactile sense: Use raised dot stickers on commonly used items. For example, place one raised dot on the low heat setting on the stove dial and two raised dots on medium. Or place dots on commonly used microwave buttons. Occupational therapists have been able to help low vision patients significantly in this area.

5. Read at the right distance: Glasses are commonly prescribed for a certain viewing distance. For example, driving glasses are for 20 feet and further. Reading glasses are typically clearest around 16 inches. If you have low vision however, you will probably need a stronger pair of reading glasses, which may require you to read at ten inches or closer. If you are unsure, ask your optometrist. A tip that often works is to hold your reading material up close against your nose and find a word or letter to focus on. Bring the reading material out until it becomes clear and this will be the correct distance to read at. Any closer or further than that and the print will not be as clear.

6. Be patient and rely on others: I know this is easier said than done, but patients who do best with limited vision are those who understand that they need to relearn how to “see”. This requires adequate lighting, contrast, size, and viewing distance, which essentially depends upon one’s patience. Having a strong support system and relying on others are key to improving one’s function and outlook. Join a support group, see a counselor or confide in a trusted friend or family member. There are numerous support groups, some often found in a community senior center.

Losing one’s vision is a devastating, life-altering experience, but it’s not entirely hopeless. A recent blog article by Dr. Lisa Weiss, OD has some great resources for those suffering from vision loss. A great place to begin is to see a low vision optometrist. Check with the California Optometric Association’s http://www.eyehelp.org to find one.

 

~ Cindy P. Wang, OD, FAAO
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

Age-related macular degeneration: what you need to know

US population – 318.8 million
US population over 60 – 60.5 million
US population with age-related macular degeneration – 15 million

Age-related macular degeneration (AMD) is the number one cause of blindness over the age of 60. As the population continues to age, AMD will continue to cause millions of people to lose their vision.

Image courtesy of Sohrab
Gollogly website at http://www.sohrabgolloglymd.com

So what is AMD and how can it be treated?

Age-related macular degeneration is the breakdown of the light sensing tissue in the back of the eye – the retina. In the normal process of seeing, as light hits the nerves in the retina, the nerves go through a chemical change in order to send a signal to the brain saying, “light, hit me.” As the nerves go through this change, they slough off a lipo-protein material called drusen that is cleaned up by the layers below the retina. In the normal process of aging, these garbage collectors in the retina don’t do their job as well and with time, drusen begins to deposit. These cells are important, not only for cleaning up the debris of seeing, but also for bringing nutrients to the retinal. In AMD, there is a faster than normal aging in the retina, resulting in a greater buildup of drusen and eventually the loss of the light sensing nerves and loss of vision.

Most people who develop AMD develop a slow loss of vision over many years. This is the definition of “Dry” AMD. In about 15 percent of patients, the body’s response is to grow new blood vessels into the damaged area of the retina in order to try to fix the problem. These new blood vessels are poorly constructed and leak badly. This “Wet” form of AMD causes bleeding in the retina and a rapid loss of vision within weeks to months.

Unfortunately, there is no treatment for macular degeneration. In some cases, the use of lasers or injections of medications into the eye can “dry up” wet-AMD, but cannot stop the slow steady loss of vision. Fortunately, AMD does not cause complete blindness, only the loss of central vision. However, dealing with the loss of vision from AMD can be difficult. Fortunately, the use of magnifiers and other low vision devices prescribed by low vision specialists can help significantly with the activities of daily living.

The goal of treatment is early detection and mitigation of vision loss. Detection can only happen by the examination of the eye by a doctor of optometry or ophthalmology using special instruments to examine the inside of the eye.

Researchers at the National Eye Institute tested the use of nutritional supplements to protect against AMD. This Age-Related Eye Disease Study 2, AREDS2, found that daily supplements of certain vitamins and minerals can slow progression of vision loss in people who have intermediate AMD, and those who have severe AMD in one eye. The AREDS2 study recommends the following nutritional supplements for patients who have AMD:

• 500 milligrams (mg) of vitamin C
• 400 international units of vitamin E
• 80 mg zinc as zinc oxide (25 mg in AREDS2)
• 2 mg copper as cupric oxide
• 15 mg beta-carotene, OR 10 mg lutein and 2 mg zeaxanthin

In addition, other factors increase the risk of developing AMD – smoking, obesity, UV light absorption, systemic vascular diseases, and poor nutrition. So it is important to quit smoking, wear glasses that inhibit UV light, eat a diet high in fruits and vegetables and have yearly eye exams to detect AMD in its early stages. Remember, there are no symptoms until the later stages of the disease, so eye examinations by doctors of optometry and ophthalmology are the only way to determine if you are at risk of developing vision loss from age-related macular degeneration.

 

~ Dr. Steven Sage Hider, OD
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

 

Coping with vision loss

Photo courtesy of Mashable.com

Sometimes, it’s easy to take our vision for granted. Vision is our most dominant sense. We rely on it for just about everything and rarely need to think about what would happen if we lost this precious gift of sight. In the last few months, this topic has hit home with me in a very personal way. My close friend, who is a graduate student, suicide crisis counselor, avid reader, husband and father to two boys has recently lost his sight. I asked him to share his experiences first hand:

“Since the complete legally blind diagnosis only came to me less than a month ago, the coping is still coming. For me, it might have helped that I was already blind in my left eye from a previous retinal detachment. In the meantime, it has been key for me to keep busy and not dwell on the negative.  Contacting the Department for the Blind and Visually Impaired (DBVI) was one of the first things we did. The DBVI have been amazing with a turn around time of two to three days, at the most. They have given me access to technology such as a portable CCTV/video magnifier and a regular CCTV/video magnifier – both have made my life easier. They will be providing me with my white cane and mobility training, as well. I have signed up for bookshare and started using an on screen magnifier, which have also helped. 

I think for me, the biggest things that have helped me cope will be returning back to school, work and my internship. It will be good to keep busy so I don’t  dwell on the topic of my blindness all the time. It has been suggested I also see a counselor, which I may do in the future.

One thing most people don’t realize is that this is a loss. I have been going through the different stages of grief, mostly anger and sadness. I think of all the things I am never going to see. I am not going to get to teach the boys how to drive or “see” them graduate high school. Then, I remind myself that it could be a lot worse. There are always worse scenarios and I just keep reminding myself of that. Of course, my wife and the boys have been very supportive and encouraging.  

No matter what, life goes on, and sometimes you get hit with a curve ball, but that doesn’t mean life has to stop.

If something is bothering your eyesight, don’t delay.  I assumed the black patch and flashing light in my eye was due to being tired and stressed. Instead, it was a retinal detachment.

Go to your eye doctor immediately. Had I done that, then I might still have vision in my left eye.

I have found the following resources helpful: https://www.bookshare.org/ | http://www.vdbvi.org/ | http://www.aisquared.com/“

 

If you are facing this challenge either for yourself or a loved one, contact your COA Optometrist for available resources in your area.  And remember to have your eye exam every year, so that your doctor can detect any potential vision threatening conditions early.

~ Lisa M. Weiss, O.D.
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org