"Eccentric viewing" treatment aids those with macular degeneration

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Date: Thu, 4 Oct 2007 22:00:07 -0400

The Daily Mail (UK)
Tuesday, October 02, 2007

By LESLEY GIBSON

Simple eye exercises that help the blind see again

The world is a dismal looking place for anyone with macular degeneration.

They can't distinguish between people's faces, can't drive, can't read or even
watch TV - words and images are just a blur.

Some can't see in colour.

For the half a million Britons who have it, macular degeneration is a pretty
bleak diagnosis - and there is no cure.

But now a simple new approach to treating the condition could greatly improve
patients' lives.

This treatment - known as "eccentric viewing" involves changing one's angle of
vision to make use of healthy parts of the eye that can still see.

It can help even those with severe sight impairment to read and see people more
clearly.

Two years ago Richard Elliott, 66, a retired civil engineer, from Shrewsbury,
developed macular degeneration in his right eye.

"My vision became distorted, so straight lines, like lampposts, looked bent,"
he says.

"I sing with my church male-voice choir and started singing wrong notes because
I wasn't seeing the first note in each bar; only the second. I was terrified I
was going to go blind."

He underwent eccentric viewing training in July and is now able to read again.

"I was so moved I cried," he says. "I was elated."

Ophthalmologists describe the technique as a breakthrough.

As Winfried Amoaku, an ophthalmologist consultant and chairman of the
Scientific Committee of the Royal College of Ophthalmologists, says: "It can
make a big difference to people's lives." The macula is the central part of the
retina -the tissue at the back of the eye that sends visual signals to the
brain.

It is the size of a grain of rice and is the area of the retina we use to see
colour and fine details. There are 1,500 conditions affecting the central
vision, but the most common is age-related macular degeneration, which
typically affects the over-60s. The retina becomes wrinkled (this is known as
"dry" macular degeneration) or abnormal blood vessels start growing and leaking
onto the retina, causing scar tissue ("wet" macular degeneration).

Both types distort central vision, although the dry form is much more common.

Wet macular degeneration is particularly serious as it invariably leads to
blindness unless treated and is the more aggressive form of the disease.

However, if caught early, the wet form can be treated with medication.

The drug Lucentis has been shown to halt and, in some cases, even reverse the
condition; but there is a postcode lottery for treatment, with some NHS trusts
rationing the drug because it is very expensive.

Avastin, which is cheaper and believed by some doctors to be as effective, is
currently undergoing NHS-funded trials.

However, there is no effective treatment for the dry form of the condition.

The new technique works by helping people to find and use peripheral parts of
the retina where the tissue is healthy, instead of the central part, which may
be useless.

For instance, instead of moving their eyes across a page, the patient learns to
find the point in their eye that can see best, and move the page across that
spot.

This might mean having to look above, below, or slightly to one side of a word
to focus on it most clearly.

Learning the technique requires dedication and concentration.

"You have to re-educate your brain to read differently, and your eyes to look
differently," says Richard Elliott.

"You have to really concentrate.

"First you use a series of charts to pinpoint the part of your retina that can
focus in the most detail. You have to aim off the target; instead of looking
straight at it, you look slightly away from it."

Richard Elliott's situation was particularly desperate as he had only one
"good" eye to start with.

Soon after he was born during World War II, his hometown of Sevenoaks was
bombed, and the shockwaves caused his left eye to turn inwards.

This meant his vision didn't develop properly.

Fortunately his right eye compensated but then, two years ago, it developed age
related macular degeneration.

Because of the risk of the right eye deteriorating even further, Richard was
given training in his "useless" left eye.

"When the training began, I could only just read the top letter on an
optician's chart: about the size of the headlines on this page, directly in
front of me. Within three days, I was reading newsprint with the left eye I'd
been told was useless. I was astonished."

With the help of strong lighting and magnifying glasses, other patients, some
of whom have been unable to read for years, can often see in enough detail to
enjoy even small text again.

Richard now trains other people in eccentric viewing, as a volunteer.

"it's extremely rewarding," he says.

"The technique is very simple, yet incredibly effective."

Not only those with age-related macular degeneration can benefit; people with
many other conditions affecting the macula can be taught to see more clearly,
too.

For younger people with macular disease, it can make an important difference to
their lives.

Sheridan Dixon has Stargardt's disease, a form of macular dystrophy which
causes gradual loss of the central vision.

It's a genetic condition for which there is no cure.

"By the age of 28, reading had become so laborious that I gave up doing it for
pleasure," recalls the 45- year-old.

"And it became difficult to recognise people from a distance."

She was registered blind at 29.

After giving up her clerical job to raise her children - she lives with husband
Jed, 51, and children Ross, 17, and Amy, 15, in Jarrow, Tyneside, - she feared
she'd never be able to return to work.

"I used to get upset," she says.

"Losing your sight is hugely frustrating.

"I worried about the effect on my husband and children, as well as on me.

"I wished I could take them out, like other mums, but I've never been able to
drive."

Then in 2005 she heard about the eccentric viewing technique through the
Macular Disease Society, and was among the first to learn it.

"The trainer helped me identify my best eye, and the part of my retina best
able to focus using high magnification and good overhead lighting," she says.

"Perfecting the technique was hard work. But I practised every day for a
fortnight, until I was reading for two hours at a stretch."

Seven years ago, Sheridan's son bought her the novel My Beloved Son by
Catherine Cookson.

"I felt very touched but terribly sad, because I thought I'd never be able to
read it," she says.

Yet after learning eccentric viewing, she was astonished to find she could read
the novel after all.

"It was so liberating to be able to snuggle up on the sofa next to my husband
and read for pleasure for the first time in 20 years," she says.

"And it was wonderful to be able to tell my son I'd enjoyed his gift."

The technique has helped her to work, too - three years ago she found a job as
an empowerment officer for the charity Sight Service.

After eccentric viewing training she was able to give a talk to 70 people at a
Department of Health conference, using the technique to read her notes.

Everyday tasks such as shopping are easier, too, now she can read labels and
cards for herself.

Eccentric viewing is being taught in three-day courses for members of the
Macular Disease Society.

For more information, contact the Macular Disease Society on 01264 350551

http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=485170&in_page_id=1774
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"Eccentric viewing" treatment aids those with macular degeneration

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