There is an article in "The Magnifier" written by Joe Fontenot, MD, CLVT which states that "...formal Orientation and Mobility training by an Occupational Therapist may be needed. This could include use of the long white cane and possibly even a guide dog." If Dr. Fontenot is on this listserv, I would certainly be interested in how he came to make that statement! (I do not understand how a person can seek ACVREP certification for CLVT and be unaware of COMS). Polly Abbott CVRT, Orientation and Mobility Specialist Certified Vision Rehabilitation Therapist Director of Rehabilitation Services Second Sense 65 E. Wacker Place Suite 1010 Chicago, IL 60601 (312) 236-8569 www.second-sense.org We can help you put your best foot forward with our employment readiness workshops at Second Sense. Learn how to work a job fair, plan your SSA benefits and test your interviewing skills! Check our calendar for dates and times for these free, informative October workshops! -----Original Message----- From: Kathy Austin Sent: Monday, September 30, 2013 12:50 PM To: Polly Abbott Subject: FW: The MAGNIFIER - ISSUE #92 JULY - SEPT 2013 Here's the article I was talking about. -----Original Message----- From: The Magnifier [mailto:keith@xxxxxxxxxxxx] Sent: Monday, September 30, 2013 2:21 AM To: Kathy Austin Subject: The MAGNIFIER - ISSUE #92 JULY - SEPT 2013 Please find attached the latest version of the MAGNIFIER Newsletter from the Macular Degeneration Foundation. The online PDF version is produced in full color and designed to read on your computer monitor with the ability to adjust its magnification in Adobe Reader and use hyperlinks embedded into the document. A separate TEXT version is also attached. If preferred, U.S. readers may request that a printed version be mailed to them. Contact Liz Trauernicht at liz@xxxxxxxxxxxx with your name and mailing address. Thank you, MDF You may automatically unsubscribe from this list at any time by visiting the following URL: <http://www.eyesight2008.org/cgi-bin/dada/mail.cgi/u/the_magnifier/>
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THE MAGNIFIER - ISSUE #92 July - Sept 2013 AGING AND VISION CHANGES As you age, it is normal to experience some changes in your vision, such as difficulty adjusting to glare, and distinguishing some colors, particularly shades of blue and green. Some common vision problems require glasses or contacts to see clearly and up close. However, these changes can be easily corrected and won't lead to vision loss or blindness. Remember, vision loss is not a normal part of aging. In fact, you can live an active lifestyle well into your later years without ever experiencing vision loss. If you have been diagnosed with macular degeneration (AMD), you probably have heard your eye specialist mention something about seeing some drusen during your eye exam. =============== WHAT ARE MACULAR DRUSEN? The development of these yellow deposits is the first signs of AMD. Some people have them even before they notice any changes in their vision. Macular drusen are yellow deposits that develop between the retinal pigment epithelium and the choroid layer - the layer of blood vessels that supply nutrients to the macula. There are many factors that lead to the development of AMD, but one of them is the inability of the macula to get rid of waste products or to get oxygen rich nutrients from the underlying tissue. Drusen can contribute to the clogging up of this transport system. The photoreceptor cells, the rods and cones, require lots of oxygen and when they don't receive enough of it, they begin to degenerate or die. The macula is made up of predominantly cone cells. Cone cells are responsible for our color vision, central vision and our detailed our sharp vision. As these cone cells die, colors are less vivid, detailed or sharp vision becomes blurry, and our straight ahead or central vision gets cloudy. Types of Drusen There are two types of drusen - hard and soft. It is important to know which ones you have. Hard drusen are small and round with very sharp borders. These well-defined deposits are light yellow and thought to be less harmful. They become more common with age and may or may not indicate the early development of age related macular degeneration. Soft drusen are different. They are larger with less defined borders. They vary in size and shape. When your eye doctor sees soft drusen during an eye exam, there is more cause for concern. These deposits are thought to be more harmful because they interfere with waste products getting removed from the macula and rich oxygen getting to the macula. People who have soft drusen will often have more vision changes than those who have only hard drusen. They may find that they need more light to see bills, to read or perform hobbies. A smudge or blurry spot may appear in the center of their vision. Questions for Your Eye Doctor The next time you go for an eye exam ask your doctor about the drusen in your eyes. Find out: 1. Do I have any drusen? 2. If so what kind of drusen do I have? 3. What size are they and how many large or medium size ones do you see? The number, size and type of drusen help to define what stage of macular degeneration the patient has. ============= PLEASE HELP ME, I'M FALLING! Common sense, as well as the Mr. McGoo cartoons, tells us that poor vision makes it more likely to fall. Medical studies bear this out. Falls are serious and frequent events. According to a 2008 report by the Center for Disease Control (CDC) one third of those over the age of 65 have a fall every year and one out of 10 falls results in a serious or even fatal injury. Falls are a major cause of death in people over the age of 65. Vision impairment is one of the major risk factors for falling. Falls occur at any age, but have more serious consequences for older people. One fall, even if not serious, may predict more dangerous falls to come. You do not need to curtail your activities, but should consider fall prevention measures. Macular degeneration and falls People who have macular degeneration are particularly prone to falling. Those with macular degeneration tend to have problems with depth perception. One eye is frequently affected more than the other, resulting in loss of depth perception, a major risk factor for falls. Contrast sensitivity, the ability to see well in low lighting and situations where there is little difference in colors and textures, is impaired. Blind spots (scotoma) are almost invariably present in macular degeneration, making it difficult to see small objects or obstacles. Although macular degeneration by itself rarely causes total blindness, it may be compounded by glaucoma or diabetic eye disease. If this is the case, formal Orientation and Mobility training by an Occupational Therapist may be needed. This could include use of the long white cane and possibly even a guide dog. However, this is rare if the only eye problem is macular degeneration. What to do? What should those with macular degeneration do to prevent falls and injury? Do not stop being active and getting out. Instead, consider the following adjustments: Glasses * Do not wear multifocal (bifocal, trifocal, or progressive) glasses while walking, especially in unfamiliar surroundings. The lower part of the glasses are designed to focus at a short reading distance and anything further than that is out of focus and blurred. Anything on the ground or stairs will be difficult to see clearly. Wear distance prescription glasses or no glasses. The great Benjamin Franklin, inventor of bifocal glasses, has been the cause of many falls. Home (where most falls occur) Modify your home environment. More than half of all falls occur at home. * High risk areas include bathrooms, especially the shower and tub. Avoid reaching for the towel bar for stability it will not hold your weight. Instead, add grab bars and rails that are permanently installed into a wall stud. Invest in a bath tub bench that straddles the tub. Sit on the bench and position yourself inside the tub. This saves energy by eliminating the struggle to regain your balance to get in and out of the tub. Avoiding loose rugs and wet, soapy floors can prevent many falls. * Stairs are another high risk area. If you fall down stairs, you may have a long way to go. It is like multiple falls. Always have at least one hand on the handrail. Do not carry things in both hands. Have good lighting, hand rails and mark the edge of steps to increase contrast. Never leave loose objects on stairs. * Do not store objects that you use frequently so high that you will need to climb on something to get them down. Store them at counter top height * Add night lights or motion sensitive lights in areas where you may go at night-as, bathroom, kitchen, etc. * Do not run to answer the phone. Carry a cell phone with you at all times, so you can answer easily and can call if injured. * Think before you climb. Improvised stands or ladders, such as a chair, cause many falls. * Remove any and all loose objects on floors and stairs. Do not have loose or unattached rugs. Clear loose power cords. In the community * If you have mobility or balance problems use a cane or walker in unfamiliar areas. Make sure your aids are properly adjusted. An evaluation by a physical therapist would be best. * Beware of uneven terrain in your yard, up and down hills, curbs and be mindful of unfamiliar stairs. * Consider installing motion sensor flood lights to the corners of your house to provide better illumination between dusk and dawn. Some creative folks string clear white Christmas lights around trees and bushes bordering their pathways to light the way. Other measures * Join an exercise program. Strength and flexibility make it more likely that you will recover from a minor imbalance. Exercise and perform flexibility and balance training. Leg strength training is the most important, as it has been shown that leg weakness is a major risk factor for falls * If you are dizzy or unbalanced on standing after lying down or sitting, ask your doctor to check you for a sudden drop in blood pressure (postural hypotension) * Do not walk in high heels or loose-fitting slippers, socks or slip-on shoes. Shoes should have non-slip soles and low heels. Do not have loose untied laces when walking. * Medication or alcohol may cause falls. Sleeping pills and antidepressants should be reviewed and discussed with your doctor, especially if you fall and were unusually unbalanced or cannot remember the fall. * Medical alert systems can be considered. Having a cell phone with you at all times is an alternative. Who can help or give advice regarding fall prevention? 1) Your local Area Agency on Aging may have a free all prevention program "A Matter of Balance". This is currently available in 38 states. Contact them for free advice and local help. Call 1-800-677-1116 to locate your local Area Agency on Aging or go to www.eldercare.gov 2) The American Foundation for the Blind's "Vision Aware " program has tips and advice regarding fall prevention 3) Many local hospitals and home health agencies have fall prevention programs. 4) Orthopedists and other medical professionals such as Occupational and Physical Therapists are knowledgeable and helpful about fall prevention. 5) You can obtain the Center for Disease Control's "Preventing Falls" publication. This has an extensive list of risk factors and recommendations. "Preventing Falls", CDC 2008 National Center for Injury Prevention Control, http://www.cdc.gov/homeandrecreationalsafety/images/cdc_guide-a.pdf 6) YouTube has a few good videos on fall prevention, such as the one below. You can search "Fall Prevention". http://www.youtube.com/watch?v=_R6iOWea00w 7) Fall prevention Day, Sept. 22, 2013 is the 6th annual National Fall Prevention day, sponsored by the National Council on Aging (www.ncoa.org) 800-677-1116. There may be local publicity and activities related to this. Contact your local Area Agency on Aging for more information. Joe Fontenot MD, CLVT Medical Director Community Services for Vision Rehabilitation Mobile Alabama Marie Cafferty LPTA SARPC, Area Agency on Aging Mobile, Baldwin,Escambia Health and Wellness Regional Coordinator ============== Applications for Your iPhone & iPad LookTel Money Reader LookTel Money Reader instantly recognizes currency and speaks the denomination, enabling people experiencing visual impairments or blindness to quickly and easily identify and count bills. Point the camera of your iOS device at a bill and the application will tell you the denomination in real-time. Twenty one currencies are supported. Color Identifier Color Identifier uses the camera on your iPhone or iPad to speak the names of colors in real-time. It will also tell you the hex value of the color, so you can identify exactly what color the camera sees. List Recorder List Recorder combines making lists with an easy to use, yet powerful audio recorder. The result is a handy app that lets you quickly jot down and organize information. It is also a great organizer, so you wont lose track of your audio after its recorded. Manage all kinds of information by making lists of items that can include both audio and text. Give your items do dates. Make lists within lists. VizWiz VizWiz lets blind users recruit remote sighted workers to help them with visual problems in nearly real-time. Users take a picture with their phone, speak a question, and then receive multiple spoken answers. HeyTell HeyTell® is a cross-platform voice messenger that allows you to instantly talk with friends and family. No account neededjust start the app, choose a contact, and push the button to start talking! ================ AREDS Trial & Omega-3 FISH US researchers from Harvard School of Public Health, Boston, MA, report the results of a study which found that eating fish, such as tuna, four times a week, may reduce the risk of macular degeneration. Subjects were participants in the Nurses Health Study and the Health Professionals Follow-up Study who did not have AMD at baseline. The researchers concluded that dietary fat intake was associated with an increased risk of agerelated macular degeneration, and that this may have been due to the presence of linolenic acid in the fat. They added that a high intake of fish, a rich source of docosahexanoic acid, may reduce this risk. OMEGA 3 NEI Press Release: In the first AREDS trial, participants with AMD who took the AREDS formulation were 25 percent less likely to progress to advanced AMD over the five-year study period, compared with participants who took a placebo. In AREDS2, there was no overall additional benefit from adding omega-3 fatty acids or a 5-to-1 mixture of lutein and zeaxanthin to the formulation. This does not say that Omega-3 is not beneficial. It says there was no ADDITIONAL benefit from adding it (along with lutein and zeaxanthin) to the formula. By removing betacarotene, the protection offered by the new formula has been reduced to 18%, but that is still way better than nothing, and it is probably good because of the inclusion of Omega-3, lutein, and zeaxanthin. ================
