by Marc R. Rose
Thanks to modern technology, people with low vision can make the most of their remaining sight. There are dozens of gadgets to choose from that will make your life as a partially sighted person much easier. You don’t have to give up the activities you love. You can remain in charge of your own finances and read those tiny labels in the grocery store.
For those who are totally blind, there are many options as well. Because most of the people who will benefit from this book don’t fall into this category, this chapter will focus on how to enhance remaining sight. If you would like information or resources on aids for the totally blind, contact the American Foundation for the Blind at (800) 829-0500.
About Low-Vision Aids
There are three categories used to classify low-vision aids:
1. Optical aids: These are used to control focus and clarify or magnify images. They include magnifying glasses, spectacles, clip-on jewelers’ loupes (these single-eye magnifiers can be attached to glasses for fine, detailed work such as embrodiery), absorptive lenses, visual aids that are worn on the head (to allow comfortable distance viewing of television, movies, or plays), and telescopes.
2. Nonoptical aids and approach magnification: These are steps you can take to control illumination and contrast to improve vision. Moving closer to an object, using brighter lights, and the use of reading and typing stands, filters, pinholes, tints, large print, visors, side shields, and guides to help with handwriting and check writing fall into this category.
3. Electronic aids: Closed-circuit television, where a book is magnified on your TV screen, is an example. In this age of computers, there are countless programs and hardware you can install to make your computer a useful and versatile tool for coping with vision loss.
In this chapter we will give you some general information about low-vision aids. In Appendix II is a listing of some of the organizations that can help you to make the most of your remaining vision. It’s important that you sit down with your ophthalmologist or an experienced low-vision specialist to discuss your options. He or she will try to understand your needs and will help you to obtain the devices best suited to your lifestyle. Ask your eye doctor to recommend a low-vision consultant in your area.
Learning to Use Peripheral Vision When You Have Macular Degeneration
For those with macular degeneration, mastery of a technique called eccentric viewing gives you full use of remaining vision. Since the blind spot is always at the very center of your visual field, you can look slightly off center. This allows you to look around the blind spot to better see the television, food on your plate, or faces you might otherwise not recognize. Try making a habit of looking at one corner of the TV screen. It takes some practice, and you will need to experiment to find your ideal off-center focus. You’ll be surprised at how much you can see once you’ve mastered this technique.
Magnifiers
There are many kinds of magnifiers for you to choose from. For hands-free viewing, you can use magnifiers that clamp onto the edge of your desk. They usually have flexible necks that allow you to move the glass around as needed. There are other models you can hang around your neck or that are worn on a headband. Large magnifiers can be mounted on four legs and placed over a book.
Hand-held magnifying glasses, often with small lights mounted in the frame, can be found in many sizes and shapes to fit in pocket or purse. You usually can find these at the drugstore. Magnifiers with high-powered halogen lights are especially good for those with poor dim-light vision. Aspheric magnifiers help eliminate irregularities in images so that you can have powerful magnification while having a large field of view.
Bar readers are long and slender, designed for magnification of a single line of text on a page. Page viewers allow you to magnify most of a page for ease in reading maps or text. Lighted fold-up magnifiers are great for reading labels or coupons at the market. Jewelers’ loupes—used by jewelers and watchmakers for very fine work—can be held to the eye or mounted on glasses. If you love to build models, embroider, or do other handiwork, loupes are indispensable. (You can buy them at camera shops.) Magnifying mirrors allow you to apply makeup, shave, and groom with a clear view.
For distance viewing, you can use focusable binocular glasses. Wearing them on a headband is comfortable for long viewing periods at movies or shows. A focusable monocular held up to the eye is good for intermittent distance viewing.
Nonoptical Aids and Approach Magnification
Bring plenty of light into your home. Adjustable halogen lamps with high-wattage bulbs can be mounted above work to create a wide pool of light. Special lamps and filters can improve contrast. Carry a halogen-light pocket magnifier with you to see better in dim restaurants and shops.
Large-print reading materials are widely available; check Appendix II.
Books on tape can be bought or borrowed from the library. Interlibrary loan of these materials is available, and you can listen to novels, nonfiction, or even textbooks.
Handwriting guides allow you to write letters and checks neatly.
Electronic Aids
For comfortable low-vision reading, you can use a closed-circuit TV system. These can be used with any television set. The document you’re reading is placed beneath a small camera, which brings the text onto your TV screen. You can enlarge it as much as you want, and some systems allow you to read either dark letters on light background or white on dark (the latter can reduce glare). This tool can be used for writing as well. A movable platform allows you to move reading or writing material in any direction. You’ll be able to pay your own bills, read your own mail, and enjoy reading books. A company called Okay Vision-Aide Corporation sells many different closed-circuit TV models at reasonable prices, and they give you plenty of instruction and support when you use their products. They can be reached at (800) 325-4488.
Visionics Corporation makes special binoculars, worn on the head, that allow you to program in your eyeglass prescription so that you don’t need to wear glasses while using them. You can use a complex set of controls to zoom in on objects across the room or to see up close. It’s like wearing a video camera on your head. It’s a new gadget, very bulky and not easy to use, but if you’d like more information you can call (800) 684-7834.
Computer Applications
Many older folks are intimidated by computers. Five-year-olds are already “surfing the Net,” but those of us accustomed to typewriters and libraries have trouble adjusting to the world of word processing and CD-ROMs. However, it’s truly astonishing what you can do with the right computer system, and for partially sighted people it can be a liberating tool.
To enlarge text on the screen, you can use the “zoom” feature included in many word-processing programs. You also can buy large magnifying screens to put over your computer screen. Programs like inLarge, from Berkeley Access (a division of Berkeley Systems, Inc., which specializes in low-vision computer applications), allow you to enlarge text or graphics from two to sixteen times. Berkeley Systems also makes a terrific, inexpensive text-to-voice translator for the Macintosh computer, as well as portable video reading systems with light headsets that you quickly can connect to any TV or monitor.
Text-to-voice translator programs or speech synthesizers can be used with your computer. Having text read to you as you read it yourself will allow you to read quickly and with great accuracy. A programmer named John F. Adams has invented a system he calls “Proportional Reading,” which allows the reader to display one sentence or even one word at a time on the screen as a voice reads it. This could be very useful for those with macular degeneration because the eyes don’t have to move along the page. Your focus could remain on one corner of the screen, and you comfortably could use your peripheral vision. His E-mail address is [email protected]. If you want to read materials other than those that can be bought on disc or CD-ROM, you can use a scanner that brings text from the page onto your screen.
A company called Universal Low Vision Aids sells and rents closed
-circuit TVs as well as computer hardware and software. Many of the manufacturers I’ve mentioned sell their products through this company. Universal Low Vision Aids also carries computer programs that allow you to Training and technical support is provided with their products. Call them at (614) 486-0098 to find out more.
• fill out preprinted forms using your computer; and
• use any video monitor or TV as a monitor for your computer. (Imagine—a big-screen TV as a computer monitor!)
Don’t let yourself be intimidated by computers. All the help you need is available from representatives of the company whose computer you buy. If you don’t have a computer yet, it’s a good idea to sit down with a low-vision-aids consultant before shopping for one. Make sure you have the best model with all the needed hardware so that you can use these special programs.
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IN SHORT…
1. If you have lost much of your vision, there are tools and gadgets in abundance that can help you to maintain your independence and your quality of life.
2. Sit down with your ophthalmologist or a low-vision-aids consultant to decide which low-vision aids will work the best for you.
3. Take advantage of the many organizations dedicated to improving the lives of partially sighted people. If there are any support groups in your area, try to attend meetings. Having the support of others with similar problems will improve your sense of well-being dramatically and diminish frustrations.
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Appendix I:
A Summary of Nutritional Prescriptions for Eye Disease
Your Daily Multivitamin Should Include…
Beta-carotene/carotenoids: 10,000–15,000 IU
Vitamin A: 5,000–10,000 IU
The B Vitamins:
Thiamine (B1): 25–50 mg
Riboflavin (B2): 25–100 mg
Niacin (B3): 50–100 mg
Pantothenic acid (B5): 50–100 mg
Pyridoxine (B6): 50–100 mg
Vitamin B12: 1,000–2,000 micrograms (mcg)
Biotin: 100–300 mcg
Choline: 50–100 mg
Folic acid (folate or folacin): 400–800 mcg
Inositol: 150–300 mg
Calcium: 300–500 mg for men; 600–1,200 mg for women
Vitamin D: 100–400 IU
Vitamin C: 2,000–10,000 mg (2–10 g)
Vitamin E: 400–800 IU
Boron: 1–5 mg
Chromium: 200–400 mcg, as chromium picolinate
Copper: 1–5 mg
Magnesium: 300–500 mg
Manganese: 10 mg
Selenium: 25–50 mcg
Vanadyl sulfate: 10–25 mcg
Zinc: 10–30 mg
The recommended amounts of nutrients in the following “nutritional prescriptions” are in addition to your daily multivitamin, unless specified otherwise.
Daily Nutritional Prescription for Macular Degeneration
Vitamin C and bioflavonoids: at least 2,000 mg of vitamin C, and 200–400 mg of bioflavonoids
Beta-carotene: 15,000–25,000 IU
Vitamin A: 10,000–25,000 IU, for three months
Lutein and zeaxanthin: 6–10 mg
Magnesium: 300–500 mg, at bedtime
Fish Oils: Follow the directions on the container.
Vitamin E: 800 IU (total)
Selenium: at least 200 mcg
N-acetyl cysteine (NAC): 500 mg, 2–3 times
Taurine: 500–1,000 mg, between meals
Garlic: about 1,000 mg of the odorless capsules
Zinc: 15–30 mg, if your multivitamin is low in zinc
Coenzyme Q10: 30–200 mg
Hydrochloric acid: 250 mg, with meals, if needed
Daily Nutritional Prescription for Glaucoma
Vitamin C: 1,000 mg
Vitamin E: as recommended in your multivitamin
Beta-carotene: 25,000 IU
Carotenoids: Use a mixed carotenoid supplement at different times from your food ingestion of beta-carotene (see page 96).
Vitamin A: 5,000–10,000 IU
Quercetin: 1,000–3,000 mg
Rutin: 1,000–3,000 mg
Magnesium: 250–400 mg, at bedtime
Vitamin B complex: as recommended in your multivitamin
Vitamin B12: 1,000–2,000 mcg (Since it is not well absorbed when taken orally, take it sublingually—under the tongue—or use a nasal spray or gel.)
Zinc: as recommended in your multivitamin
Coenzyme Q10: 90–200 mg (Use with ginger root capsules for added effect if you have low-pressure glaucoma; this will increase your heart’s pumping capacity.)
Carnitine: 500 mg, to strengthen the heart’s pumping power
Omega-3 oils found in fish (see page 98). (DHA, a component of omega-3 oils, is a component of the optic nerve lining.)
Garlic: 1 raw clove, with food; or 1,000 mg of the odorless capsules
Coleus (forskolin): 200–400 mg
Chromium: 200–600 mg if you are using beta-blocker eye drops, to help boost HDL cholesterol
Daily Nutritional Prescription for Cataracts
Vitamin E: as recommended in your multivitamin
Vitamin C: 1,000–2,000 mg
Beta-carotene: 10,000–25,000 IU
Vitamin A: 5,000–10,000 IU
Zinc: 15–30 mg (total for the day)
N-acetyl cysteine (NAC): 500 mg, 2–3 times between meals
Rutin (a bioflavonoid): 250 mg
Quercetin (another bioflavonoid): 1,000–3,000 mg
Chromium:200 mcg
Riboflavin: 50 mg (If you need to add to your multi-vitamin, do so.)
Coenzyme Q10: 30–90 mg
Curcumin (turmeric): liberally as a spice, or taken as a supplement according to directions on the bottle
Daily Nutritional Prescription for Diabetic Eye Disease
Vitamin C: 1,000 mg (This may alter the color of urine strips.)
B vitamins: as recommended in your multivitamin
Vitamin E: as recommended in your multivitamin
Beta-carotene: as recommended in your multivitamin
Quercetin: 500–1,000 mg
Chromium: 100–200 mcg
Vanadyl Sulfate: 10–20 mg
Magnesium: 400 mg, at bedtime
N-acetyl cysteine: 500 mg, 2–3 times between meals
Omega-3 oils from cold-water fish (see page 98)
Garlic: 1 raw clove, with food; or 1,000 mg of the odorless capsules
Zinc: as recommended in your multivitamin
Carnitine: 500 mg
Alpha lipoic acid: 500 mg in divided doses (Use caution; it may cause your blood sugar to dip precipitously.)
Daily Nutritional Prescription for Retinitis Pigmentosa
Vitamin E: as recommended in your multivitamin
Vitamin C and bioflavonoids: 1,000–2,000 mg and 250–400 mg, respectively
Beta-carotene: as recommended in your multivitamin
(Take all of the above antioxidants together, so they can re-energize one another as they work.)
Lutein/zeaxanthin: 6–12 mg, at different times from your food ingestion of beta-carotene
Zinc: as recommended in your multivitamin
B vitamins: as recommended in your multivitamin
N-acetyl cysteine (NAC): 500 mg, 2–3 times between meals
Quercetin (another bioflavonoid): 500–1,500 mg
Bilberry, grapeseed, and cranberry extracts: (These are other good sources of bioflavonoids, which help vitamin C to strengthen capillaries in the eyes.) Follow dosage instructions on the container.
Coenzyme Q10: 30–200 mg
Magnesium: 300–400 mg
Carnitine: 300–1,500 mg
Cayenne pepper capsules: 1–2 capsules with meals to help relieve headaches
Ginkgo biloba: 120–360 mg
Alpha lipoic acid: 100–300 mg
Taurine: 1,000 mg (taken with 800 IU vitamin E, divided into 2 doses) if you have the autosomal dominant form of RP, or if you have Usher’s s
yndrome
Daily Nutritional Prescription for Clear, Strong Blood Vessels
Vitamin C: as recommended in your multivitamin, and up to 10,000 mg (10 g) if needed
Vitamin E: as recommended in your multivitamin
Magnesium: as recommended in your multivitamin
Folic acid: as recommended in your multivitamin
Vitamin B6: as recommended in your multivitamin
Vitamin B3 (niacin) in the form of inositol hexanicotinate: 100 mg
Vitamin B12: 1,000–2,000 mcg sublingually or intranasally
N-acetyl cysteine (NAC): 500 mg, 2–3 times
Lysine: 300–500 mg, 3 times
Proline: 300–500 mg, 3 times
CoQ10: 30–90 mg, in the liquid oil form
Carnitine: 100–150 mg
Betaine hydrochloride: a 300-mg tablet, increasing the amount if needed, with meals to improve digestion and absorption of B vitamins
Appendix II:
Resources
For More Information on Intravenous Nutrients
Call or write the American College for Advancement in Medicine, listed below under “Chelation Information,”
or
Order Nutritional Therapy in Medical Practice, by Alan R. Gaby, M.D., and Jonathan Wright, M.D., by writing Wright/Gaby Seminars, 515 W. Harrison Street, Suite 200, Kent, WA 98032, or calling (206) 854-4900, ext. 166.
Chelation Information and Referrals to Alternative Health Care Professionals
American College for Advancement in Medicine (ACAM)
P.O. Box 3427
Laguna Hills, CA 92654
(800) 532-3688
In California: (714) 583-7666
Mail Order Vitamins
The Vitamin Shoppe, Call 1-800-223-1216 to order a catalog.
Life Extension Vitamins 1-800-544-4440
Organizations for the Partially Sighted and Blind
Support, Information, and Low-Vision Aids
National Association for the Visually Handicapped
22 W. 21st Street
New York, NY 10010
(212) 889-3141
Fax: (212) 727-2931
Provides counseling in the testing, purchase, and use of low-vision aids and special illumination for the low-vision reader. A catalog is available. The NAVH also offers a large-print lending library by mail, with over five thousand titles to choose from. They put together a newsletter and offer educational materials on eye diseases and emotional support for those individuals and their families who suffer from them.