Winter 2001 VIEWPOINT



Articles published in The Viewpoint are in compliance with Public Law No.104197, Copyright Law Amendment of 1996. This law allows authorized entities to distribute copies of previously published non-dramatic literary works in specialized formats, including Braille, audio or digital text that are exclusively for use by Blind people or those with disabilities. Any further distributing of such articles in another than a specialized format is an infringement of copyright.

Table of Contents
President's Message
Low Vision, A History of Corrective vision aids
VisAble VideoTelescope, A Revelutionary Aproach to Vision Enhancement
A research Institute investigates whether dietary changes can reduce the development of age-related macular degeneration
The future possibility of retina transplants, by Loryn Ashley
Have you ever hailed a police car instead of a cab? Low vision redefines life
Florida Council of Citizens with Low Vision Membership and Renewal Application


President's Message

Greetings one and all! Florida Council of Low Vision has been well represented recently at many area events that hold particular interest to us, society members with some usable vision.

I have worked locally with the Broward County Elections Supervisor to let them know we want to be able to vote independently. The proposed touch screen system can have an added audio feature that will give us this right. This is a major issue throughout the state and the Florida Council of the Blind is working hard to make voting a right of which we should not be deprived. I took part recently on a focus group that may help enhance services to individuals who are disabled return to work. I had an opportunity to test out the new VisAble Telescope, discussed in our last issue as well as the current issue of The Viewpoint. Input was given to the manufacturers and engineering will work to make the product even better for the Low Vision population. Additionally, I am working with Asko on the Talking Prescription bottle reader and hope to tell you more about it soon. I will also be working with the commission for the Transportation Disadvantaged to give input as a visually impaired consumer.

We have been working to reunite FCCLV and CCLVI (Council of Citizens with Low Vision International). Another print copy of our membership database was sent, received an input. I still find it amazing that the CCLVI organization has fewer members in total representing the entire United States and abroad, than FCCLV has for just our state. FCCLV will survive regardless of what the future may hold in relation to CCLVI.

We have a new addition to our Professional Advisory Board. Nutrition advisor Julie Herbst, has joined. She has submitted an article included in this issue. She is part of FCCLV to help you. Any questions you may have regarding nutrition as it relates to vision, give her a call.

FCCLV is a unique organization. We attempt to address any and all issues relating to vision loss and utilizing the vision you have to its fullest advantage. Florida is united in its stand for the visually-impaired and we are proud of our accomplishments. In this publication is a renewal form for the 2002 year. Although dues are increasing within all affiliates, FCCLV will keep membership dues to $15 for 2002. If you are currently a member and wish to renew, a special cost of $13 is again offered to you to thank you for your continued support. Thanks to each of you for making us as large and strong as we are! Have a happy and healthy holiday season and New Year.


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Low Vision, A History of Corrective Vision Aids -- from Reading Stones to LASIK

Since ancient China, humans have designed and improvised a variety of vision devices to correct faulty eyesight. By Tania Bayard

Eyeglasses to correct vision were not known in ancient times. In Rome, people with failing sight had to resort to being read to by their slaves. The ancient Chinese used sunglasses, but the lenses were not ground to correct vision; instead, they were thought to contain spirits that would do the job. By the year A.D.1000, people with poor eyesight employed reading stones, segments of glass spheres held in front of the letters to magnify them.

Eyeglasses for improving presbyopia came into being almost simultaneously in China and in the West in the late 13th century. At first, spectacles were simply two quartz-magnifying lenses set into bone, metal, or leather frames and riveted together. Concave lenses to correct myopia came about in the 16th century, and glasses to correct astigmatism were introduced In the 19th century.

Benjamin Franklin invented bifocals in the 18th century. He was unhappy using two pairs of spectacles, one for near vision and one for distance, because when he was at dinner parties he couldn't concentrate on the food and look at the people across the table at the same time. So he had both pairs of glasses cut in half and inserted one half of each in the same circle.

In the West, spectacles were at first necessary mainly for scholars and monks. After the invention of printing in the mid 15th century, more people wanted to read, and inexpensive, mass-produced spectacles proliferated. By that time, eyeglasses were also common in China, where they were a symbol of intelligence and affluence, which meant that the bigger the lenses, the smarter and richer the wearer.

For many years, people who used spectacles had to figure out how to keep them on. They could, of course, simply hold them in front of their eyes, but they also attached them to the brims of their hats, looped them around their ears with strings, or fastened them to their hair. It was not until the early 18th century that a London optician, Edward Scarlett, devised metal temple pieces to hook over the ears.

Eyeglasses may have been a status symbol in China, but until recently many people in western countries found them unfashionable. This led to a number of curious inventions, such as the lorgnette. The name, from the French word lorgner, "to peer at," is apt, because these spectacles with a handle were used for looking surreptitiously at others as well as for improving vision. Spectacle makers devised ways to conceal these glasses in parasol handles, smelling salts flasks, toothpick cases, and the handles of men's canes.

A German baron, Philipp von Stosch, developed the monocle, held in place in front of one eye by what has been described as a "grim grimace," in the 18th century. Lord Peter Wimsey and Mr. Peanut notwithstanding, this peculiar device went out of fashion after World War I. The pince-nez was another attempt at evading the fact that one's glasses were really necessary. The name means "pinch-nose," which describes perfectly how the device is fastened on.

Today, eyeglass frames are designed in all shapes, sizes, and colors, and they are often used to make a fashion statement. Nevertheless, 80 million men and women worldwide prefer extended wear contact lenses, and LASIK, surgery to improve eyesight so that glasses are not necessary, has grown into a $3 billion-a-year industry. Which goes to show that many people must believe Dorothy Parker's famous quip, "Men seldom make passes at girls who wear glasses," as well as its reverse.

The Whole Truth About Supplements
If you suffer from macular degeneration, the most common cause of irreversible blindness in the elderly, you have probably heard about supplementing your diet.

For years doctors have been prescribing vitamins A, D and E to treat macular degeneration. But, within the past few years, scientists and researchers have discovered that adding supplements may not be the answer. According to Dr. Julie Perlman, an ophthalmology professor at the University of Wisconsin, "We just don't know how well the nutrients in multis are taken up by the body." (Organic Style Magazine, Sept./Oct., 2001)

The Massachusetts Eye and Ear Hospital, the most sophisticated, well-known hospital for ophthalmology in the world, studied the diets of people with macular degeneration. The results showed that vitamins A, C and E did not prevent macular degeneration but, rather, one half cup of spinach once a week reduced the incidence of macular degeneration and blindness by 33%. The reason is that the antioxidant of the retina is lutein, not beta-carotene or alpha tocopheral.

So how about taking lutein in a supplement form rather than through whole food? The difference is phytochemicals. These beneficial chemicals made by plants act as antioxidants that reduce cell damage, stimulate the immune system, and fight bacteria and viruses. They can also reduce blood pressure, regulate cholesterol and hormones, and prevent stroke by keeping platelets from sticking together.

"The combination of these biologic processes, rather than any one mechanism, influences disease risk," explains Johanna Lampe, RD, PhD, of the Fred Hutchinson Cancer Research Center in Seattle. (WebMD Medical News, Aug. 27, 2001)

So far, more than 25,000 different phytonutrients have been discovered in fruits and vegetables. Researchers are now discovering that these chemicals, found in whole foods, work in concert, orchestrating natural harmony in body systems.

So if you want to see clearly, you have to eat your spinach, plus a whole lot more.

Julie Herbst
(561) 750-3288 or 1-866-750-3288 (toll free)
E-Mail: herbstj@bellsouth.net
Website: www.juiceplus.com/+jh59421


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VisAble VideoTelescope, A revolutionary approach to vision enhancement.

The VisAble VideoTelescope is a lightweight, hand-held video low vision aid. VisAble can deliver unmatched near, mid and long range vision enhancement capabilities to individuals affected by age-related vision conditions including: macular degeneration, diabetic retinopathy, retinitis pigmentosa, glaucoma and cataracts.

VisAble is the first device to capitalize on the latest developments in digital video image processing, microelectronics and advanced optics. Its ergonomic design, optimized for a wide range of hand sizes and dexterities, contains the high magnification, wide field of view and contrast enhancement capabilities of video reading stations (CCTV's), but in a portable device.

All this power in such a discreet little package means that you can use it for so much more than just reading: spot the correct bus, browse a library shelf, recognize a friend, enjoy the outdoors, take notes from a black or white board, examine a cash register receipt, find a dropped object on the floor, pick out the right product on a store shelf, read a menu in a dim restaurant, use an ATM - hundreds of tasks that make up your day.

Below is a hypothetical description of how someone with low vision, Alan, could apply the VisAble to a variety of vision tasks, throughout the day.

Personal Grooming
Alan picks up his VisAble and scans the contents of his closet to pick what he's going to wear. After getting dressed he scans himself in a mirror, straightens out his collar and heads out to the grocery store.

Recognizing A Face
When he steps out his front door he hears a familiar voice from across the street. He spots a figure with VisAble. The sun is shining brightly, but as he zooms in, the image on the color display remains sharp and he recognizes his neighbor Tom.

Mobility And Security
He uses the VisAble to scan both ends of the street before crossing then walks over to chat with his neighbor. Being able to read the bus numbers and route as well as view the posted schedule.

Spotting in the Grocery Store
With VisAble he checks the list his wife Mary left him this morning. In the soda aisle he scans the yards of shelves filled with identically shaped bottles to find the section that has their brand, then he picks out the right flavor.

Spot Reading For Safety
His grandson's allergic to peanuts. So when Alan buys a frozen cheesecake he uses VisAble to carefully read the small writing on the ingredients list.

Leisure, Enjoying the Arts
In a theatre, he's able to enjoy a matinee performance of musical even with the variety of lighting that a live show uses. Following the action easily with the auto focus function, Alan can in a split second go from taking in a big chorus number, to zooming in on a solo performance.

Independence And Orientation
Back at his condo complex, in the dusk light the identical entrances of the units can be disorienting. Before he had VisAble, more than once he tried to get his key into the door of the wrong unit. Now Al checks his orientation to get to the right door.

Reading
Al has been using VisAble all day but since he shuts it down when he's not using it, the battery still has plenty of power left. But when he locks it into place in the optional reading station (available in Fall 2001), VisAble will be running off power from the outlet. He places his daily paper on the reading table and reads the image on a 19" computer monitor.

Computer Search in Library
A student can use any terminal, no need to ask for assistance from library staff. By using the included near lens he/she can focus and magnify between 1" to 36". The crystal clear display with its, high resolution and refresh rate magnifies computer screen with minimum or no distortion.

Locate Shelf
Zoom in on signs at the end of shelves to identify which one to browse. Even if sign is not at eye level, or subject to poor lighting (common in library stacks) high zoom, illumination and contrast enhancement makes locating easy.

Browse Books On Shelves
Scan the book spines to choose a book, then quick read a few pages at the shelf to decide if it may be useful, the visually-impaired student can now browse books at the shelves - the same process as sighted classmates. The VisAble is effective for both identification reading and quick, on the spot continuous reading even in poor lighting.

Leisure Reading
Go to a reading station either at home, or in the library, insert the VisAble and read the book at length.

In the Classroom
The same combination of distance and near capabilities can be invaluable in the classroom.

Activity At The Front Of The Class
Watch what's happening at the front of the class. Including blackboard/whiteboard work, overhead projections, demonstrations or slides. If it is something that will require longer watching like a video or film, any standard tripod can be used to increase comfort.

Work At Desk
Switch from the near task of reading textbook at desk, to checking work or notes, to looking up at action at front of classroom.

Group Or Partner
Work on experiments, projects etc. in groups. Versatility of VisAble allows student to go from observational activity at mid and distant range to near tasks like measuring quantities for a chemistry experiment, checking a thermometer examining a rock, animal or other specimen.

Field Trips
The mobility and portability of VisAble makes attending field trips to museums, landmarks, outdoors etc. far more productive and enjoyable.

Social Integration
The VisAble doesn't look like a low vision device easing social integration through watching and participating in school social life such as playground activity, shows and plays, sports, dances/proms and general social interaction.

For more information or to schedule a demonstration, call Lesa Kretschmer of Florida Reading & Vision Technology at 1-800-981-5119 or e-mail: LBK25@aol.com.


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Can Dietary Modifications Affect the Development of AMD? Max Snodderly, PhD at Schepens Eye Research Institute, investigates whether dietary changes can reduce the development of age-related macular degeneration.
By Leslie Burling

Abnormally low levels of lutein and zeaxanthin, carotenoid xanthophylls found naturally in yellow or green leafy vegetables, have been associated with the development of age-related macular degeneration (AMD). Both are highly concentrated in the macular region of the eye. Although their precise functions are currently unknown, it is postulated that these elements act as anti-oxidants to protect the macula against short wavelength visible light.

"I think it will take 5 to 10 years to assess [the] effects of modifying dietary intake. It may take quite a while longer to understand the mechanisms," says Max Snodderly, PhD, senior scientist at Schepens Eye Research Institute. Two of the proposed theories of lutein's action include: There is an inverse correlation between the amount of lutein in the retina and the risk of developing AMD. Loss of lutein in the retina occurs as a result of damage caused by AMD.

Dr. Snodderly is currently testing one of these theories. "We are studying the retinas of monkeys that have been raised with no lutein to assess whether there are changes in their retinal anatomy that might indicate a deficiency syndrome." He further explains, "Eventually there will have to be a prospective intervention study in which people are given lutein/zeaxanthin and then followed to determine how their vision changes and whether their risk for disease is modified."

In 1997, Dr. Snodderly found that some subjects experienced an increase in macular pigment (MP) density after just four weeks of a dietary modification that included an increased intake of lutein and zeaxanthin. The complete results of this study were published in the August 1997 issue of Investigative Ophthalmology and Visual Science.

Other researchers have reported similar results with lutein and zeaxanthin supplements. An article published in Investigative Ophthalmology and Visual Science (October 2000) described subjects who experienced a significant increase in MP after only 12 weeks of taking lutein supplements.

"There is a nutritional component to risk for age-related macular degeneration. Whether it is specifically lutein/zeaxanthin, or other nutrients linked to a diet rich in these compounds is a topic for study," says Dr. Snodderly. In addition, "I might add that there are other aspects of the aging process that may be related to macular pigment or related nutrients and these deserve study in their own right, whether they cause macular degeneration or not."


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Michael Young, PhD, of Schepens Eye Research Institute, Discusses the Future Possibility of Retina Transplants
By Loryn Ashley

Cutting-edge research, where stem cells, neural stem cells, and retinal stem cells are transplanted into the adult diseased retina, looks promising for the replacement of photoreceptors and other neurons that are lost due to retinal degeneration.

Michael Young, PhD, assistant scientist at Schepens Eye Research Institute, and instructor at Harvard Medical School, envisions strategies that will involve transplanting an entire new retina to the eye and having that retina connect up to the brain stem. Three groups of diseases that affect the eyes of the aging population are age related macular degeneration, retinitis pigmentosa, and glaucoma.

"In all three of these diseases, neurons, the brain part of the retina are lost and the tragic feature that they all share is that when these cells are lost, they are lost forever," says Dr. Young. "The retina is not able to grow new neurons or have those neurons that are damaged regenerate. So our goal is to replace those lost neurons with new cells." Using rodent models exclusively, Dr. Young finds stem cells in their brains and in their retinas, which he then isolates in a dish where they proliferate.

"We transplant those cells back into the eye where it is our hope that they will survive, develop and connect up with the host retina," says Dr. Young. "Our eventual goal is to have these cells become normal retinal neurons that are functional and can have behaviorally relevant consequences for the animal. Maybe we can make a blind animal see better."

The field of neural stem cells has exploded within the last two years with the discovery that humans possess these cells. "Adult humans possess neural stem cells in parts of their brain and are continually adding new neurons throughout their lifetime," says Dr. Young. "So it is very new and it really changes the way we think about development and repair of the central nervous system."

Dr. Young says that it will be years before stem cells will be transplanted into the human retina. "In terms of other diseases such as Parkinson's disease and spinal cord injury, I think within the next year we will see stem cell transplants in these diseases," says Dr. Young. "Hopefully, we will be able to work out a lot of the detail about the safety and the efficiency of this cell type in the setting of central nervous system disease."

"The field of stem biology is really in its infancy and it is a very exciting field to be involved in," says Dr. Young.


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Have You Ever Hailed a Police Car Instead of a Cab? Low vision can redefine life in ways that most people never see.

By Loryn Ashley

Declared legally blind as young men, Richard Godfrey, volunteer patient liaison at Schepens Eye Research Institute in Boston, and Richard Cohen, a journalist from New York, navigate their way around Boston as our cameras follow them. "Low vision can redefine life in little ways that most people never see; life's little tasks take on enormous proportions," says Cohen.

Something as simple as crossing the street presents a challenge to those with low vision. "I take my cues from someone else, or I would stand and 'scan' in both directions using my peripheral vision. It can be scary, there is no such thing as quick looks anymore," says Godfrey. Standing on a curb waiting to cross the street, Cohen asks Godfrey: "Have you ever hailed a police car instead of a cab?"

"No, I have never hailed a police car," says Godfrey. "I have," replied Cohen. "How much did they charge you?" Godfrey asks as both men laugh.

This sense of humor permeates their conversation and gives us a glimpse into one of the coping mechanisms both men use to deal with low vision. Low vision redefines three-dimensional life; everything you do is different. The men climb up two long flights of stairs to a train platform where Godfrey explains the need to pay close attention.

"I am aware that these stairs are trouble for me, so I run my foot over the edge of the stair to see where it starts. I have missed a step, or thought there was one more step at times, and that is a problem." As they enter a hardware store, Godfrey says, "I will need to ask someone for help. If I need a one-inch screw, I would not be able to find the display. This way someone can direct me and I do not have to fumble around."

Godfrey and Cohen both stress the importance of verbal communication. Low vision is invisible to the public; there are no guide dogs or white canes as indicators that the person is legally blind. "Everything you do is different, but only you see it," says Cohen. "It is critical to ask people to help. No one will know you are in need of assistance unless you ask."


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FLORIDA COUNCIL of CITIZENS with LOW VISION MEMBERSHIP and RENEWAL APPLICATION

DUES $15.00 PER YEAR
PLEASE PRINT CLEARLY and MARK APPROPRIATE RESPONSES.

LAST NAME:________________
FIRST NAME: _____________________
M.I.: __
STREET ADDRESS: _______________________________________
APT #: ____________ CITY: _____________________ STATE: __________ ZIP_________
PHONE No(S), WITH AREA CODE
HOME:_________________
WORK: _______________________
FAX : __________________
E-mail:_________________________

COUNTY of RESIDENCE: __________________________

SIGHT: _____ VISUALLY IMPAIRED/LEGALLY BLIND/TOTALLY BLIND/SIGHTED

MEDIA NEED: _____LARGE PRINT _____CASSETTE _____DISC
_____E-MAIL _____NONE

SIGNATURE:____________________________ DATE:___________

Make check payable to FCCLV and mail to:
Lesa B. Kretschmer
P. O. Box 519
Fort Lauderdale, FL 33302


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