Photograph by Paul Myers

I See!: Barbara Emerling views photographs on an Aladdin Rainbow Pro, manufactured by Telesensory in Sunnyvale. The machine is a color video magnifier.




Helping seniors improve vision

By Rita Baum

Irene Garnel loves her job. She works for the California Department of Rehabilitation as a senior vocational counselor helping visually impaired and blind persons adapt to vision deficits and loss. She has an average caseload of 60 clients, many of whom are 65 or older. All of them have very poor vision: 20/200 or worse in both eyes, or a visual field of 20 percent or less, usually due to an age-related eye disease that could not be corrected by treatment, glasses or surgery.

It is possible to enhance poor vision by utilizing aids and devices and by making environmental modifications. A history and assessment of the problem and a home visit help a counselor determine precisely what services, training and assistive devices are appropriate for each individual's needs. "It's wonderful to watch people brighten when they learn about the training options and the many vision aids available to them" says Garnel.

Whether the object is to prepare a meal, read a book, or surf the World Wide Web, manual and electronic aids can help people make the most of their remaining vision. Practical solutions that can make daily life easier include raised and colored markings on kitchen appliances, talking clocks and scales, hand-held or freestanding magnifiers, and other special equipment.

Writing desks and other key areas can be equipped with bright lighting. Checks and writing paper with raised guides can replace ordinary writing materials. Strips of colored tape placed at the edges of doors and steps prevent accidents. Some medical needs can be managed through devices such as talking glucometers for diabetics. Telescopes, hand-held or mounted on spectacles, make it easier to read street signs, house numbers and watch sporting events.

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Vision Aid Resources: Groups and companies that offer aids and devices.

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Computer technology opens the door to many of the activities of a fully sighted person. At least 1.5 million visually impaired and blind Americans use computers. Computer training for people with low vision is available at nonprofit centers. Sensory Access Foundation, in Sunnyvale, provides training to help people with low vision stay on the job. "Our program is strictly about technology and quality of life," says Executive Director Diana Drews. "Older people make up about 12 percent of class participants, but the number keeps growing," she says. The oldest person ever served was 93. Typically, a trained staff member will visit and assess the work site. Then a plan is designed using adaptive technology to help the individual continue doing the same tasks performed prior to the onset of vision problems. In some cases, people with low vision can be trained at the foundation to learn new jobs.

The Lions Center for Visually Impaired and Blind serves people throughout Santa Clara County. Lions Center participant Nancy Campisi is a good example of a proactive, visually impaired person. She has 20/200 vision in one eye and 20/400 in the other eye. She contacted Pacific Gas and Electric's Rehabilitation Department to get special raised and colored markings riveted to various appliances, and her telephone company supplied her with a special phone that has a large keypad, speed dialing and call-waiting programs--all at no cost. Campisi has taken advantage of the many classes at the center, including computer programs. "Now I can use email and other programs using software that enables large text to print on the screen," says Campisi, who works at the Center part-time as a volunteer coordinator.

Peninsula Center for the Blind and Visually Impaired helps residents of Santa Clara and San Mateo County. Like the Lions Center, it offers services free or on a sliding fee scale. Its clinic is staffed with specially trained low-vision optometrists and other staff who have master's degrees in vision rehabilitation training or counseling. Counseling is available in daily living skills, orientation and mobility techniques. The clinic offers low vision seminars, typing and computer classes. Staff members demonstrate magnification devices and electronic equipment recommended by the optometrists to meet the individual needs of the client. Closed circuit TV, screen magnification software, a selection of magnifiers, and other items are available for trial in the center's training room.

Most libraries in Santa Clara County have computer text enlargement capabilities, books on tape, and large-print books and magazines. San Jose's Dr. Martin Luther King Jr. Main Library has a variety of sophisticated technologies for use by visually handicapped library users. Patrons can use the Chroma CCD print enlarger, a color video magnification system that enables printed material placed on a moveable tray to be magnified up to 60 times. Other tools available at the library include text-to-speech programs such as JAWS and PW webSpeak, and the Reading Edge, that read Internet pages, word-processing documents, and text on a page aloud in synthesized speech. Computer screen magnifiers such as Zoom Text are also available. Books Aloud, a nonprofit organization based at the main library, records books onto cassettes tapes at the library and makes them available along with a cassette player--all mailed free to visually-impaired or physically disabled persons with a doctor's certification.

Many vision enhancement technologies are available for home use. Telesensory, a manufacturing firm in Sunnyvale, makes video magnification systems that work similar to an overhead projector. Newspapers, photos, books and other materials placed on a plastic tray are displayed and magnified on a screen. Older adults with macular degeneration or other low vision conditions purchase about 40 percent of the systems. The many variations of the system include the mini-magnifier, complete with battery pack and carrying case.

The future for vision impaired people is continually improving. The American Academy of Ophthalmology is urging members of Congress to pay for low-vision aids and therapy under Medicare. The Americans With Disabilities Act requires that state and local government instrumentalities cannot deny services to people with disabilities, participation in programs or activities that are available to people without disabilities.

New low vision treatments and technologies may be on the horizon. Now in the first stage of USA clinical trials is a new Implantable Miniature Telescope. A local Saratoga company called VisionCare Ophthalmic Technologies is testing the IMT. "Invented in Israel, the IMT is implanted in one eye in an outpatient surgical procedure," explains Allen Hill, Saratoga resident and CEO of the company. "The IMT has been designed to provide enhanced central vision and improved quality of life. Individuals with moderate to severe central vision impairment in both eyes due to end stage wet or late stage dry age-related macular degeneration may be candidates for clinical trials," says Hill.

Science fiction Author William Gibson, who envisioned the Internet before it existed, imagines a future where vision-impaired persons are aided by high technology. In his 1996 novel Idoru, (Berkley Books, New York) set in a time approximately one generation from now, people who are totally blind are able to "see" thanks to video units coupled directly to the optic nerve.Gibson's vision is hypothetical but not unthinkable, considering how rapidly technology is advancing. Perhaps the '80s pop band Timbuk3 said it best: "The future's so bright, I gotta wear shades."

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Rita Baum is a Los Gatos resident. She has a degree in gerontology and has worked in the field of gerontology for more than 20 years.

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