About Low Vision

There are many people who have a vision loss that is not correctable with typical eyeglasses or contact lenses. They've lost some vision and are unable to see well enough to participate in activities that are important to them. We say that these people have low vision. Eye diseases like macular degeneration, diabetic retinopathy, Stargardt's disease and glaucoma, among others, are common causes of low vision. Low vision is not the same as legal blindness.
For many years there have been optometrists who help low vision patients see better so they can return to a more normal life. Special telescopic or microscopic glasses are often prescribed which help the person return to reading, driving, using a computer, participating in hobbies or crafts. Some people are able to return to work.
In most cases these people have been told by their eye doctors that nothing can be done to help them. It is true that there is no cure for these diseases and the vision will not return to normal. The job of the low vision optometrist is to evaluate the person's remaining vision and prescribe appropriate glasses or other devices which magnify what is seen, making it easier to see.

Free Telephone Consultation
My practice is totally dedicated to helping low vision patients. That is all that I do. I always speak with patients before scheduling a low vision evaluation. That helps me understand how much remaining vision they have and what their goals are. I also answer questions and give the person an idea of what to expect from the evaluation and from the special glasses. I only schedule people who I can help.
Call me for a free telephone consultation. I will be happy to speak with you and I will tell you if I can help you see better. Call toll free 1 866 321-2030
I see low vision patients in offices in Roanoke, Charlottesville, Harrisonburg and Wytheville, VA.

More information at VirginiaLowVision.com and StargardtsDiseaseHelpNow.com

Tuesday, November 4, 2014

Free Telephone Consultation with Dr. Armstrong, the video

I have just added a video to my website that describes the free telephone consultation that I offer low vision patients.  The consultation helps me get an idea of the person's remaining vision and their goals.  That information allows me to tell the patient if I will be able to help them.  I only schedule people who I am quite certain that I can help.  I invite you to click the link below and watch the video.  Then give me a call.  1 866 321-2030  I will be happy to discuss your vision challenges with you.  I would love to help you see better.  http://virginialowvision.com/videos.html#consult 

Thursday, October 30, 2014

Vision Loss from Sarcoidosis

   I had the opportunity this month to help a lady who's vision loss is the result of sarcoidosis.  Sarcoidosis is a condition that mainly effects the lungs but sometimes the eyes as well.  Tiny collections of inflammatory cells grow in the body.  There us usually accompanying fatigue, fever, swolen lymph nodes and loss of weight.  When sarcoidosis affects the eyes it may blur the vision, cause pain and redness.  Light sensitivity is common.
   My patient, Linda, has a profound vision loss in her right eye resulting from a bout of sarcoidosis 3 years ago.  She wears a contact lens in the left eye and her best vision is 20/40.  She is being followed by two ophthalmologists and has to retire from her job due to her vision loss.  She came to me asking for help with driving, reading and recognizing other people's face.
I evaluated Linda's vision with several different types of low vision glasses and prescribed a new one-piece E Scoop pair.  They improve her vision with the left eye for both distance and reading vision.      Unfortunately, the right eye interferes with her vision when she is reading and it is necessary for her to cover it.
   When I spoke with her a couple weeks after she received the glasses she told me that they are especially helpful when she is reading.  She is able to small print like account numbers on bills much better.
   There are many diseases and conditions that can damage vision.  What I need to know is how much vision the person has remaining for me to work with.  The exact cause of the vision loss is not as important to me as the remaining vision.
   If you have suffered a loss of vision I may be able to help.  Give me a call at 1 866 321-2030 and I will be happy to discuss your vision with you.  by asking a few questions I can tell you if low vision glasses will help.  I'd love to speak with you and help you see better.

Wednesday, October 22, 2014

Bioptic Driving Video

   All of my patients have reduced vision.  When I ask what activities they most want me to help with the top two are reading and driving.  Because I screen patients by phone before scheduling them I am usually able to help them achieve their goals.

   Most states allow people with low vision to drive while wearing bioptic telescopic glasses.  The states issue a special license to these people.  I thought that it would be interesting for people to see how someone drives with bioptics and to actually have a chance to look through them.  So I have posted a selfie video on my website.  The video shows me driving while wearing bioptic glasses.  As I drive along I explain them and discuss the requirements for obtaining a permit in Virginia.  Finally I park and give the viewer an opportunity to look through the glasses and see what I am seeing.
   If you'd like to learn about bioptic driving take a look at the video.  I hope you find it interesting.  Just click on this link to get to the video.  www.VirginiaLowVision.com #biopticdriving #bioptictelescopes

Tuesday, October 14, 2014

iPhone Helps for the Visually Impaired

Yesterday a man who I've known since he was a child came in to have a small repair made to his telescopic glasses.  TJ is now 53 years old and his vision has been worsening gradually over the years.  While he was here he gave me an amazing demonstration of how a smart phone can help someone with a severe vision loss.
We were talking about guitar music and he mentioned a couple classical guitar artists who he enjoys.  I was in one room and he in another and I heard him talking to his phone.  He was making requests of "Siri" that I was not really paying attention to.  In a couple minutes he came in holding the phone and he asked if I'd like to hear some music by Doc Watson.  He immediately started the music playing.  He wanted me to hear some other artists and by making requests of Siri and Pandora we were able to enjoy a couple others of his favorites.
He told me that he had asked Siri for directions to my office.  TJ was not the driver. He and Siri were navigating. 
TJ showed me how he could ask Siri for a particular type of music from Pandora.  When a list of selections came up on the screen he touched each one and the iPhone spoke the name of the musician and the song.  Pretty amazing.
He demonstrated how the phone is able to help him find helpful information.  He asked Siri to find a recipe for deviled eggs.  Sure enough, it popped right up.
TJ has spent a lot of time mastering the many different ways that the iPhone can help him and it is a tremendous help.  What a blessing this fantastic technology is to a person with a visual impairment.

Wednesday, September 17, 2014

What is Stargardt’s Disease?

  Stargardt’s Disease, a type of macular degeneration, effects over 25,000 Americans, occurring in about one in 10,000 children. Because it begins in children and young adults it is also known as Juvenile Onset Macular Degeneration. Like the more common Age Related Macular Degeneration, Stargardt’s damages the macula, the part of the retina responsible for central vision. As the central vision gets worse, reading, driving and other tasks requiring sharp vision become more difficult. Eventually Stargardt’s victims are unable to perform these tasks. Although the peripheral vision is unharmed, that is small comfort for the person who has lost the best, sharpest part of their vision.  Children of a parent with Stargardt’s Disease have a 25-50% chance of developing the disease themselves.
  There is no cure or treatment for Stargardt’s Disease. Persons with Stargardt’s are advised to protect their eyes from sunlight by using good sunglasses which filter out ultraviolet light. Genetic counseling is also recommended.
  My experience has been that persons with Stargardt's Disease do very well with low vision glasses. They are often able to return to driving and other important activities. Anyone suffering a vision loss from Stargardt’s should consult a low vision optometrist for an evaluation.
  You can call me toll free to discuss your vision problem.  I will be happy to speak with you.  After asking you questions about your remaining vision and your goals I will tell you if I can help you with low vision glasses.   Call me at 866 321-2020#stargardtsdisease

Friday, September 5, 2014

Driving Safely With Bioptic Telescopic Glasses

Kelly Henley returned to see me last week to be recertified for driving with bioptic telescopic glasses.  In 1996 Kelly was told that he had to give up driving.  His vision was getting worse and he was no longer able to meet the Virginia DMV vision requirements.  He'd been diagnosed years before with juvenile macular degeneration (Stargardt's disease).

Kelly Henley
It was not until the spring of 2013 that Kelly learned that he might be able to obtain a special driver's permit allowing him to drive while wearing bioptic glasses.  His optometrist referred him to me for a low vision evaluation and I prescribed the bioptics.  After using them for a couple months he applied for a learner's permit and then the special license.  The DMV examiner was pleased with Kelly's driving during a road test and he was granted the license.
At his visit last week I heard how well he is doing driving with the glasses and how happy he is to be back on the road.  He and his wife recently took a vacation trip to the Smokey Mountains and Kelly drive the entire way,  at least 400 miles.
Kelly Henley is a great example of how someone with a vision loss can return to normal activities by using low vision glasses.  He's gotten his independence back.  He's happy and I am happy to have been able to help him.
If you have a vision loss from Stargardt's or some other cause you owe it to yourself to investigate low vision glasses.  Give me a call.  I will be happy to discuss your vision and your goals.  I'll tell you if I can help.  There is no charge for the call or the telephone consultation.  Call me at 866 321-2030

"Damn! I can read with that!"

A ninety year old lady who'd been referred by her ophthalmologist came for her low vision evaluation today.  She has both glaucoma and macular degeneration.  The vision in her right eye is almost completely gone.  With the left she sees only 20/160 with her glasses.  For the past 3 months she has not seen well enough to read.  Her caregiver has been reading to her.  All she wanted help with is to be able to read.  She brought two large print Danielle Steel novels with her hoping that I'd be able to prescribe some low vision glasses and she'd be able to read them.

Because of some physical limitations resulting from Parkinson's Disease she was unable to use the glasses and hand magnifiers that I tested her with.  I then demonstrated a desktop electronic magnifier.  That device allowed her to look straight ahead at the screen while her novel lay on a flat surface below.  She did not have to hold the book or lower her head.  Without hesitation she began reading. 

I asked her what she thought about the device and she responded "Damn!  I can read with that."

There are a lot of ways to help people who have lost some of their vision.  I prefer to prescribe low vision glasses because they allow the person to have both hands free to hold a book or sign a check.  They can be carried easily allowing them to be used anywhere you go.  Sometimes a hand magnifier works better and sometimes, like this lady, a desktop electronic magnifier is the best thing.

A low vision optometrist like myself is aware of the many possibilities and by evaluating the remaining vision and the person's goals can recommend the appropriate help.  If you'd like to talk with me about your vision problem please call me toll free 1 866 321-2030.  There is no charge for the call or the telephone consultation.  I'll be happy to speak with you and tell you if I can help.

Tuesday, August 26, 2014

I Can Read For Hours

   I had a call today from a low vision patient, Joseph.  He has lost vision from macular degeneration and was referred to me by his ophthalmologist.  What Joseph really wanted to do was read the New York Times.  He hoped that I could help him with that.
   Joseph's vision with his glasses was 20/60 on the day of his low vision evaluation.  He was not doing badly for distance vision.  It was the reading that bothered him.  The thorough low vision evaluation revealed that his near vision could be improved nicely with telemicroscopic glasses.  The ones that I prescribed magnified almost 2 times and focused at 10 inches from his face.  He could easily read the Times.
   Today, Joseph called to tell me how well he is doing and how much he likes the glasses.  "I can read for hours with them" he told me.  "I love them".
Telemicroscopic glasses with iPad
   One other thing that has helped Joseph's reading is that he has good light.  He took my advice and bought an Ott Lite.  The Ott Lite gives him plenty of soft, no glare, daylight right on his paper.  I recommend an Ott Lite for anyone who has vision loss.  They really help.
   I am pleased that Joseph has been able to get back to reading the Times.  It is very satisfying to be able to help people return to activities that they enjoy but had been unable to do. #maculardegeneration #microscopicglasses

Thursday, August 21, 2014

Sight Saving Tips

 A recent article in Optometry Times by Colleen E. McCarthy listed several steps that people should take to help preserve their sight.  Titled "Help elderly maintain independence with 7 sight saving tips"  I share those tips with you. I have summarized the tips a bit.
  1. Get a comprehensive eye exam.  Yearly dilated eye exams are crucial for detecting changes in vision which may indicate a developing eye disease.
  2. Know signs of vision loss.  Symptoms may be noticed when reading, watching TV, driving, recognizing friends faces.  Sometimes friends or family members notice that we are having difficulty with our vision.
  3. Make eye-healthy food choices.  Choose foods low in fat , rich in fruit, veggies, whole grains.  Foods rich in vitamins C and E, zinc, lutein and zeaxanthin have been shown to reduce the risk of macular degeneration and dry eye.
  4. Quit smoking.  Smoking or exposure to second-hand smoke increases the risk for cataracts and macular degeneration.  It worsens dry eye and raises the risk of cardiovascular diseases which can influence eye health.
  5. Maintain normal blood pressure, cholesterol and glucose levels.  Keeping these levels well controlled can reduce the risk of vision loss from eye disease.
  6. Get regular physical activity.  Thirty minutes of exercise per day is good for general health as well as eye health.
  7. Wear sunglasses.  Sunglasses with 100% UV protection reduces the risk of cataract, growths on the eye and cancer.  #Maculardegeneration #cataract

Monday, August 18, 2014

The Importance of Good Lighting

A few weeks ago I dispensed a pair of Clear Image microscopic glasses to a lady who wanted to be able to read her newspaper.  She has macular degeneration and has been unable to see well enough to read.  The day she received the glasses she read her hometown newspaper easily.  They worked very well in my office.  I explained how the glasses are to be used, stressing that she hold her paper in the correct place and use proper lighting.  I demonstrated both of these things to her and sent her home with written directions (large print).
Several days later she called to tell me that the glasses were not working.  She could not read the paper. What happened?  I asked a family member to take some photos of the lady attempting to read and text them to me.  As I suspected, her paper was very poorly lighted.  I could see how the light was on her shoulder but not on the paper.  I called and discussed what I'd learned from the photos and explained to the lady and her family just how to light the reading material.  Proper lighting makes all the difference.  That solved the problem for her.  She is able to read the paper again.
This lady has macular degeneration but I think there is a lesson here for all people with low vision. 
 Good lighting is important. The light must be close and fully illuminate the task. Sometimes that is all that a person needs.  No special low vision glasses. Just proper lighting.
The photo shows me reading under an Ott Lite.  I think that they are the best.  Ott Lite is natural daylight color, soft yet bright enough to do the job.  I recommend them to all my low vision patients.  #Stargardtsdisease #Ottlite

Tuesday, July 22, 2014

Age-related macular degeneration occurs much earlier than previously assumed

The summary below is from a large study done in Germany.  This new information adds to previous studies that show a strong link to heredity and smoking.  There are some things that can be done to reduce the chance of getting ARMD. 

1. If you smoke, quit.
2. If you have a parent or sibling with ARMD consider taking one of the supplements recommended for people with macular degeneration.  There are many.  I recommend "Macular Shield AREDS 2 plus Complete Multivitamin" , a product of Doctors Advantage.
3.  Have a complete, dilated eye examination yearly.
July 21, 2014
Universit├Ąt Mainz
Even individuals under the age of 50 years can suffer early forms of age-related m
acular degeneration, researchers say. With the help of their findings, the researchers were also able to gain insights into how frequently the various forms of age-related macular degeneration occur. On average, about 12 percent of the examined 35- to 74-year-olds had early stage AMD, but only 0.2 percent of the study participants exhibited symptoms of late stage AMD, which is often associated with severe visual impairment. #maculardegeneration

Tuesday, July 15, 2014

Still Playing in the Band

Donald Jenkins called a couple weeks ago to tell me he is still enjoying playing in the Community Band in his town in North Carolina.  "I love my low vision glasses.  They have allowed me to keep playing in the band for the past 3 years."
I first met Don in May 2011.  He has macular degeneration and came to me for help.  He was having trouble reading the music, even when he enlarged it with a copy machine.  I prescribed telemicroscopic glasses focused at 24 inches, the distance of his music.  By knowing his goal of reading music and the distance to the music I was able to prescribe glasses specifically for his needs.
Thanks to the improvement that the glasses make Don can read the music again and continues to enjoy playing tunes from Broadway, Glenn Miller as well as Sousa marches. 
I am very happy for this nice man and appreciate his letting me know how much difference the telemicroscopic glasses make to him. #maculardegeneration#lowvisionglasses