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, 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 Ligting

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
Source:
Universit├Ąt Mainz
Summary:
Even individuals under the age of 50 years can suffer early forms of age-related m
Date:
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

Thursday, July 10, 2014

Having Trouble Reading Your Medicine Labels?

Most prescription labels fail to meet guidelines, risking dosage errors, Canadian study concludes
Posted: 09 Jul 2014 08:54 AM PDT

"Small print and poor printing on prescription labels handed out by pharmacists may be misread and may lead to errors in taking medication, according to new research. By simply following recommended guidelines for font size, use of bolding, justification, sentence case and spacing, researchers expect pharmacies can improve the legibility of their labels without the need for new technologies or larger labels."

This post from today's  "Science Daily" points out a very real problem that people with low vision face.  The majority of my patients tell me that they need help reading medicine labels.  In addition to the suggested improvements that the pharmacy could make I recommend one other thing.  Ask the pharmacist to put the meds in larger bottles and rotate the label 90 degrees.  That allows you to read an entire line of print without having to rotate the bottle.  Much easier.  This can be done.  I have requested it of pharmacists and they understand.

Monday, July 7, 2014

Reading with Low Vision Glasses

Before I accept someone as a low vision patient I always speak with them by phone. I question them about their remaining vision and their goals and I'm able to tell them if I will be able to help them with low vision glasses. I do not schedule anyone for a low vision evaluation unless I think that I will be able to help them. When I ask about their goals, what activities they would like help with, the two most common replies are reading and driving. Those are very important to most people. If your vision loss has taken away your ability to read and to drive you have lost your independance. Reading and driving are both learned skills that can be lost by lack of use. I have seen patients who have not read for a year or two who have lost the ability. When I improve their vision with microscopic glasses which allow them to read very small letters or numbers they struggle reading words or sentences. They can see the words but are unable to say them. I know that it will take lots of practice reading with the low vision glasses before they become fluent again. I encourage you, if your vision is beginning to cause trouble with reading, to call for a telephone consultation. Don't wait until your vision is so poor that reading is impossible. It is much better to seek help from a low vision optometrist while you are still able to read. You will adapt easier and benefit more the sooner you get help from low vision glasses. If you are having trouble reading, driving or with other visual tasks and have been diagnosed with macular degeneration, Stargardt's, diabetic retinopathy or some other damaging eye condition give me a call. I will be happy to speak with you. We will discuss your current level of vision, your goals and I will tell you if low vision glasses will help you. Call me toll free at 1 (866) 321-2030 for a free telephone consultation. Don't wait until you have stopped reading and are beginning to lose your reading skills #lowvision
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Friday, June 27, 2014

"They have exceeded my expectations"

Richard Weddle came to me recently from North Carolina. Richard's low vision is caused by rod-cone dystrophy. That is a condition, usually inherited, that effects both light sensitive parts of the retina. The rods are the retinal cells that help us see in low light. Cones help us in bright light and are also responsible for color vision. When someone has rod-cone dystrophy they gradually lose the use of their night vision, their sharp daylight vision and their color vision. Richard has been dealing with low vision from this condition since birth. Several members of his family also suffer from rod-cone dystrophy. Over the years Richard has seen several low vision doctors who have prescribed various devices that help him. When he came to me he was most interested in help with watching television. He has a good size television, about 60 inches, but needed more magnification. Most of the testing in the low vision evaluation was done at 10 feet. That is the distance that he prefers to sit from his TV. Richard's visual acuity with his glasses was 20/160 with each eye. Testing showed that adding a 1.7X wide angle telescope to his eyeglass prescription improved his acuity at the TV distance to 20/90 right and 20/100 left. Because of the wide angle telescopes he is able to see most of the width of the 60 inch TV. The photo shows Richard Weddle wearing the new wide angle telescopic glasses which I prescribed to help him watch television. After using the glasses for a few days Richard called to tell me how pleased he is with them. "They're great. They have exceeded my expectations. I can see TV well from 12-15 feet." Rod-cone dystrophy is one of several conditions where low vision glasses help. If your vision is reduced due to some uncorrectable eye disease you may be a candidate for these special glasses. Call me toll free for a free telephone consultation. I will be happy to speak with you and by asking you a few questions I'll be able to tell you if you are a candidate. Call me at 866 321-2030. #rodconedystrophy

Tuesday, June 17, 2014

Smart Glasses” For Those With Severe Vision Loss

Researchers Work On “Smart Glasses” For Those With Severe Vision Loss. Smart Glasses” For Those With Severe Vision Loss Smart Glasses” For Those With Severe Vision Loss BBC News (6/17, Brimelow) reports that “researchers from Oxford University say they’ve made a breakthrough in developing smart glasses for people with severe sight loss.” The glasses are said to “enhance images of nearby people and objects on to the lenses, providing a much clearer sense of surroundings.”

Monday, June 9, 2014

"I Just Want to See Better"

People with low vision want to see better. That seems simple enough. They just want to see better. Sometimes they seek out the real experts in their condition and come away disappointed and frustrated. After lots of testing, the diagnosis is confirmed but no help is offered. Worse yet, they are often told that "nothing can be done". Truth be told, the expert is probably frustrated also, They want to cure problems. Make them go away. Restore their patient's vision. Sometimes that can't be done. A lady came to me this past week who is a good example. She had experienced a hole in the macula of both eyes. Both required surgery by a retinal surgeon. One of the holes recurred and required a second surgery. Her vision was reduced, especially in the right eye. In hopes of being able to see better she went to the eye clinic at Duke University and then to the Mayo Clinic. No help was offered. One of the doctors told her "Sorry, you've lost it and it's not coming back". She returned to her opthalmologist in a small southwest Virginia town, He realized that she just wanted to see better and referred her to me. Her vision with her present glasses is about 20/100 with the right eye and 20/80 with the left. Not good enough to drive. I carefully measured the power of both eyes, found more astigmatism and corrected the right to 20/60 and the left to almost 20/25. That is good enough to drive in any state. The experts had been concentrating on accurate diagnosis and a cure. Worthy goals for sure. But, the lady just wants to see better. A change in her glasses will do that. In addition to the new lens prescription I have prescribed E Scoop glasses. That is a new type of glasses from the Netherlands. (see picture) The clip on in front of the prescription glasses sharpens vision, reduces haze, improves contrast and magnifies what is seen to a small degree. When I demonstrated them to the lady she loved the improvement in her vision. Low vision optometrists, like me, concentrate on maximizing the patient's remaining vision. We use various types of glasses that magnify and make things easier to see. We try to remember that people with low vision just want to see better. If you've had disappointment and frustration and been told that nothing can be done to help you see better, give me a call. I will be happy to discuss your vision and your goals. I'll tell you if low vision glasses will help you. There is no charge for the telephone consultation. Call me toll free 1 866 321-2030 #lowvision#macularhole

Wednesday, June 4, 2014

Driving With Stargardt's Disease

A patient with Stargardt's Disease returned to me after using his bioptic telescopic glasses for over 5 years.  Blake White was able to obtain his drivers permit when he got the telescopic glasses.  He has been driving safely with them.  Blake returned for re evaluation as required by the DMV.  Blake and I were both pleased to find that heis still eligible to drive while wearing the special glasses.

Blake told me an interesting story.  He has been seen by another low vision doctor who is a state examiner in West Virginia.  That doctor prescribed a very small telescope, for his right eye only even though Blake's vision is almost equal in both eyes.  Blake has been unable to wear them and prefers the wide angle telescopes that I prescribed.  He misses the left telescope and also the wide view of the pair that I prescribed.  He drives a lot and only uses the wide angle pair.

Years ago when I was a state examiner here in Virginia I realized that the devices available through the state were not always best for the patient.  I gave up serving as a low vision examiner for the State of Virginia years ago.  Since then I am able to prescribe what is most helpful for the patient, not just what the state will pay for.

Here is the point.  If you have had a low vision evaluation and are not happy with the devices prescribed it may be helpful to see another doctor.  Someone with a different perspective. A doctor who is not limited by the state may be able to help you.  I invite you to give me a call.  Let's talk it over.  I will tell you on the phone if I will be able to help you.  Call me toll free at 866 321-2030 #stargardtsdisease#bioptictelescopes

Saturday, May 24, 2014

"Just a note to let you know how thrilled I am"

"Hi Dr. Armstrong, Just a note to let you know how thrilled I am with my new tinted bioptic telescopic glasses. Due to severe macular degeneration, I have had to depend on others for transportation for almost five years. Since my new glasses arrived I have been driving myself. Oh, the lovely sense of independence again! Thanks again, Sandra Allen" It is always good to hear how people are doing with their low vision glasses. I appreciate this nice note from Sandra.