Low Vision Help

No Risk Low Vision Promise

2012-01-31T08:15:00.001-05:00

You may have been told by your eye doctor that nothing can be done to help you. You may be hesitant to schedule an appointment with a doctor dedicated to helping persons with low vision achieve their goals. Having special glasses that will allow you to return to activities that you’ve given up may sound too good to be true.

To help you decide to schedule a low vision evaluation I make the following promises:
1. I will accept you for a low vision evaluation only after I have interviewed you on the telephone and I sincerely believe I can help.
2. If I accept you as a low vision patient it is because, as a result of your answers to my questions, I believe that you will benefit from low vision glasses or other devices.

3. During the first 15 minutes of the visit I will demonstrate to you that I can help you see better. If successful, the remainder of the evaluation will be used to determine the best types of low vision devices for your needs. The fee for the evaluation is $235.

4. If, during the first 15 minutes, I am unsuccessful in demonstrating that I can help you see better, the evaluation will be terminated and there will be no fee charged.

5. During the evaluation I will show you exactly how various low vision glasses will help you. You will see exactly how they help your vision and what they look like.

6. At the end of the evaluation I will tell you exactly which glasses I am prescribing for you and their cost. You will then have the opportunity to choose how much help you want and how much you wish to pay.

7. On the day that you receive your low vision glasses I will again demonstrate that they help you more than your previous glasses. If you do not see an improvement the fees that you paid for the glasses will be refunded. The evaluation fee is non-refundable.

I make these promises based on years of experience helping persons with macular degeneration, diabetic retinopathy and other eye diseases. Because of this experience I have the skills to identify the people who I can help and to prescribe appropriate low vision glasses for their needs. I invite you to call me for a free telephone consultation. Call me toll free at 1 866 321-2030

Dr. David L. Armstrong, Optometrist

"I'm thrilled"

2012-01-27T08:05:00.001-05:00

Recently a gentleman returned to receive his low vision glasses that I'd prescribed a few weeks before following a thorough low vision evaluation. He is a builder and cabinet maker in Baltimore, MD and suffers a vision loss from macular degeneration. He had requested help with reading, especially blueprints, and also watching TV and driving. He has been seen regularly for his macular degeneration at Johns Hopkins and at a large retinal pactice in Washington, D.C. Neither had referred him to a low vision specialist. He found me through my newspaper ad.

To help him with reading I prescribed glasses which included a telebinocular. the telebinocular is a small telescope built into the lower part of the eyeglass lens, angled down and focused for reading. He brought blueprints to his evaluation and was able to read them easily with the telebinocular glasses. Yestereday I handed him USA Today. He was able to easily read the regular print and also print less than half that size.

Next I dispensed his bioptic driving glasses. They have small telescopes near the top of the lenses that magnify 2.2 times. He looked down the hallway at a framed picture about 35 feet away and said "With my regular prescription that is just a blur. When I look with the telescopes it is much easier to see. I can see detail in the picture".

The final pair, set to focus at 9 feet will help him watch TV. They include wide angle bioptic telescopes. He was able to see much better at the 9 foot distance of his TV.

As he was about to leave for home I asked him how he felt about the new low vision glasses. He said, "I am thrilled. I have been really excited waiting to get the glasses and I am just thrilled at the way they help me see. It is a shame that it is so hard for people to find help from a doctor like you. It must be really satisfying helping people with poor vision."

I am writing about this man's experience because it illustrates several things:
1. Even though people with vision loss have been cared for by the best doctors they are rarely referred to a low vision doctor who may be able to help them.
2. With a proper evaluation low vision glasses can often be prescribed to help the person return to activities that they have had trouble with or have given up.
3. Low vision glasses are prescribed for very specific purposes. It may require more than one pair to meet the person's goals.

In answer to my patient's question, "Yes, it is very satisfying to help people see better". Especially those with severe vision problems who have been told by other doctors that nothing will help them. I would like to help you. If you suffer from vision loss from macular degeneration, diabetes, glaucoma, retinitis pigmentosa, Stargardt's disease, stroke or some other cause give me a call. I will be happy to speak with you at no charge and I will be honest with you. If I feel that I can help we will schedule an evaluation. If I don't think I can help you I won't make you an appointment. I don't want to take people's time and money and then disappoint them. By asking the right questions on the phone I am able to help over 90% of the low vision patients who I see. Call me toll free at 866 321-2030 for a free phone consultation.

Low Vision Office Locations

2012-01-18T21:51:00.000-05:00

In order to serve my low vision patients better I have offices in 4Virginia cities, Roanoke, Charottesville, Harrisonburg and Wytheville. One of these offices is within a 2 hour drive of most of Virginia as well as parts of West Virginia, Maryland, North Carolina, Tennessee and the District of Columbia. I will be happy to speak with you by phone and, if I feel that I can help you, schedule a low vision evaluation in one of these offices. All free telephone consultations and appointments are arranged by calling me Toll Free at 866 321-2030

What is Stargardt’s Disease?

2012-01-18T15:45:00.000-05:00

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 us 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.
Persons with the Stargardt's can be helped to function better by the use of low vision glasses. 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

"Dr. Armstrong, you have washed the world. It is clean and bright."

2012-01-09T10:50:00.000-05:00

Linda Schaaf suffers from low vision caused by myopic degeneration. She has a high amount of nearsightedness (myopia) and astigmatism. Even with her glasses, the Illinois college professor, sees only 20/120 with her better eye. The other is much worse.

Professor Schaaf came to me asking for help correcting student assignments, reading the newspaper and books, using her computer and recognizing faces. I evaluated her vision using microscopic lenses, telescopic lenses and telemicroscopic lenses. The best solution proved to be a pair of bioptic telescopic glasses for distance and telemicroscopic glasses for reading and computer use.

Professor Schaaf has found many benefits from her low vision glasses. When I talked with her a month after she received them she told me "I am thrilled to death. I can see my students faces now. People on TV have faces. I can sit in the back of the church and see the priest's face. I can see the traffic lights better and see the colors. It takes me less time to correct my student's papers. I am able to use the computer without enlarging the font. Dr. Armstrong, you have washed the world. It is clean and bright."

A low vision evaluation is very different from the usual eye examination. Different testing methods are used, different types of lenses are considered and the goals of the patient must always be considered.

Many people, like Professor Schaaf, can benefit from low vision glasses. If you have low vision, regardless of the cause, and even if you have been told by your doctor that nothing can be done, there may be help available for you. Give me a call and I'll discuss your situation with you. I'll tell you if I think that I can help you and we can schedule an appointment for you. If I don't think that I can help I will be honest with you. I do not make appointments for those who I do not feel that I'll be able to help. Call me at 1 866 321-2030. There is no charge for the call or the telephone consultation.

"I Can See Clearly Now, The Rain Is Gone"

2012-01-06T22:15:00.000-05:00

Clarisa Shepherd has a ministry of song. She loves to sing in her church to praise the Lord. She has had reduced vision since birth due to optic atrophy, an optic nerve disease. She sees lights only with her right eye. When she came to me Clarisa was using prismatic glasses prescribed by her previous eye doctor. They allowed her to read but required her to hold her book or music just a few inches from her face. She asked if there were glasses that would allow her to hold her music lower and farther from her face so her voice would project better and she could see the people she was singing to.
The previous doctor had considered putting a small telescope in her glasses to allow for better distance vision. Clarisa was unable to use that because her eyes are in constant motion, a condition called nystagmus. The telescope was so small that she was unable to keep looking through it.
After evaluating Clarisa's vision with various low vision devices I prescribed a wide angle telescope mounted in the left lens of her glasses. The wide angle telescope gives her improved distance vision. She has worn the telescope at a school play and was able to see the actors and follow the action on stage. Two accessory lenses were prescribed which she can add to the telescopic lens. One allows her to hold her music farther away and below eye level. The other helps her read the screen of her computer.
"Thank you very much for the glasses. What a difference they make." Clarisa is enthusiastic about her new low vision glasses. "I love my new glasses. I can see the music and also the audience. I can stand back with the rest of the group and still read the music. Reading is much better and my husband says that I am reading out loud much faster than before."
It is very satisfying to be able to help people like Clarisa Shepherd. If you have a vision loss that makes it difficult to do the normal, daily activities that you would like to do give me a call. I will be happy to talk with you and tell you if I can help. Call me toll free at 866 321-2030.

"I highly recommend Dr. David Armstrong

2011-12-27T21:25:00.001-05:00

Patients often write to let me know of their experiences with low vision and their successes with the special telescopic or microscopic glasses that I prescribed for them. Excerpts from one such letter follows:

"For years, I have struggled with low vision. I was diagnosed with Macular Degeneration and have been seen by four different eye specialists over the last few years. I have even undergone surgery to regain my sight.

Nothing worked and I was very distraught about the situation. My family showed me Dr. Armstrong's advertisement and I made an appointment.

Dr. Armstrong is a kind, caring person. His winning personality and positive words of encouragement gave me hope. With Dr. Armstrong's help, I can now read for periods of time and was able to maintain my license to drive with the aid of bioptic telescopic glasses.

I highly recommend Dr. David Armstrong. He helped me regain a part of my life."

Sincerely,

Helen Pullen

Virginia

“I am so much happier now"

2011-12-22T14:29:00.001-05:00

Shelby Lester has lost vision in her right eye due to macular degeneration and because of a retinal hemorrhage in the left eye. A retinal specialist has been treating the left eye with injections for over a year. Mrs. Lester heard about me and my work with low vision patients. She wanted to be able to return to driving and to be able to read. Shelby loves to sing and was unable to read the music. No glasses had ever been prescribed for her.

After evaluating Shelby’s vision and I found that with a conventional eyeglass prescription her vision improved but not enough to pass the DMV requirements. I prescribed bioptic telescopic glasses that allow her to meet the requirements for a special daylight only license. For reading and music, prismatic glasses were prescribed.

Shelby later sent me a list of the things that she is able to do with her low vision glasses:
1. “I can see the channel numbers on the TV and the picture is much clearer now.”

2. “I can see the settings on my stove, washing machine and dryer.”

3. “I can see people’s faces clearer and see things at a distance with my new low vision glasses.”

4. “The prismatic glasses really help with reading”

5. “They help me to be able to drive again.” (She later was able to obtain a driver’s permit allowing her to drive when wearing the bioptic glasses.)

“I am so much happier now. Before getting the glasses I had to depend on my husband a lot more and that made me feel very sad. I pray so many more people can be blessed by getting these glasses.”

Mrs. Lester suffered unnecessarily from her vision loss before discovering that help is available. Her low vision visit with me and the special low vision glasses that I prescribed were the beginning of happier times for her. If you are unable to see well enough to do the things that are important to you call for a free telephone consultation. In a few minutes I will tell you if I will be able to help you see better. Call toll free 866 321-2020 for the free consultation.

Will Low Vision Glasses Help You? Test Yourself

2011-12-22T07:49:00.000-05:00

Often when I am speaking with someone about their low vision problem I recommend that they try a test at home to show them if low vision glasses will help. This is something that you may want to try before calling me for a free telephone consultation. Here is what you do:

You will need a pair of binoculars. It is best if they are no more than 7X (magnify 7 times or less). The power is written right on them. You will probably be able to borrow a pair if you don't own one. If not, go to a store where they are sold. Ask if you can try a pair right there in the store. You don't need to buy them.

If you are at home, stand about 15 feet from your TV and see if the binoculars help you see it better. Then ask someone to stand 15 feet from you, in good light. Can you see their face better with the binoculars? Take them outdoors. Are you able to see your neighbors house better? Do they help you see the cars and the people better? If you are at a store just look around the store, look at people's faces and the displays. Do the binoculars help?

It is important that you do this test both with your glasses on and also without them.

After you have tried the binocular test give me a call. I will be happy to discuss your low vision problem with you. Knowing how the binoculars helped will make it easier for me to determine if I can help you. Call me toll free at 866 321-2030 for a free telephone consultation.

Good luck. I hope that the binocular test shows you that magnification helps. If they do I should be able to prescribe proper low vision glasses to help you return to some of the activities that you have been unable to do.

"It is amazing, I can’t believe it. I really enjoy them.”

2011-12-21T21:34:00.002-05:00

Jarrod Church has had reduced vision since he was an infant. The Southwest Virginia native has been seen by several eye doctors and by the Virginia Department of the Blind and Vision Impaired. He has used a closed circuit reading machine but wanted to be able to read better, use his computer as well as watch sports and television. Jarrod came to me requesting help with those activities. I carefully evaluated Jarrod's vision and prescribed telescopic glasses adapted for reading and computer use and bioptic telescopic glasses to help Jarrod see better at a distance. He uses the second pair for television and to watch sports.

A few months after getting the low vision glasses Jarrod wrote, “After Dr. Armstrong got me the bioptic telescopes; I’ve seen things that I’ve never seen before. I went to Cincinnati to see the Reds play the Dodgers. I‘ve never been to a ball game before. With my bioptic telescopes I could actually see the baseball! I couldn’t believe that I saw every pitch thrown. It is amazing, I can’t believe it. I really enjoy them.”

With the computer telescopic glasses Jarrod says that he can see everything on the screen. He also uses them for reading and has read lots of books with them.

Jarrod finished his note “I just want to say THANK YOU Dr. Armstrong! My only regret is that I didn’t know about your great work sooner.”

Some things can't be rushed

2011-12-19T08:36:00.000-05:00

I have had a couple of low vision patients recently who both commented on the length of time that I spent with them doing the low vision evaluation. The patient yesterday came to me from Maryland. Over the 5 years that he has had macular degeneration his vision has reached the point that he requires someone to do his driving and has given up some of the very detailed work that he has done in his hobby of making reproductions of antique furniture. His occupation requires that he use blueprints often. His, off the shelf, hand magnifier was not helping him much with the blueprints. He had been seen many times by the doctors at Johns Hopkins and at the National Retina Institute. One had recommended that he begin to learn braile.

I spent well over an hour with him, carefully evaluating his vision with various low vision devices. The end result was that when he receives his low vision glasses in a few weeks he will be able to easily read his blue prints, see TV better and be able to drive safer. The same glasses that help with the blueprints will help him with the fine details of furniture making.

The earlier patient, a lady from West Virginia, was also suffering from macular degeneration. She had traveled to Germany where she underwent a stem cell procedure intended to improve vision. The results of that were very shortlived. Later she received acupuncture in New Mexico at a clinic that helps people with reduced vision. When she discovered that she would have to continue going there every month or so she discontinued her treatment.

As always, I spent well over an hour with her ,evaluating her vision, with a variety of devices. My goal was to help her with the activities most important to her, reading and watching TV. For reading I prescribed a handheld electronic magnifier. She was able to read newspaper or magazine print with it. Help for the TV was provided by telescopic glasses that magnified the picture. An additional lens that she can easily add to the telescopic glasses helps her read from the screen of her computer.

Both of these people had been seen by many doctors in many different locations. Both had been told that nothing further could be done to help them. Neither of them had a low vision evaluation until coming to me. Helping people with low vision takes time as well as skill. It is not something that can be done in a 10 minute exam or delegated to a member of the staff. A doctor, almost always an optometrist, who is serious about helping patients with low vision will arrange his/her schedule to allow enough time for the evaluation.

If you have macular degeneration, diabetic retinopathy, retinitis pigmentosa, Stargardt's disease or any other condition that has reduced your vision call me. I will return your call and spend a few minutes with you discussing your present condition, your goals and will give you an honest opinion of whether I can help you. Only if I feel that I can help you will I schedule you for a low vision evaluation. Because I have had lots of experience with these phone interviews I am able to help over 90% of the low vision patients who I see for an evaluation. The call and the telephone interview are free. Call me toll free at 1 866 321-2030. I look forward to speaking with you.

Woman with Diabetes, Glaucoma and Macular Degeneration helped to read

2011-12-18T21:02:00.000-05:00

The three leading causes of vision loss and blindness are diabetic retinopathy, glaucoma and macular degeneration. Any one of them can have devastating effects on a person's eyesight and their life. I had the opportunity to perform a low vision evaluation on a lady (GW) who had all three conditions. She asked for help in seeing better for some of the day to day activities that she had given up.

The top 4 things on GW's wish list were to be able to read her Bible, read her mail, use her checkbook and use her computer. Following a thorough low vision evaluation using low vision glasses she was able to do all of these things.

GW had no prescription glasses. Her doctor had recommended that she go to the store and find a pair of readers, telling her that nothing else could be done to help. She also had a low power hand magnifier. Her distance visual acuity with the right eye was 20/240 and 20/700 with the left. When I measured the power of her eyes I found that there was a moderate amount of astigmatism in each eye. Correcting that alone did not improve her vision very much.

A 4X Clear Image microscopic lens combined with the astigmatism correction allowed GW to read a large print Bible easily. With that lens she read letters one third the size that she could with the readers.

When the astigmatism correction was used along with a 2.2X bioptic telescopic lens for distance vision GW was able to read 20/60 letters, one fourth the size that she was able to read with no lenses. She was able to see her husband's face well from about 20 feet and saw the cars and people well when she tested the bioptics outdoors.

GW ordered the Clear Image microscopic glasses for reading, the bioptic telescopic glasses for television and to recognize faces when she is at church or shopping. In addition, she has a lens cap for the telescopic glasses that allows her to use her computer with them.

Although this nice lady has the three most damaging eye diseases she responded very well to low vision glasses and is enjoying them.

You might think that someone with this combination of eye diseases could not find help. The reason that I accepted her as a patient and is that I'd interviewed her by phone and was sure in advance of her appointment that I could help. I do not accept low vision patients until we have talked by phone and I feel that they have sufficient vision that I can help them achieve their goals.

If you would like to talk about your low vision problem and your goals please give me a call. We can quickly determine if I will be able to help you. Call me toll free 1 866 321-2030.

Technological Advances Benefit People With Low Vision, USA Today

2011-09-12T09:27:00.000-04:00

The following summarizes two interesting articles from USA Today.

USA Today (9/12, Healy) reports, "Low vision is not a direct result of aging," explained Dawn Kissner DeCarlo, OD, MS, FAAO, "chair of the American Optometric Association Vision Rehabilitation section and director of the University of Alabama Center for Low Vision Rehabilitation," but "usually 'results from eye injuries, birth defects, macular degeneration, cataracts, glaucoma, poorly controlled diabetes and other eye and health conditions.'" The article details technological advances that make it possible for people with low vision to live as normal a life as possible. "Given Baby Boomers' higher risk for age-related eye disorders and a dramatic nationwide increase in type 2 diabetes, the National Eye Institute estimates that vision disorders will double in 30 years."

"Bioptics" Help People With Low Vision Drive. In a related story, USA Today (9/12, Healy) reports that "independence and mobility of driving is a real option for some with vision impairments, thanks to 'bioptic driving.'" Bioptics "are small telescopes mounted into ophthalmic corrective lenses above a person's line of sight that improve the sharpness of far vision." According to optometrist Laura Windsor of the Low Vision Centers of Indiana, "those eligible for bioptic driving typically have 'mild to moderate vision loss that is stable,' along with 'pretty near-perfect' peripheral vision."

Vitamins to Prevent Vision Loss

2011-07-15T08:33:00.001-04:00

July 14, 2011, 12:58 pm

Vitamins to Prevent Vision Loss
By THE NEW YORK TIMES
Josh Ritchie for The New York Times

This week, Stephen Rose, chief research officer for the Foundation Fighting Blindness, joined the Consults blog to answer reader questions about age-related macular degeneration and related disorders. Several readers had questions about vitamins and nutrients to combat the vision loss of macular degeneration.

Q.I am 68 and my eye doctor recently said I have precursor signs of macular degeneration. She recommended the Areds vitamin formula, 2 times each day. Do you think the vitamins really do any good to prevent development of macular degeneration? Is there anything else that you recommend to prevent it?
Reader, Bangor, Me.

Q.My 82-year-old mom has macular degeneration and is urging me to take a particular brand of very high-dose vitamins that claims to preserve vision. Is there a benefit to these products?
annieb3, Calif.

A.Dr. Stephen Rose responds:
The National Eye Institute at the National Institutes of Health conducted the first Age-Related Eye Disease Study, known as Areds, which evaluated supplements for slowing the progression of age-related macular degeneration. The first Areds study enrolled about 3,600 patients who took a combination of antioxidants and zinc. The formula included specific amounts of vitamin C, vitamin E, beta carotene, zinc and copper.

For people who had intermediate-stage age-related macular degeneration, or A.M.D., the formula reduced the risk of developing advanced disease by 25 percent. The formula also led to a 19 percent reduction in vision loss for people with intermediate A.M.D. in one or both eyes, or advanced dry or wet A.M.D. in only one eye. The Areds study also showed that age and smoking influenced progression of A.M.D. The formula did not have any apparent benefit for people without A.M.D. or with early disease.

The Areds formula is now available over the counter from pharmacies and other retail outlets, but you should take it only if your doctor recommends it.

Diet alone cannot provide the same high levels of antioxidants and zinc as the Areds formulation. Also, standard daily multivitamins cannot substitute for taking the Areds formula supplement. However, diets rich in green leafy vegetables have been shown to lower the risk of developing A.M.D.

It is important for you to talk with your doctor about your stage of A.M.D. and whether the Areds formula is right for you. No one can tell you how fast your A.M.D. will progress, but if you don’t smoke and eat a healthy diet with lots of fruits and vegetables, you are reducing your risk of vision loss from A.M.D.

The National Eye Institute is currently conducting a second Areds study, called Areds II, which is evaluating a second supplement for reducing the risk of vision loss from macular degeneration. The Areds II supplement contains DHA, EPA, lutein and zeaxanthin. DHA and EPA are found in the oils of cold-water fish like tuna and salmon. Lutein and zeaxanthin are prevalent in colorful fruits and vegetables. No results from Areds II have been reported yet.

Q.A study in (I think) The Archives of Ophthalmology from Rotterdam showed that nutritional intervention in carriers of genes predisposing for age-related macular degeneration, more than half the risk to get the disease by just making sure one gets enough lutein, zeaxanthin, zinc and omega-3 in their diet. Just test early and suggest the intervention while awaiting results of research in novel treatments (forget the protein that was described as defective a few months ago).
acstas, bangkok

A.Dr. Stephen Rose responds:
Regardless of whether you have age-related macular degeneration or are predisposed to getting A.M.D. because it runs in your family, maintaining a diet rich in omega-3 fatty acids (DHA and EPA), lutein and zeaxanthin is a good idea. If your diet includes cold-water fish like tuna and salmon, which are rich in DHA and EPA, and lots of leafy and colorful fruits and vegetables, rich in lutein, zeaxanthin and several other protective nutrients, you are likely to be healthier than if you ate a lot of junk food.

The Rotterdam study you reference suggests that a diet rich in the nutrients mentioned above prevents age-related macular degeneration. However, the Rotterdam study looked retrospectively at people’s dietary habits through a questionnaire, so it is scientifically less reliable than a prospective study like the Age-Related Eye Disease Study II, which is much better controlled in terms of who is in the study and what nutrients they are consuming. In Areds II, participants are being studied over time as they follow a strict protocol of nutrient intake.

The National Eye Institute is conducting Areds II because of the evidence that DHA, EPA, lutein, and zeaxanthin may lower macular degeneration risk. Because the study is so well controlled, I believe it will give us the best information about what really works and what doesn’t.

Keep in mind that taking large amounts of vitamins and nutrients can be unhealthy. That’s another reason these controlled studies are important; they give us an understanding of the right amounts of nutrients we need for optimal health.

Q.I have macular degeneration and have been taking the Areds formula capsules twice a day for several years on the advice of my excellent retinal specialist. My M.D. is stable and has not become worse since I began taking the Areds. I also take 1,000 milligrams of omega-3 every day. So far, so good.
Liz, Albany, Calif.

A.Dr. Stephen Rose responds:
I am glad to hear that you have found a good retinal specialist and a treatment approach that is working. It is imperative that everyone with age-related macular degeneration see an eye doctor regularly, and that the doctor answer your questions and respond to your needs and concerns. Vigilance is critical with A.M.D. You need to stay on top of the condition to ensure it isn’t getting worse, and if it does, take whatever action or treatment you can to reduce your chance of vision loss. If you have any significant changes in your vision, get to your doctor as quickly as possible.

Genetics, Lifestyle May Contribute To AMD Progression

2011-07-11T10:30:00.000-04:00

The following brief article in The Boston Globe, July 8, 2011 discusses a recent study which looked at the relationship between macular degeneration and genetics. Cigarette smoking was also strongly connected to the incidence of advance macular degeneration.

We’ve known for years that macular degeneration – the leading cause of blindness in people over 55 – is associated with genetic as well as environmental factors. But how can we tease the two apart? Researchers at Tufts Medical Center found one way to do so: Study twins.

A study published last week in the journal Opthalmology looked at over 200 male pairs of identical twins. In some of the pairs, each twin had age related macular degeneration (AMD), but at different stages, while in other pairs only one twin had the disease. Based on questionnaires filled out by participants, as well as their AMD diagnoses, the study found that the twin with the more advanced stage of AMD tended to be a heavier smoker. And, twins in whom AMD progressed more slowly reported higher intakes of the nutrients betaine and methionine. Foods like fish, grains, and spinach have betaine, while methionine is found in poultry, fish, and dairy products.

So what does this mean for your susceptibility to AMD? “There’s definitely a strong genetic component,” says the study’s lead author, Dr. Johanna M. Seddon. A previous study of identical and fraternal twins done by her research team found that genetics explained between 46 and 71 percent of the severity of the disease, while environmental factors explained between 19 and 37 percent. But that doesn’t mean that there’s nothing you can do about it.

“One of the modes of management of this disease is adherence to healthy diet,” said Seddon, a professor of ophthalmology at Tufts University School of Medicine and an ophthalmologist at Tufts Medical Center. “This study underscores the fact that, here you are with twins with the same genes, and there’s no question that these behavioral modifiable factors make a difference.”

Protecting your eyes from the sun is another way to guard against AMD, as we wrote about last week.

Contact Neena Satija at nsatija@globe.com.

Help for a Lady with Stargardt's Disease

2011-06-09T08:58:00.001-04:00

Bobbie Poling knows the value of a Leader Dog. She has had Danae helping her for 3 years and, working through her Lions Club, Bobbie helps others obtain Leader Dogs to assist them.

Bobbie was diagnosed with Stargardt's Disease, a form of macular degeneration, in 1991 and has gradually lost her central vision. Danae, her Leader Dog, is her constant companion and helper.

When Bobbie came to me recently she was hoping for help seeing the faces of her family and with reading, as well as many hobbies that she had previously enjoyed. Bobbie has a CCTV reading machine but hoped for something more easily used and portable.

Danae and Bobbie's husband watched patiently as I evaluated her distance and near vision. Several types of low vision glasses were considered and I determined that she would benefit most from a pair of 3x bioptic telescopic glasses for outdoor activities, wide angle telescopic glasses for viewing television and a hand held electronic magnifier to help with reading.

Bobbie wrote later to thank me and report on her success with the low vision devices. "Dr. Armstrong helped me to be able to see the face of my husband, children and grandchildren. He gave me the ability to see TV and enjoy that again. I recommend him to anyone who needs help with their vision issues."

"You did a super job of looking at me as a whole person and tried to help me maintain my quality of living. Thank you so much for what you did for me." Bobbie Poling

If you would like to discuss your vision issues please call me toll free. I will be happy to talk with you and will give you an honest opinion of whether I can help you.

For more information about Leader Dogs call 888 777-5332 or go to the website http://www.leaderdog.org/.

Omega-3 reduces the risk of macular degeneration.

2011-03-17T08:47:00.003-04:00

AOA First Look, March 15, 2011 included the report below. Note that although the study was done on women there is a message here for men also. I always recommend Omega 3 to my patients with macular degeneration as well as a multivitamin containing many ingredients known to be helpful in protecting the health of the eyes. If you are not using appropriate nutritional supplements and have macular degeneration or are at risk this is your message to begin now. Increase your consumption of fish. Ask your doctor what supplements you should be taking. You must be proactive if you want to preserve your vision.

Consuming Omega-3 Fatty Acids May Help Reduce A Woman's Risk Of AMD.

HealthDay (3/14, Mozes) reported, "Women who consume fish regularly -- and the abundance of omega-3 fatty acids found in that meal choice -- have a lower risk of developing age-related macular degeneration (AMD)," according to a study published online March 14 in the Archives of Ophthalmology. In a study encompassing some 38,000 women who were followed for about 10 years, researchers found that women "who consumed the greatest amount of one or both omega-3 fatty acids (DHA, EPA) were found to have a 38 percent lower risk of developing AMD compared with those women who consumed the least."

"What's more, women who ate one or more servings of fatty fish per week -- mainly canned tuna and dark-meat fish -- were 42% less likely to be diagnosed with AMD compared with women who ate fish less than once a month," WebMD (3/14, Mann) reported.

MedPage Today (3/14, Fiore) reported, "Potential mechanisms by which omega-3s may lower the risk of AMD, they speculated, include the fact that the fatty acids may modulate the inflammatory and immune processes thought to play a role in the pathogenesis of the condition." MedPage Today also pointed out that the "study was supported by grants from the National Institutes of Health."

Also covering the story are Reuters (3/15, Joelving), the UK's Telegraph (3/14, Alleyne), the UK's Daily Mail (3/15, Hope), and the UK's Press Association (3/15).

Incidence of Macular Degeneration Decreasing

2011-01-24T09:24:00.001-05:00

Research reported in the January 21, 2011 New York Times veals that since 1994 the incidence of macular degeneration has decreased significantly. It is speculated that reduction in smoking, better diet, exercise and improvements in blood pressure have caused this to happen.

There is a strong message here for those at risk of developing macular degeneration: Quit smoking, get some exersize, eat right and keep your blood pressure well controled. Those at risk of developing the disease, who would benefit most from these lifestyle improvements, are those with a parent or sibling with macular degeneration. Get started now and you may be able to avoid losing vision.

Healthy Habits Reduce Risk of Macular Degeneration

2010-12-15T09:28:00.001-05:00

Medpage Today reports that a recent study showed the value of healthy habits in reducing the risk of developing macular degeneration. Reported online in the Archives of Ophthalmology the study looked at diet, exersize and smoking history of 1,313 women as part of the Women's Health Initiative. The study showed that women who exersize, eat healthy and don't smoke reduced their risk of getting macular degeneration by more than two-thirds.

There is a real message here for those who have a parent or sibling with macular degeneration. Another study showed that persons over the age of 50 with a parent or sibling with macular degeneration have a 50% risk of developing the disease themselves. Those people should be doing all that they can to cut their risk. If you have a close relative with macular degeneration get some exersize, stop smoking and eat a healthy diet.

Another thing that may reduce your risk is to use proper supplementation. Nutritional supplements based on the Age Related Eye Disease Study (AREDS) and other studies since then are a wise choice. Ask your eye doctor what he/she recommends. More about this in a future posting.

To read more about this study click on the link below.

MedPage Today

Study: Alcohol consumption in diabetics causes vision loss

2010-12-06T08:53:00.002-05:00

AOA First Look, December 6, 2010 reports on a study which shows that alcohol comsumption are at increased risk of blurry vision. Among patients with type 2 diabetes, those with even moderate alcohol consumption (1 to 14 drinks/week) had significant visual acuity loss over five years of follow-up but no difference in development or progression of retinopathy.

People With Type 2 Diabetes Who Drink Alcohol At Increased Risk For Blurry Vision.

MedPage Today (12/3, Gever) reported, "People with type 2 diabetes who drink alcohol are at increased risk for blurry vision unrelated to retinopathy," according to a study published in the journal Diabetic Medicine. While "moderate drinking did not increase the risk for or progression of retinopathy in a study of more than 1,200 diabetics...it nearly doubled the risk of losing two eye-chart lines of visual acuity over an average of five years." The study authors theorized, "Alcohol is known for its neurotoxic properties, which could induce oxidative damage to the retina and the optic nerve, leading to visual loss."

Study to evaluate use of stem cells in Stargardt's patients

2010-11-22T09:05:00.001-05:00

An Associated Press report printed in today's Washington Post tells of a new study just starting which will look at possible help for suffers of Stargardt's Disease. I have attached a link to the article for your convenience. AP It will be interesting to see how this study turns out.

Bioptic Glasses and Driving

2010-11-08T21:09:00.001-05:00

When I talk with people who have experienced a vision loss from eye disease I always ask what they would like to be able to do if I am able to help them. A large number would like to return to driving. Some have given up driving voluntarily and others have been unable to meet the requirements of the DMV and have lost their license. In either case they have lost their independence. They are now dependant on others to help them do the simplest of things, like a trip to the grocery store or post office or church.

Let me explain a bit about driving with low vision glasses. Bioptic telescopic glasses have small telescopes imbedded in the upper part of the regular lens. The person's eyeglass prescription is in the telescope as well as the regular lens. The telescope is used to spot things that need to be seen better like traffic signals, signs, other cars, people, etc. The person just lowers their chin a little, takes a quick look through the telescope and then goes back to driving with the main lens of the glasses, called the carrier lens. You will see examples of my patients wearing bioptic telescopes as I begin to post actual patient experiences and photos.

The laws are different in each state regarding driving with bioptic telescopes. Some allow persons to be licensed to drive with these special glasses and some states do not. All states will allow you to drive with the telescopic glasses if you already have a valid license. If you are wondering about your state's regulations you can check with the DMV or call me toll free and I'll tell you what your state allows and we can talk about whether you are likely to be able to meet the requirements. Call me at 1 866 321-2030. There is no charge for the call or the consultation.

My state, Virginia, is one of the states that issues a special driver's license for persons requiring bioptic telescopic glasses. Our DMV requires at least 20/200 in the better eye with the normal eyeglass lenses and improved to 20/70 with the bioptic. There is also a requirement of 150 degrees of peripheral vision (visual field). Once the person obtains the bioptic glasses they must use them daily for 2 months and then return to the low vision doctor for certification that they meet the above requirements.

If you think that you might require this type of license do not wait until the last minute. Call for an appointment 4 or 5 months in advance. That will allow time to have the low vision evaluation, receive the glasses and use them for the required 2 months before your license expires.

Many people have returned to safe driving by using bioptic telescopic glasses. Perhaps you could become one of them

"Why quit when you're having fun?"

2010-10-10T12:46:00.003-04:00

Today The Roanoke Times was kind to include me in an article about people over the age of 70 who are still active and doing the things that they love. I thank Kevin Kittredge for his kind words and his skill in expressing so well the way that I feel about what I do. I have practiced optometry for many years and have never had a day when I wished that did not have to go to the office. The Lord has blessed me with good health, energy, a wonderful family and a profession that I truly love.

I include this in this blog because I know that people go to my website or blog to get an idea of who I am and what to expect if they choose to come to me for help with their vision problems. I hope this will be helpful.

70+ and still going and going ...

By Kevin Kittredge
kevin.kittredge@roanoke.com
981-3323

Not everyone past a certain age pines for the rocking chair.
As Americans live longer -- life expectancy in the United States is now 78 years, according to the CIA World Factbook, compared with 47 in 1900 -- many people in their golden years continue to enjoy the active life.
Here are four Roanoke Valley folks who have passed the age of 70 and have yet to stop doing what they love.
Name: David Armstrong, 71
Hometown: Roanoke
How he does it: Exercise, good genes

People often ask Roanoke optometrist David Armstrong if he has picked a date to retire.
His answer: "Not really."
"I like what I do," Armstrong says. "This is working for me. I'll stay with it as long as the Lord lets me."
Armstrong, who moved to the Roanoke Valley from upstate New York in 1972, is 71, though his looks and bustle both belie his age. He is married with three grown children and five grandchildren.
He takes no medicines beyond a daily aspirin and vitamin supplements, and he enjoys bicycle riding and hiking in his leisure hours.
A devout Christian, he neither drinks nor smokes. "I do exercise. I think all those things help," he said. "I'm not sure they help as much as good genes."
His mother died a week before her 100th birthday, and his father at age 82.
As for continuing to work, Armstrong said he enjoys keeping up with advances in optometry and enjoys the people he works with as well.
"I'm in contact with a nice bunch of people every day," he said. "A lot of them are people I've known for a long time. I just love that.
"Why quit when you're having fun?"

New Implantable Telescope May Help People With AMD.

2010-09-13T08:47:00.001-04:00

The following brief article from AOA First Look, Sept. 13, 2010 reports on an article from the Chicago Tribune discussing the new implantable miniature telescope. As part of all low vision evaluations I am now determining if the patient is aa candidate for the implanted telescope. If they meet the FDA requirements I will use a small telescope to demonstrate how their vision will look if they have the surgery. We will then compare it with their vision using low vision glasses. That will allow the patient to see which would be the better option for them. Call me toll free, 866 321-2030, for a free telephone consultation. I will ask questions to help me determine if you can be helped by low vision devices such as the implantable telescope or low vision glasses. Only if I feel that I can help you will we schedule an appointment for an evaluation.

New Implantable Telescope May Help People With AMD.

The Chicago Tribune/McClatchy (9/11, Chan) reported that a "tiny implantable telescope has been developed to help people with" age-related macular degeneration (AMD). "The telescope, smaller than a pea, works by allowing light to be focused on working parts of the retina," thus helping "restore the ability to see what had been previously lost." CMS has yet to approve the device for Medicare patients, however.

UV Rays May Cause Significant Damage To Unprotected Eyes.

2010-08-23T08:03:00.001-04:00

AOA First Look on August 23, 2010 included the following news article which is especially important to those who are at risk of getting macular degeneration. Those are people with a sibling or a parent who have macular degeneration.

UV Rays May Cause Significant Damage To Unprotected Eyes.

HealthDay (8/20, Thompson) reported that "ultraviolet, or UV, rays can cause significant damage to unprotected eyes, resulting in a number of illnesses and disorders that can rob people of their sight." Over the long term, UV exposure can play a role in the development of cataracts, macular degeneration, and even cancer. "The eye tends to develop melanoma, while the eyelids usually are inflicted with basal cell carcinoma." Eye experts recommend that people wear sunglasses "rated to absorb 99 to 100 percent of both UV-A and UV-B radiation." And, because the majority of sun exposure happens early in life, parents should make sure their children wear sunglasses, too.

UV Exposure To Eye May Cause A Pterygium. In a related story, HealthDay (8/20, Thompson) reported that cumulative UV exposure to the eye may cause "a pterygium, a non-cancerous growth that forms on the clear, thin tissue that covers the white part of the eye. ... If left alone, they eventually can grow large enough to cover the cornea and impair sight." The growths can be surgically removed.

New Treatment Improves Vision Lost From Central Retinal Vein Occlusion

2009-09-17T08:08:00.004-04:00

The Sept. 16, 2009 "AOA First Look" reports on a study that holds promise for those who have lost vision due to central retinal vein occlusion (CRVO). CRVO is a major cause of vision loss, especially among diabetics. The study showed that injection of a steroid, triamcinolone, resulted in vision improvement in about one fourth of those treated. An article on the same subject in MedPage Today points out that for blockages in smaller branches of the vein did not find the steroid treatment to be superior to laser treatment.

Persons who have lost vision from CRVO may be able to function better when using special low vision glasses, either telescopic or microscopic. Call me toll free for a phone consultation. I will tell you if I can help enhance your vision and make it easier for you to read, drive, recognize faces, use a computer or other activities that you are having difficulty with. Call toll free 1 866 321-2030

Read the following, from AOA First Look for more information on steroid use in CRVO.

Study indicates triamcinolone may restore vision in patients with retinal vein occlusion.
HealthDay (9/15, Dotinga) reported that, according to a study published in the Sept. issue of the journal Ophthalmology, researchers from the University of Wisconsin-Madison said "they've found the first long-term treatment for people who suffer vision loss when the large veins in their eyes become blocked." The group discovered that "injections into the eye of a corticosteroid" called triamcinolone "improved vision in patients."
Reuters (9/15, Stern) reports that central retinal vein occlusion is a common complication of diabetes, occurring when blood clots hamper or impede circulation in retinal tissue. Following age-related macular degeneration, it is the second most common cause of vision loss.
CQ HealthBeat (9/16, Reichard) reports, "After one year, treated patients were five times more likely to be able to experience a vision gain of three or more lines on a vision chart," which is "the equivalent of reading letters half as small as before treatment."

At Risk For Macular Degeneration? Eat Fish and Nuts

2009-09-08T07:48:00.004-04:00

I was looking over some archived issues of "medpageToday" and came across the attached article on the importance of eating fish and nuts for persons who are at risk of developing macular degeneration. As our population ages there are predicted to be increasing numbers of people suffering from macular degeneration. More and more research, like this study from Australia shows that persons at risk of macular degeneration should be proactively working to avoid this devastating, blinding disease.

Who is at risk? Those closely related to someone with macular degeneration (parent or sibling), smokers, diabetics and people who have lots of unprotected sun exposure have an increased risk. In addition to yearly, dilated, eye examinations they should be taking steps to try to prevent macular degeneration.

Read this article and speak to your eye doctor for more information. Fish, Nuts Protective Against Macular Degeneration

Electronic Magnifiers

2009-08-19T21:47:00.004-04:00

In my low vision practice I try to prescribe low vision devices that are convenient for people to use. If possible I prescribe magnification in eye glasses so the person will be able to have both hands free for writing, holding a book, etc. Both telescopic lenses for distance vision and microscopic lenses for reading can be mounted in eye glass frames. That allows the person to easily take them along when shopping, driving, at church or the theater or for other activities.

Many people benefit from video magnifiers (reading machines) which project the pages of a book or paper onto a screen like a television set. These machines are wonderful but are large and definately not portable.

New smaller electronic video magnifiers are now available which are easily carried in pocket or purse and provide more magnification than can be put into low vision reading glasses.

I have had experience in my practice with a new small video magnifier called a Pebble as well as a somewhat larger device, the Amigo. Both offer several different magnifications, various contrast and color options as well as the ablilty to take a temporary picture of something that you may want to study more closely. These easily used devices have proven helpful to several of my patients.

Depending upon the patient's level of vision loss, their needs and goals I often show them how the Pebble or Amigo might help them. While most of my patients do well with low vision glasses some find that these video devices meet their needs very nicely.

Checked out by an expert

2009-08-19T21:20:00.004-04:00

I had an interesting conversation with a low vision patient this afternoon. He told me that he had read about me in a newspaper sent to him by a friend. What he read, my advertisment, "Was too good to be true". He decided to check me out. Being a retired U.S. Post Office fraud investigator he knew just how to do that. He called people he knew in Roanoke, where I've lived and practiced optometry for 37 years. The people he talked with all gave me a thumbs up. They gave him a good report so he called me hoping that I could help him see better for reading, using his computer and watching television.

Today he is very happy that he called. As I was dispensing his low vision glasses he was able to quickly and easily read articles from USA Today and Sports Illustrated. He is sure that he will benefit from the special glasses and has promised to report back to me in a couple weeks to let me know how he is doing.

I know that he is not the first to doubt that properly prescribed low vision glasses will help them. Almost all of the patients that I see who have low vision have been told by their doctor(s) that nothing can be done to help them. That is a shame because microscopic and telescopic eyeglasses have been available through low vision optometrists for over 40 years and have helped countless people get back to doing the activities that they'd given up.

If you have low vision from any cause, macular degeneration, diabetic retinopathy, glaucoma, stroke, inoperable cataracts, or any other disease you owe it to yourself to see if you can be helped. Call me toll free at 866 803-2030. We'll talk over your problem and your goals. I'll ask you some questions to help me understand the extent of your problem. I'll explain what I do and what you can expect. Only if I believe that I can help you will I schedule an appointment for a low vision evaluation. If I don't think that I can help I will be honest with you. I do not want to take your time and money and then disappoint you. Give me a call. I'll be happy to talk with you.

Omega 3 Fatty Acids Offer Protection Against Progression of Macular Degeneration

2009-06-11T08:21:00.004-04:00

The following article from "AOA First Look" shows the importance of Omega 3 fatty acids for persons with macular degeneration. If you suffer from macular degeneration be sure to ask your optometrist what you should be taking in hopes of slowing the progress of vision loss. Those at risk due to family history of the disease should be watching their diet and taking supplements as well.

Eating oily fish may reduce risk of AMD progression, study suggests.
Following a BBC News story, WLS-TV Chicago (6/9), an ABC affiliate, reported on its website that according to a study published in the British Journal of Ophthalmology, "omega-3 fatty acids, which are found in oily fish such as salmon and mackerel, appear to slow age-related macular degeneration (AMD)." Scientists believe that "omega-3 offers protection by altering fat levels in the blood that can be damaging to the body."
Explaining the study's methodology, MedPage Today (6/9, Smith) noted that researchers from Tufts University examined "dietary information from 2,924 eligible participants from the original" Age-Related Eye Disease Study, analyzing AMD "progression in 5,146 eyes." The team found that "dietary factors can influence the risk of progression of AMD." Specifically, people "in the highest quartile of" docosahexaenoic acid "consumption -- more than 64 milligrams a day -- had a hazard ratio for progression of 0.73...compared with the reference group," while participants "in the highest quartile of" eicosapentaenoic acid "consumption -- more than 42.3 milligrams a day -- had a hazard ratio for progression of 0.74," when "compared with the reference group." Notably, "the lower bounds for the highest quartiles of the two fatty acids are still significantly lower than the recommended daily dose of 650 milligrams."

Help For A Patient With Stargardt's Disease

2009-06-07T17:39:00.003-04:00

This past week I had the opportunity to evaluate and help a lady with Stargardt's Disease. Stargardt's, also known as juvenile macular degeneration is hereditary condition that usually first effects a person's vision in their first or second decade of life. It has the same devastating effects on the victim's eye sight as the more common Age Related Macular Degeneration.

The patient this week is 38 years old and has had Stargardt's for many years. Although she has glasses to compensate for myopia (nearsightedness) she rarely wears them because they make very little difference in how well she sees. With the glasses her visual acuity, measured with a special low vision chart, was only about 20/240 with her better eye.

Her top goals are to return to driving, read her mail, read medicine labels and to be able to see her computer monitor. Unfortunately, her vision is not sufficient to obtain a driver's permit in Virginia, even with the use of bioptic telescopic glasses. I was able to help her with the other three things on her wish list.

I prescribed prismatic glasses for use in reading and for the computer monitor. The pair used for reading magnify 2 times and she was able to easily read the newspaper or large print bible. The second pair of prismatic glasses magnify a little more than one time and allowed her to read the computer monitor in my office without enlarging the font.

Reading medicine labels is especially important and is actually required in her job. For that purpose I prescribed a new electronic video magnifier, called a Pebble. Pebble is a small, lightweight, hand held device with three different magnifications, from 5X to 10X. Using the Pebble she was easily able to read medicine labels. Other uses of the Pebble are to read price tags, ingredients and directions on packages, menus and other similar tasks. When I asked what she thought of the Pebble, she said "I love it". Pebble costs $695 plus shipping and with it's small size and 10X magnification should be a very valuable tool for many people with low vision.

There are many different causes of low vision and many different ways of helping people cope with the problems. A specialized low vision evaluation by an optometrist skilled in low vision care can result in an improved life for many of these people. In my low vision practice the key to my success in helping people is a careful telephone screening before they are scheduled. If you would like help with your low vision problems call me toll free 866 321-2030 for a free telephone consultation. I'll be able to tell you in few minutes if I can help you reach your goals. If I cannot help I'll be honest with you and will not schedule an appointment. Give me a call. I'll be happy to talk with you.

Woman With Macular Degeneration is Able to Return to Driving

2009-05-28T07:48:00.005-04:00

When she came to me for a low vision evaluation Laura Stanley's goals were:
1. To be able to read letters, newspapers, medicine labels
2. Return to driving
3. See the television picture better
4. Recognize peoples faces
As a result of her low vision evaluation I was able to help Mrs. Stanley achieve all of those goals.

Mrs. Stanley suffers from macular degeneration and with her glasses was able to see only 20/120 with her better eye. Not sufficient to drive in Virginia. She hoped to be able to obtain telescopic glasses and get a Virginia driver's permit allowing her to drive with them.

Through testing her vision with various types of low vision glasses I determined that 1.7X bioptic telescopic glasses which included her eyeglass prescription allowed her to read 20/70 letters with each eye. That meets the DMV requirement to drive with bioptics. The same glasses help her recognize her friends faces from a greater distance.

For television I prescribed wide angle telescopic glasses adjusted for the distance of her TV. A cap with a convex lens can be placed over the left telescopic lens and is used for reading.

Two months after receiving her telescopic glasses Mrs. Stanley returned to me for certification to apply for the special drivers permit. She passed that easily wearing the bioptics and was able to return to driving.

Mrs. Stanley told me, "These glasses are really worth the money. I can read and see TV better. I have used them at meetings and was able to see the person leading it better. I am looking forward to getting back to driving."

If your vision is keeping you from doing the things that you'd like to do give me a call. I'll talk it over with you and tell you on the phone if I can help you. I do not accept low vision patients unless I feel that I will be able to help them achieve their goals. Call me toll free at 1 866 321-2030.

2009-05-18T08:01:00.004-04:00

An article in today's AOA First Look reports on research showing the importance of proper diet in reducing the risk of macular degeneration(AMD). Those at risk for macular degeneration should consider diet changes as indicated in this report. Risk factors for macular degeneration include age over 6o, family history, smoking, sun exposure.

Researchers explore role diet may play in lowering AMD risk.
HealthDay (5/15, McKeever) reported that, according to a study published in the May issue of the journal Ophthalmology, "eating foods rich in vitamins C and E, zinc, lutein, zeaxanthin, omega-3 fatty acids, and that have less impact on blood sugar levels (so-called low-glycemic index foods) can lower the risk of developing age-related macular degeneration (AMD)." For the study, researchers from Tufts University's Jean Mayer USDA Human Nutrition Research Center on Aging analyzed "the eating habits of more than 4,000 study participants and determining their AMD risk from diagnostic photographs of their eyes." The investigators "found the lowest risk of developing early and advanced AMD was among people who consumed more protective nutrients and low-glycemic index foods." HealthDay noted that "citrus fruits, vegetable oils, nuts, whole grains, dark green leafy vegetables, and cold-water fish contain higher levels of these eye-healthy nutrients."

Different solutions for two ladies who want to be able to sew again

2009-05-08T11:26:00.004-04:00

Yesterday I had the opportunity to perform low vision evaluations on two ladies who had similar sounding goals that resulted in very different solutions. Both suffered from macular degeneration, their vision in the better eye was quite similar and they both wanted to go back to a hobby that was very important to them. They both wanted to be able to sew again. While it sounds like they might benefit from the same type of low vision glasses, there was quite a difference in their needs and the solution.

The first patient, E.R. wanted to be able to do "chicken scratch" which she explained to me is similar to cross stitch. That meant that she would be holding the needle and thread as well as the cloth in her hands. To help her I prescribed 2X Clear Image microscopic glasses which included her prescription for astigmatism. They allow her to hold her sewing at about 7" from her face. At that distance she was able to see fine stitches in a piece of fabric.

Patient M.B. wanted to be able to sew with a sewing machine. Of course, that requires a greater distance. I prescribed 1.7X Wide Angle Telescopic glasses with an additional lens that can be added to make it focus at about12-14 inches. She was able to see fine stitching along the placket of a shirt. Another use of this pair of low vision glasses is that with the telescope alone they can be used to view television. With the additional lens added they give good vision for the sewing machine or for reading.

In both cases good lighting is a must and I recommended an Ott Lite for both ladies. Ott Lites give a soft, daylight light and are excellent for reading and other near activities. I use them on my desk at home and have several in use in my office.

If you have low vision and there are some activities that you have given up or are having trouble with give me a call on my toll free number, 866 321-2030. We can talk it over and I'll tell you if I can help. I will not schedule a low vision evaluation if I do not feel that I will be able to help you.

Column explains how eggs may decrease the risk of macular degeneration

2009-05-07T21:09:00.004-04:00

The following article from AOA First Look, April 28, 2009 shows an interesting way of consuming more lutein and zeaxanthin, which are known to be beneficial to those with macular degeneration or to those at risk of the disease. Another way of obtaining the nutrients that promote macular health is through proper supplementation. Your doctor should be able to recommend products based on AREDS research and the studies that followed AREDS. This is something that a low vision doctor will recommend to all macular degeneration patients. I recommend supplements that contain all of the helpful nutrients. I believe that is preferable to making up your own combination of ingredients that you have heard may help.

In a syndicated column appearing in Canada's Niagara Falls Review (4/27), W. Gifford-Jones, MD, wrote that eggs "contain lutein and zeaxanthin, known as carotenoids, that help to decrease the risk of age-related macular degeneration (AMD)," a disease that "affects central vision and is the leading cause of blindness for people over 65 years of age." According to research done by Dr. John Landrum, of Florida International University, who "is a world authority on macular pigments," patients "with the highest intakes of lutein and zeaxanthin had 43 percent less chance of developing" AMD. In addition, a "study from the National Institute of Health...found that those with the lowest level of carotenoids had the highest risk of AMD." Recent data from the National Cancer Institute "show the overall decline of lutein intake.known This decrease in dietary lutein was particularly striking in those groups at risk of macular degeneration." Scientists "believe that lutein and zeaxanthin protect the macula by absorbing harmful blue light rays from the sun's rays," and may "act as antioxidants that neutralize free radicals, the end products of metabolism that are believed to cause aging."

Woman with Diabetes, Glaucoma and Macular Degeneration helped to read

2009-04-27T08:54:00.006-04:00

The three greatest causes of vision loss and blindness are diabetic retinopathy, glaucoma and macular degeneration. Any one of them can have devastating effects on a person's eyesight and their life. This past week I had the opportunity to perform a low vision evaluation on a lady (GW) who had all three conditions and was asking for help in seeing better for some of the day to day activities that she had given up.

The top 4 things on GW's wish list were to be able to read her Bible, read her mail, use her checkbook and use her computer. Following a thorough low vision evaluation using low vision glasses she was able to do all of these things.

GW had no prescription glasses. Her doctor had recommended that she go to the store and find a pair of readers, telling her that nothing else could be done to help. She also had a low power hand magnifier. Her distance visual acuity with the right eye was 20/240 and 20/700 with the left. When I measured the power of her eyes I found that there was a moderate amount of astigmatism in each eye. Correcting that alone did not improve her vision very much.

A 4X Clear Image microscopic lens combined with the astigmatism correction allowed GW to read a large print Bible easily. With that lens she read letters one third the size that she could with the readers.

When the astigmatism correction was used along with a 2.2X bioptic telescopic lens for distance vision GW was able to read 20/60 letters, one fourth the size that she was able to read with no lenses. She was able to see her husband's face well from about 20 feet and saw the cars and people well when she tested the bioptics outdoors.

GW has ordered the Clear Image microscopic glasses for reading, the bioptic telescopic glasses for television and to recognize faces when she is at church or shopping. In addition, she will have a lens cap for the telescopic glasses that will allow her to use her computer with them.

Although this nice lady has the three most damaging eye diseases she responded very well to low vision glasses and I expect her to enjoy them.

You might think that someone with this combination of eye diseases could not find help. The reason that I accepted her as a patient and is that I'd interviewed her by phone and was sure in advance of her appointment that I could help. I do not accept low vision patients until we have talked by phone and I feel that they have sufficient vision that I can help them achieve their goals.

If you would like to talk about your low vision problem and your goals please give me a call. We can quickly determine if I will be able to help you. Call me toll free 1 866 321-2030.

Stem Cell Research May Reverse Vision Loss From Macular Degeneration

2009-04-20T09:35:00.005-04:00

Patients often ask what research is being done to treat macular degeneration and other sight threatening diseases. A recent article in the British newspaper reports on a new treatment possibility using stem cells. Trials are expected to begin in about two years and actual use with patients will follow if the trials prove that the procedure works. To read the article click on Telegraph

An Interesting Patient With Diabetic Retinopathy

2009-04-03T17:01:00.004-04:00

This week a patient with a vision loss caused by diabetic retinopathy came to me for help. She had completely lost the vision of one eye and the vision in the other was damaged also. She was having problems with both her distance and near vision. There were several very different tasks that she wanted help with. The solutions to these problems illustrate some of the many ways that low vision patients can be helped.

Her vision goals and the solutions that I recommended to her are listed below:

1. She has trouble reading signs when driving. I prescribed a bioptic telescopic lens for her better eye which resulted in her reading 20/25 letters. When we took the testing lens outdoors she was able to read distant signs much better.

2. She has trouble using her computer. It is blurred and hazy. I prescribed a convex lens cap for the bioptic lens to make the driving telescope focus at the computer screen. An amber tint in that lens improved contrast on the screen making it much easier for her to see.

3. She wanted to be able to read, use her checkbook, etc and previous strong reading glasses focused too close to her face. She wanted to hold her books at a more normal distance. I prescribed a telemicroscope that focused at 16 inches from her face allowing her to hold her book in her lap and read easily.

4. She wanted to be able to read her insulin pump and glucose meter. Both of them had small screens with black letters and numbers on a gray background. Not very much contrast and very difficult for her to read. I prescribed a hand magnifier with an LED light and she had no trouble reading those small screens.

There are many ways that people with low vision can be helped to see better. Often they have several different requirements like this lady had. A low vision doctor with a thorough knowledge of the various devices available can often make life much easier and more enjoyable for them.

If you have low vision and some specific tasks that you'd like help with give me a call. I'll talk it over with you and tell you if I will be able to help. Call me toll free 866 321-2030 for a free phone consultation.

USA Today gives tips on preventing macular degeneration

2009-03-24T07:30:00.002-04:00

The following article and link to USA Today came from AOA First Look, the online newsletter of the American Optometric Association.

Columnist provides tips on how to prevent AMD.

In the USA Today (3/23, Painter) Your Health column, Kim Painter writes that, according to a study published in the Archives of Internal Medicine, "women over 40 who took supplements of folic acid and vitamins B-6 and B-12 were less likely than those who took placebos to report a diagnosis of" age-related macular degeneration (AMD) "after seven years." Meanwhile, "eye experts say" supplements "can help adults avoid AMD, or at least ward off the worst effects." While some "known risk factors" cannot be changed, such as "gender (women may be at higher risk)...race (whites are most affected)," and genetics, risk can be minimized by following "a healthful diet with plenty of vegetables and fish," not smoking, and getting regular vision check-ups. During "regular, comprehensive eye exams," optometrists "can spot early signs of AMD, even if...vision is still good." And, "for people with signs of moderate AMD -- including a buildup of yellow deposits called drusen under their retinas -- doctors recommend a supplement cocktail" containing "vitamins C and E, beta-carotene, zinc, and copper."

Low Vision Patients Can Continue to Enjoy Their Music

2009-03-16T08:57:00.008-04:00

Low vision patients often tell me that they have had to give up playing instruments or singing because they cannot read the music. Some have used a copier to enlarge the music, but that is cumbersome and does not always help.

I have often been able to help people read the music by using low vision glasses. There are several ways to do that, depending on how far they are from the music, if it is at eye level or below and the nature of their vision problem. That is all important information to bring to the low vision evaluation.

Here are some examples of actual patients and how they were helped to read their music and keep playing or singing.

1. Patient D.C., low vision caused by optic neuropathy: I prescribed wide angle telescopic glasses that allow her to watch television and other distance activities. When D.C. sings in the church choir she attaches a lens cap over the telescope. The cap allows her to hold her music below eye level and read it well. She is able to look at the choir director by looking through the top of the glasses. She says "It allows me to sing in the choir and hold my music lower so I can see the director and my voice is not smothered by the book being held so close in front of my face."

2. Patient T.O., low vision caused by macular degeneration and diabetic retinopathy. Has had corneal transplants in both eyes. T.O. is a serious musician. He plays trombone in 2 bands and was having problems reading the music. I prescribed a telemicroscope. Small telescopes in the lower part of the eyeglass lenses, in the bifocal position, that focus at the distance of his music stand. T.O. measured the distance from his eyes to the music so I could calculate the proper lens power.

3. Patient M.P., had given up playing the piano due to a vision loss caused by Stevens-Johnson Syndrome. I prescribed bioptic telescopic glasses that allow her to drive and watch sports events. When M.P. wants to play the piano she has a small lens that she fits over the telescope allowing her to focus on the music.

4. Patient T.C., has low vision caused by diabetic retinopathy and macular degeneration. T.C. sings and plays the piano. She was asking for help in seeing her music. I prescribed wide angle telemicroscopic glasses. T.C. reports that "she can see the music perfectly at 19 inches". She is also able to thread a needle and read books with them.

There are many ways to help patients suffering from low vision keep enjoying their music as well as hobbies and other activities that are important to them. Be sure to mention these activities when you call for the free telephone consultation.

A Patient With Retinal Pattern Dystrophy Helped

2009-03-10T07:35:00.004-04:00

There are many causes of low vision. While the most common are macular degeneration and diabetic retimopathy there are many other eye diseases that cause eye damage and reduced vision. In helping low vision patients it is more important to me to know what vision they have remaining than to know the cause of the loss. Whatever the cause of the problem if there is some remaining vision I have a chance of helping that person return to some of the activities that they have given up.

George Martin came to me seeking help with his vision. Mr. Martin has reduced vision caused by Retinal Pigment Dystrophy and was hoping to be able to see better for driving and reading. He did not wear glasses for his distance vision and was using only over the counter readers for near vision. His distance vision in the better eye was 20/100 and it could not be improved with conventional spectacle lenses.

The low vision evaluation improved his distance vision to 20/50 with a bioptic telescopic lens. His near vision with microscopic glasses resulted in a major improvement in reading and other near activities.

I talked with Mr. Martin after he received the low vision glasses and he told me "The telescopic glasses make a big improvement. I can see oncoming traffic better and tell how many cars are coming now. They are a big help when I'm looking over the fields at my farm."

The microscopic glasses also make a big difference. "I can read and program my cell phone with them."

Regardless of the cause of your vision loss, if you are seeking better vision there may be help available. If you would like to know if you would benefit from a low vision evaluation call for a free phone consultation. I will be happy to discuss your condition with you and tell you if I can help you achieve your goals. Call toll free 1-866-321-2030.

Two Interesting Articles on Low Vision

2009-03-01T22:21:00.002-05:00

The following two articles were reported in AOA First Look the on line newsletter of the American Optometric Association and may be of interest to low vision patients and vision care providers working with low vision patients. Unfortunately, if you click on the link to the Tri-County Times there is a charge to read the entire article. There is no charge to read the LA Times article.

Low vision is AOA-recognized specialty, article explains.

Michigan's Tri-County Times (2/10, Rummel) reported, "Low vision has been defined as a visual impairment not correct-able by standard glasses, contact lenses, or magnified, tinted lenses," and may be caused by "conditions such as macular degeneration, glaucoma," inoperable cataracts, "or diabetic-related eye problems," or even "retinal detachment, optic neuropathy, multiple sclerosis, corneal disease, stroke, and some genetic conditions." Low vision is also "a recognized specialty by the American Optometric Association within the optometry, ophthalmology, and optical professions." Optometrist Shelton Smith, O.D., who has "a subspecialty in low vision," explained that his "role is to maximize the functional level of a patient's vision with the use of rehabilitative devices." He pointed out, "The more usable vision a person has, the greater number and more demanding visual activities are possible." Many people who could benefit from low-vision services, however, do not know about them, he added.

General Medical News

Vigorous exercise may help prevent AMD, cataracts, studies suggest.

Writing in the Los Angeles Times (2/10) Booster Shots blog, Jeannine Stein observed that, according to two studies published in the Jan. issue of Investigative Ophthalmology & Visual Science, "vigorous exercise...may help prevent age-related macular degeneration (AMD) and cataracts." Both "studies looked at data from almost eight years of follow-up from the National Runners' Health Study. In one, 110 men and 42 women received a clinical diagnosis of" AMD "during the follow-up." But, "running an average of two to four kilometers a day reduced the risk by 19 percent, and running more than four kilometers per day reduced the risk by 42...to 54 percent, compared with those who ran less than two kilometers a day." The second study found that men who "ran 64 or more kilometers a week had a 35 percent lower cataract risk than those who ran less than 16 kilometers per week," and "those with better cardiovascular fitness were also at less risk than men who were less fit."

New Bioptic Telescopic Glasses Help Long Time Low Vision Patient

2009-02-28T14:51:00.005-05:00

Ben Webb came to me in the Fall of 2008 seeking help with his vision. He had suffered retinal detachments in both eyes as a result of a childhood accident. Ben had been using bioptic telescopic glasses for a number of years and was hoping that newer technology would give him improved vision compared to his present bioptics. There is no usable vision in Ben's right eye and even the left eye has a significant vision loss. After a thorough low vision evaluation I prescribed a 2.2X wide angle bioptic telescope for Ben's left eye.
On the day that he received the glasses Ben and I went outdoors so he could see how they were going to help. He told me "Everything looks clear. This is going to help."
Several weeks later Ben wrote:
"Dear Dr. Armstrong,
The glasses that I received from you on October 30th, 2008 are absolutely amazing. I can see so much more and read things like signs on the Interstate.
Thank you very much for helping me get more sight back.
Ben Webb"
Ben has worn the low vision telescopic glasses on a 14 hour trip from his home in Southwest Virginia to New England and reports that he is seeing well. He has never seen well enough to drive but says "I can see to do anything that I want to except for driving. These glasses are definitely worth the money."
As I do with all of my low vision patients, I spoke with Ben on the phone before scheduling his appointment. From the phone interview I was sure that I would be able to help him. I do not schedule low vision evaluations for persons who I do not feel that I can help.

New Macular Degeneration Research

2009-02-27T07:22:00.003-05:00

There has been a new study published that links folic acid and vitamin B to possible reduction of macular degeneration. Additional studies are needed to verify these findings. This brief report is from AOA First Look, an online news service of the American Optometric Association.

"Folic acid, B-vitamin combination may help prevent macular degeneration, researchers say.
Following a USA Today story, KLAS-TV Las Vegas (2/25, 12:44 p.m. MT, Francis), a CBS affiliate, reported in a health segment, "Aside from Alzheimer's, probably the cruelest disease of aging is macular degeneration," a condition that "slowly eliminates central vision. ... Eventually, the lost area almost fills the field of vision, leaving only peripheral images." Now, "researchers at Harvard Medical School and Brigham and Women's Hospital" have "found that a combination of folic acid and vitamins B-6 and B-12 lowered the chances of age-related macular degeneration by 35 to 40 percent" in a multiyear study of "middle-aged women taking the supplements."

Bioptic Telescopes and Driving

2009-02-22T19:43:00.002-05:00

Help Is Available for Persons With Low Vision

2009-02-22T19:11:00.002-05:00

One of the very unfortunate facts related to low vision problems is that most low vision patients are not aware that there are ways that they can be helped to return to some of the activities that they have had to give up. Of course, there are no magic cures for macular degeneration, diabetic retinopathy and other diseases that rob people of clear sight. However, there is help available for many who suffer from these conditions.

A couple years ago the magazine, Eyecare Business reported on a survey of 60 patients who had been helped by a low vision doctor in the Western U.S. Their average age was 68. "Most said that they had visited and average of 3 other providers who did not help before finding one who did. In fact, 47 percent said they were previously told nothing could be done to help."

In my low vision practice I'd say that almost all of the patients have been told that there was no help available for them. Of the patients who I accept over 90 percent can be helped. They can benefit from some form of low vision device which will allow them to achieve their goals.

It is true that there is no current treatment that restores the vision of someone who has lost it to eye disease. However, there are many ways that patients can be helped to perform those activities that are important to them. Careful srceening in advance of the low vision appointment will identify those who can be helped and those who cannot.

All of the above explains the reason for my beginning this blog. My intention is to give real life examples of patients with various eye diseases and the ways that I was able to help them. All of those patients have given me permission to use their information. They share my desire to spread the word to other persons with low vision. "You do not have to give up your normal activities. A low vision evaluation, by an experienced low vision doctor, can reveal ways in which your vision can be enhanced and ways to assist you."

In addition to sharing real life success stories through this blog I'll be providing information on the many diseases that result in low vision. I'll also discuss types of low vision devices and how they can be applied to various everyday activities. My hope is that you find this information helpful and if you or someone you know has a vision problem you will seek help. If you would like to discuss your situation with me please call toll free 1 866 321-2030. Just leave a message and your phone number. I'll be happy to call you back for a phone consultation at no charge.