Shavelson112186
Aging and Low Vision
Reporter: Lonny Shavelson 510 849 9382 lonny@photowords.com
Editor: Alisa Barba

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Time: 5:30

Host’s introduction
In the next fifteen years, millions of aging baby boomers face vision-stealing diseases like glaucoma, diabetes and macular degeneration.  The number of severely sight-impaired seniors is expected to nearly double, to six million.  Until recently, there was little most eye doctors could do to treat these problems—they’d prescribe stronger glasses, or perhaps urge you not to drive.  But now the country’s largest association of ophthalmologists is encouraging every member to offer another kind of treatment, called vision rehabilitation.  Reporter Lonny Shavelson has this story.

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“Try to access your peripheral vision, Esther.  Move your head a little bit, and try now to look at that dot.”
“I can see it on the periphery, yeah.”

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In a converted apartment in a foggy San Francisco neighborhood, the National Association for the Visually Handicapped has set up a rehab shop, lined with shelves of magnifiers and computer reading aids. 

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“Your central vision is obstructed…”

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Here, counselor Jeannine Toussaint is meeting with residents from one retirement community where so many have minimal sight they formed their own support group.  

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“You all want to read small print.”
“Any print.  I can read one word at a time. It’s not good.  A lot of it’s blurry.” 

 (ducks under trk2) “Because you have macular degeneration…”

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For millions of seniors with low vision, the culprit is macular degeneration, which damages the light-sensitive retina at the back of the eye.  This treatment-resistant disease so blurs central vision that you can't read or see fine details.  In past years, those with such minimal sight have been trained as if they were blind-using seeing eye dogs and canes.  But today's  rehabilitation teaches them to use whatever sight they have, with the help of bright lights and magnifiers. The rehab can be surprisingly simple. Poorly sighted seniors cannot pour milk in a white cup and see when it overflows; but teach them to use their side vision and give them a black cup-and not a drop spills.  Or provide high intensity light for reading.    

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Because by the time we are in our seventies, we need seven times the amount of light (fade down) to see the same amount of detail we saw in our twenties.

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Dr. Daniel Schainholz is one of the few eye doctors who has specialized in low vision rehab.

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“I typically can teach a patient to learn to read again, learn to use their residual eyesight effectively, live independently.”

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Seniors with progressive vision loss can't drive, read, or see their TV, and their kids insist they stay away from the stove. They are more likely to suffer severe depression than those with illnesses like heart disease or cancer.

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“My name is John Madison and I have macular degeneration. When I was diagnosed, there was absolutely nothing that was mentioned to me in regard to support services available. And I just vegetated, sat around and stewed.”

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John Madison is in a support group for seniors with low vision in Marin County, California.  Of its twelve members, not one had been told about vision rehabilitation by their eye doctor, even though medical researchers have found that this therapy can teach sight-impaired seniors to recognize faces, read street signs and even newsprint.  Madison found this rehab on his own. 

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“I do now have the use of a reading machine, at least I can read mail, bills and things of that sort. So that has made life much better.”

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Experts say there are many reasons why vision rehab is rarely offered to patients. Medicare agreed to pay for it only two years ago, and it's been slow catching on even since.  And there's been little consumer demand from today's seniors who have come to think that seeing poorly is an  inevitable part of aging.  But also, claims rehab specialist Dr. August Colenbrander, ophthalmologists have been so attracted to lucrative surgical procedures like lens implants and Lasik, they've paid little attention to vision rehab.    

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“Many eye doctors have never dealt with the question, what can I do for the patient, even if there’s nothing that I can do for the eyeball.”     

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Now that Medicare pays, and millions of aging, blurry sighted baby boomers are increasing consumer demand, the country’s largest association of eye doctors has decided it’s time to heal their blind spot about this therapy.  In January, the American Academy of Ophthalmology launched a Smart Sight Initiative, to persuade their members to routinely offer low vision rehabilitation.  Dr. Susan Day is the president of the Academy.    

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We want to help our patients use the vision that remains. It’s another part of the ophthalmologists’ responsibility.

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The Academy says its initiative will help poorly sighted seniors avoid the medication mixups, falls and depression that put them into nursing homes.  83-year-old Joan Burton’s eyesight dimmed only three years ago. She was trapped at home, (fade up sounds of bus, from Shavelson050131amb5.wav) until vision rehabilitation taught her to get around by bus. 

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Joan Burton: When we lose our sight we don’t lose our brains.  Here’s the bus.  Hi.  53? 
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For NPR news, I’m Lonny Shavelson.

Host’s tag:
To see Lonny Shavelson’s photographs of vision rehabilitation, go to NPR.org.