Focusing on solutions to low vision problems
Anyone with low vision will tell you how devastating it is not to be able to perform daily tasks they once did effortlessly. However, low vision specialists and vision enhancing technology are now more readily available to patients living in Eastern Oregon.
Dr. David Glabe, O.D., M.S. is the only residency-trained low vision specialist in Eastern Oregon. He has eight years of research in macular degeneration, a leading cause of low vision.
Last July, he joined Dr. Samuel Kimball, O.D., M.S. at La Grande Family Eye Care, 1502 N. Pine St., Suite 3 in La Grande.
“Low vision means that someone cannot see as well as we would expect in spite of the best possible correction using glasses or contact lenses,” said Glabe. “Low vision can range from a little below 20/20 to no light perception.”
The leading causes of low vision are usually age-related.
According to the Centers for Disease Control and Prevention, more than 3.3 million Americans age 40 and older are either legally blind or worse, or have low vision. Some of the primary causes of low vision include macular degeneration, glaucoma, diabetic retinopathy, cataracts, retinopathy of prematurity (in preemie babies), retinitis pigmentosa, retinal detachment, corneal scars, stroke or trauma.
“Some of those conditions result in a decrease in central vision while others result in a decrease in peripheral vision, but low vision intervention is designed to help anyone with reduced vision in their daily functioning,” Glabe said.
People who are experiencing low vision should first receive a routine eye exam so that an accurate diagnosis can be made. This will equip the low vision specialist to properly advise the patient of his prognosis.
Will the condition worsen? Will it stabilize or improve with time? The answers to these questions will enable a specialist to plan an appropriate management of the patient’s condition.
Beyond standard eye examination equipment, there is quite a variety of visual aid technologies available to help a patient see better and engage more fully in daily living.
“That may mean watching the TV, reading the newspaper, performing occupational tasks, writing, or seeing small print on parts or medicine bottles. That may also include performing a hobby you had to quit due to decreased vision,” said Glabe. “A patient’s treatment will center around specific tasks that he or she needs or would like to perform.”
The type of intervention a patient receives will vary depending on the visual demand of the task. The working distance is a critical aspect of low vision intervention because often the magnifiers used have a short range of focus.
Handheld, lighted magnifiers come in 3x to 15x magnification which may suffice for some patients.
For others who have difficulty reading, writing checks, putting on makeup, threading a needle or performing a hobby that requires delicate hand work, more specialized magnifiers are an option.
Dr. Glabe’s office can help a patient find the right model for their purposes or shop online. There are several manufacturers that make these models of magnifiers.
The good news is that technology keeps improving for low vision patients. There are several electronic devices that brighten, sharpen contrast or magnify, and there is also a free app called “Brighter Bigger” that can be downloaded onto an iPhone or iPad for magnification. This app is a reading tool for people who have difficulty reading fine print and focusing on nearby objects.
“There is also equipment called a closed circuit television (CCTV) where you put a page of text on it, press large, touch-screen buttons, and it will scan the text to digest the material, then read it back to you.” said Glabe.
“Some video magnifiers have a camera system attached to them so that if someone has a hobby, doing woodwork for example, the camera is pointed on the object and magnified on the screen.”
Glabe’s passion for his work with low vision patients is fueled by an experience his grandmother encountered years ago. She went blind from macular degeneration, and she was advised by her eye doctor that there was nothing more that could be done for her.
“I’m sure that the doctor meant that he couldn’t do anything to cure her vision, but what he neglected to tell her was that there is a lot that can be done to help her function better with low vision devices,” Glabe said. “So my grandmother went through years with very poor vision and had to have other people read for her, other people do her finances and other people tell her how much money was in her wallet because she couldn’t read the bills. When we introduced her to some low vision glasses, she was able to function again, and she remained that way for most of the rest of her life.”
As a result, Glabe is determined to help others with low vision to maximize what vision they do have to function better in their daily tasks of living. He wants those with low vision to have hope and become aware that there are technologies and specialists to help them regain their visual independence.
“Does insurance help pay? Often the answer is no,” said Glabe, “but there are other options if the patient qualifies, such as help to pay for exams from the State or Medicare. Also, the Lions Club, charitable organizations and organizations for the blind may offer financial assistance to acquire some of these things.”
Most devices are not overly expensive, ranging from a pair of eye glasses that has a modified prescription to magnifiers that can cost as little as $30. There are also digital magnifiers that range from the $100s to table-top magnifiers that run about $1,300.
“It’s really not bad considering what a wheelchair would cost or other medical devices that people use to help them function better,” said Glabe.
“These devices have the potential to help someone regain the ability to see and function again. There is some training involved to learn to read differently, and that’s where I come in to help.”
Glabe, a doctor of optometry who also provides comprehensive eye care, received his low vision credentials from a subspecialty residency program in ocular disease and low vision at the Kansas City VA Hospital.