Monthly Archives: August 2017

The Solar Eclipse and Your Vision

NASA

Just a few notes about watching a solar eclipse. A patient called me a few days ago looking for solar eclipse glasses.  In my mind it is never a good idea to look in the direction of the sun.  I do realize, however, that there are a lot of people who want the experience of seeing a solar eclipse since it is so rare.

There is eye pathology associated with sun gazing called solar retinopathy. This damage is caused by high intensity light exposure.   Retinopathy is damage to the very sensitive  light detecting neurons in the back of the eye, which are responsible for vision.  While solar retinopathy will not result in total vision loss, it is damage to the macula, which is the area of our most critical and detained vision.

Looking at the sun, if inadequately protected, can result in solar retinal damage in 30 seconds or less.  Sunlight is not only a source of high intensity UVA and UVB wavelengths, but also radiates other potentially damaging wavelengths of light, such as Infrared and near infrared.  For this reason, regular  UV 400 protective sunglasses, no matter how dark, are not enough.

Symptoms of solar retinopathy are felt a few minutes to a few hours after exposure, depending on the intensity of the burn. Visually there may be blurring, a scotoma (an area of no vision, a ‘blind spot’), and/or distortion accompanied by a headache.

The solar eclipse glasses which are recommended have additional specialty filters to guard against the other high intensity wavelengths of light. The international safety standard is labeled  ISO 12312-2.  This should be indicated on the glasses, along with the name of the manufacturer.  A list of reputable manufacturers of solar eclipse glasses can be found at American Astronomical Society(AAS), Vendors of Solar Filters and Viewers.  They are not expensive, but don’t take a chance on poorer quality, or even worse; fake solar filters.

If you would like a comprehensive description of eclipse viewing, go to the NASA.gov website.  On this page, they describe how to use the solar filters and make other safety recommendations. They also describe an indirect technique  to experience the solar eclipse.  Through the NASA.gov website you can access ways to watch live streams:

eclipse2017 NASA.gov

Why You Should Seek a Low Vision Evaluation

Here is another excerpt from my book from the chapter titled: Acceptance-Adjustment-Adaption

The low vision evaluation is different from the medical eye examination that you receive from your optometrist or ophthalmologist.  The medical examination is focused primarily on evaluating the health of the visual system, concluding with a diagnosis and subsequent treatment, if needed.  The refraction, which determines the eyeglass prescription, is generally a part of that medical examination.  Your eye doctor wants you to leave the office with the best vision possible.

If your vision is not optimal, in other words, not “20/20’ with a new eyeglass prescription, additional testing will be done and a diagnosis determined.  The doctor next considers the appropriate treatment, either medication or surgery.  Sometimes there is no treatment, or the maximum treatment has been given, and there is no improvement in vision.  The doctor may say ‘nothing more can be done, see you in three months.”

Nothing more can be done!  This clinician may be brilliant within his/her scope of practice, but may not be aware of what the low vision specialist does, is too busy to concern himself, or may not be familiar with a referral network.  They may think the patient is too old or the vision loss is too severe.  I have heard of doctors, at the top of their profession, who send the patient out shopping for magnifiers.

This is where you need to be your own advocate.  Low vision services can be found in private practices (optometrists or ophthalmologists who also practice low vision), low vision multidisciplinary centers, and state or federal agencies.  Multidisciplinary low vision referral centers will have low vision specialists who work with occupational therapists, rehabilitation therapists, and counselors.

Low vision specialists are licensed optometrists or ophthalmologists, who understand the disease process and will have insight into the prognosis because of their medical training.  They are knowledgeable about functional vision loss and understand their limitations.  They have seen people with similar problems before, and will not think you are too old or too debilitated.  Their goal is to help maximize your visual potential, and help you through the adjustment and adaption process.

The low vision specialist evaluates the type of vision loss, whether it is a loss of visual acuity, visual field, or contrast sensitivity, and then evaluates what visual function remains. Their goal is not to treat the disease process in a medical sense, as with medications or surgery.  Medical treatment is still the domain of your regular eye doctor, with whom you should continue to see on a regular basis.

Here are the reasons to get a low vision evaluation;

  1. To Advocate for Yourself;
  2. Introduction to Visual Aids and Techniques;
  3. Education and Counseling, and
  4. Appropriate Referrals.

Thought for the Day: The beautiful thing about learning is that no one can take it away from you.   B.B.King

Adjusting to Vision Loss

The following is another exerpt from my book.

 

Adjustment is the psychological and social resetting of your life.  There are many factors that will affect how you adjust:  things like age of onset, rate and severity of disease progression, living situation, and financial concerns.

Coping is how we deal with the changes.  It is how we adjust and adapt  to the nuances of our psychological, social, and personal functional needs.  An individual’s coping mechanisms at the beginning of the disease are different from those at the various stages of the disease process.  Someone who loses vision suddenly will need to overcome the shock of sudden disability, while someone with a slow, progressive onset of vision loss may have years to adjust and develop compensatory techniques.  An individual with profound vision loss will need to work harder to compensate versus having to adapt to a milder vision impairment.  One’s living situation, whether living alone or in a family unit, can impact the capability to cope, depending on the situation, either positively or even negatively.  Sadly, financial resources can impact the capability to cope.  While state and federal agencies provide some valuable services, those extras like electronic technology, transportation, and home assistance may be financially out of reach.

There are several emotional issues that can affect one’s capability to cope with a disability;

Grief

Depression

Negative Self-Perception

Loss of Independence