Featured article in the New York
Times, Science and Technology section,
April 6, 2004
The
New York Times
Sleek New Devices Help Low-Vision Patients See
By KENNETH CHANG
New York Times, April 6, 2004
With a stylish exterior of metallic blue and gray, the device
looks like a personal digital assistant but slightly larger.
Julius Mendalis, 84, a lawyer for the company that makes
Arizona Iced Tea, paid $795 for this gadget, and he loves it,
though he is not a man of technology, rarely uses computers and
does not surf the Web.
It is helping him read again.
The Quicklook, an amalgamation of a tiny digital video camera
and a four-inch liquid-crystal display screen, acts as an
electronic magnifying glass, enlarging the text of a newspaper
or a legal brief to an inch high. At that size, Mr. Mendalis,
whose vision has deteriorated from macular degeneration, can see
the letters clearly.
"This has been a world of good," he said. "It's brought back to
me what I've been able to do all the time. It's been wonderful
for me."
About 16 million Americans suffer from uncorrectable vision loss
from glaucoma, cataracts, diabetes, macular degeneration and
other diseases. Effective treatments exist for glaucoma, and
cataracts can be removed by surgery. But for other eye diseases,
no cures exist, only treatments that slow the loss. The National
Eye Institute estimates the number of Americans who lose part of
their vision to disease will double in 30 years as the
population ages.
Macular degeneration, which usually strikes people over 60,
destroys the central part of the retina, blurring the center of
a patient's field of vision and making it hard to read or
recognize faces. About 1.7 million Americans have lost part of
their vision from the disease.
Diabetic retinopathy, a complication of diabetes, damages tiny
blood vessels in the eye and causes severe vision loss or
blindness if the vessels break.
Magnifying glasses, eyeglasses and more elaborate devices like
wearable telescopes are the traditional vision aids.
Closed-circuit television systems that look like library
microfilm readers have been available for decades to enlarge
text.
But the proliferation and miniaturization of consumer
electronics in recent years have led to a new generation of more
powerful and more portable gadgets for low-vision patients.
The computing power of electronics offers capabilities
impossible for optical devices. With built-in illumination, they
work even in dim lighting.
"Restaurants in the city are notorious for their poor lighting,"
said Dr. Bruce P. Rosenthal, chief of low-vision programs at
Lighthouse International, a Manhattan-based nonprofit group that
provides services to people with vision problems.
Electronics can also alter the image on the fly. Black text on a
white background can be flipped to show white text on a black
background; the greater contrast is easier for many people to
read. Distracting color can be reduced to black and white.
"Eventually, a lot of the electronic devices will begin to
replace some of the optical devices," Dr. Rosenthal said, adding
that anyone who is thinking about buying a vision aid should
first visit an eye specialist to diagnose the underlying
problem.
The vision aids, experts say, may even improve mood. A
Lighthouse study of 584 low-vision patients found that people
who used optical aids, either traditional or electronic,
suffered measurably less depression than those who did not have
such help.
"Optical aids do contribute significantly to a decline in
depression and a decline in disability in the first six months,"
said Dr. Amy Horowitz, senior vice president for research at
Lighthouse.
By contrast, so-called adaptive aids like large-print books,
talking clocks and Braille watches did not reduce depression.
"I think it's psychological," Dr. Horowitz said. With optical
aids, "you're still doing things the way you used to."
The adaptive aids, she said, might be in essence a surrender to
vision loss.
The study could not tell whether the use of optical aids staves
off depression or whether people who seek out optical aids are
by nature more determined to continue their usual routines and
less susceptible to depression, the Lighthouse researchers said.
An eye doctor diagnosed a mild form of macular degeneration for
Mr. Mendalis two decades ago, but that did not slow him down.
Then, a year and a half ago, while at a restaurant, the vision
in his right eye suddenly went black. The blood vessels there
had started leaking — the more severe, or "wet," form of macular
degeneration.
A laser treatment, photodynamic therapy, helped stop the
leaking. A few months later, blood vessels in the left eye
started hemorrhaging. He underwent more laser surgery Mendalis
continued working, but "my entire work is document reading," he
said.
Because he was unable to see clearly, his wife, Sylvia, read
documents aloud. She said they got into many more arguments.
"It's frustrating for him," she said.
Mr. Mendalis's eye doctor referred him to Lighthouse
International.
Scarring in the retina has left the vision in his left eye
irreparably blurry, but special glasses with a magnifying lens
now allow Mr. Mendalis to read using his right eye, though he
has to hold the paper a couple of inches from his face.
On a visit to the store at Lighthouse International, he spotted
the Quicklook, made by Ash Technologies of Ireland, and bought
one. His wife said that with the glasses and the Quicklook,
"he's pretty much on his own now." She added, "My nights are now
free."
As the technology has changed, product design has become
snazzier. Just a year ago, a device similar to the Quicklook had
the size and aesthetics of a large brick, and it was $100 more
expensive. Cost is important, because Medicare and most private
insurance plans do not pay for visual aids. A federal study this
year will look at the feasibility of Medicare coverage for
vision rehabilitation services.
Excerpted from The New York Times, April 6, 2004
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