University of Michigan Kellogg Eye Center | 1000 Wall Street, Ann Arbor, MI 48105 | 734.763.8122
Copyright © Regents of the University of Michigan
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| living with Low Vision
That is certainly the case for Laura Barbour, an artist and seamstress who has lost much of her vision to macular degeneration. When you enter her home you are keenly aware of Mrs. Barbour’s love of art. On one wall is a full size kimono, one of fourteen she has sewn over the years. Several works in fiber hang over the fireplace, and on another wall is her rendering of the Grand Canyon, painted on fabric. Now, with the help of Ms. Terpening, Mrs. Barbour is finding new ways to carry on her sewing and painting. On this second home visit, Ms. Terpening brings a mini telescope that can be mounted over eyeglasses for watching television or other activities that require distance viewing. She also asks Mrs. Barbour how she is doing with the “Jordy,” a device that looks like a high-tech pair of glasses but contains a small video camera. It magnifies and projects images onto a screen inside the device, right before the viewer’s eyes. Mrs. Barbour has used it for reading, and, if she wishes, she can connect it to her television to receive images directly. She will also use it when she resumes her painting. She says that the device is not especially heavy or complicated. “At first I thought it might be hard to use, but I believe that ‘use of habit’ overcomes difficulty.” And, as Ms. Terpening is quick to add, “Mrs. Barbour is a highly motivated individual with a very positive attitude. It makes all the difference.” Although Mrs. Barbour acquired the device only two weeks earlier, she has just created a Valentine card designed with layers of petals in the shape of a heart. She calls it her “first Jordy success.” The design clearly requires precision and a sure hand. To achieve the look of a rose petal, Mrs. Barbour held small pieces of fabric over a flame until the edges curled to just the right degree. Adjustments in the home that make life easier Ms. Terpening often works with clients in her office at Kellogg, but she prefers to make home visits. “This way, I can work in surroundings that are familiar to my clients, and I can see how lighting and other environmental factors affect their activities. Some people are simply more comfortable tackling new ideas in their own setting,” she says. During this visit, Ms. Terpening and Mrs. Barbour walk through the home, pinpointing problem areas. Ms. Terpening marks the oven dials with small strips of bright orange fabric paint that form a raised surface, allowing her client to see or feel the “on” and “off” positions. The washer and dryer and the thermostat are similarly marked, but together the women decide that the bread machine has dials large enough to read and that Mrs. Barbour is so familiar with the microwave that she doesn’t need the added markings. Ms. Terpening also has suggestions that will allow Mrs. Barbour to continue sewing. She fits the sewing machine with a needle that has a slit rather than an eye so that the seamstress can simply slide the thread in place. Mrs. Barbour has macular degeneration in both eyes, and she explains that she met Ms. Terpening when the condition escalated. “I suddenly went blind in one eye, and my son took me to the emergency room. I already had an eye doctor at Kellogg, and from there I found Cheryl in the Low Vision Clinic. It was a happy day that I found this solution.” Macular degeneration affects over thirteen million Americans. The most common form, dry macular degeneration, occurs more frequently as people age, thus the name, age-related macular degeneration (AMD). “On average, one in four people over the age of 65 have AMD,” says Ms. Terpening, and the number jumps to one in three for those 85 and older. The disease is progressive and occurs when the light-sensing cells in the center of the retina (macula) begin to deteriorate. People with AMD gradually lose their central vision until finally they seem to have a dark circle at the center of their sight. Peripheral vision and color vision are not affected. Learning to use peripheral vision Through a series of reading exercises, Ms. Terpening helps her patients make the best use of their peripheral vision, a task that is difficult because our side vision is designed to decipher large objects. Reading with peripheral vision can be frustrating because you must begin with very large type—so large that only three or four lines fit on a page. Ms. Terpening helps patients train their peripheral vision on these large letters, before shifting to smaller type and adding a magnifier. Mrs. Barbour was able to change her reading habits rather quickly. “At first I couldn’t imagine why a magnifying device would work if you can’t see straight ahead. With practice, I’m getting better at spreading out the letters.” But it’s not quite so easy for everyone. Ms. Terpening explains, “You have to learn how to use peripheral vision before you can make the best use of a magnifying device. It’s definitely not an intuitive process. Your brain is accustomed to shifting to central vision, and it takes real concentration to stay focused at the edge of your vision.” Ms. Terpening encourages ophthalmologists to refer patients with declining sight to a low vision clinic as early as possible. “I like to work with patients before their sight is too limited,” she says. “Trying to read with partial vision is a slow and frustrating process. It’s helpful to learn the scanning techniques while you still have some vision.” Medicare will pay for services of an occupational therapist for people whose vision is 20/70 or worse in the better eye. Some insurance companies also help cover the costs. Before the visit is over, Mrs. Barbour shows two more works of art. One is a drawing by her daughter, an artist who lives in Philadelphia. The other is Mrs. Barbour’s rendition of the same subject, but this one is created with fabric. The mother and daughter have exhibited their work together on several occasions, and it is easy to imagine that they will do so again. |
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University of Michigan Kellogg Eye Center | 1000 Wall Street, Ann Arbor, MI 48105 | 734.763.8122
Copyright © Regents of the University of Michigan |