Avoidable Blindness

I still get National Geographic even if I don’t read it cover to cover like I used to. I mean to get back to it – I really do; I love it! – but CCTV lights shining on glossy pages are a bit much. However, when my husband handed me a pile of old Nat Geos (National Geographics) and I saw the cover of September, 2016, I had to read at least one article. The title was The End of Blindness: Winning the Fight to See.

My first thought was “We have made the big time!” Cover of Nat Geo is absolutely the big time in my book. Then I thought “Everything they are saying about the incredible research and the discoveries made really is true.” Nat Geo for me is sort of like Walter Cronkite; if they say it, it is true.

The article has some scary statistics: 39 million people are not able to see, as in no functional vision at all. 246 million have reduced vision. That is rather a lot of people.

The article went on and talked about the research that is occurring. It talked about genetic engineering and stem cells. They also mentioned two different types of ‘bionic eyes’.

In addition, it mentioned that Sanford Greenberg has pledged $3 million in gold to the person who contributes the most to ending blindness by his end date, 2020, of course! (Better get busy on your cure projects!) The Audacious Goal Initiative continues going strong, handing out money to worthy research projects. People are putting their money where their mouths are and getting behind this campaign.

Eliminate all blindness by 2020? Great goal, but probably not attainable. Curing avoidable blindness might be possible. Avoidable blindness?

AMD is my condition and my passion. I am doing well but I would do a heck of a lot better if someone found a cure for this stuff. Problem is, according to Nat Geo, AMD is a piddly 1% of the total picture! It is important to you and me but it barely makes a blip on the world radar.

If our condition is so insignificant in the big picture, what is significant? Refraction errors. That is 43% of the problem. Nearly half of the vision problems of the human race could be cured by giving people glasses.

Guess that means we all get to dig in drawers and find our old spectacles. Call your local Lions Club to find the nearest collection box. Or better yet, Walmart Optical is supposed to collect them. Drop them off the next time you go shopping. Better they are helping someone to see than sitting in a drawer for the next decade or two.

And if you really want to get rid of more sight problems, try cataracts at 33%. In the developing world people with cataracts get to go blind. No one to do the operations is part of the problem. Nat Geo says Niger has 18 million people and 7 ophthalmologists! The other problem is funding. Subsistence farming does not allow one to pay for medical specialists.

One last plug and I am out of here. Nat Geo mentions a worthy charity: SEE International. Stands for Surgical Eye Expeditions. They provide cataract surgeries free of charge.

Done here. Bed time! Night! Continue reading “Avoidable Blindness”

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Yes, Virginia

In real-time today is my birthday. I am 63 years young. Or at least I feel fairly young. Most of the time. 😆

I hope to make it to 93 (not too much longer. Not wanting to have a poor quality of life at the end). That makes me wonder what visual impairment is going to be like in 30 years. Will there even be visual impairment? Will the Audacious Goal project actually work? Will age-related macular degeneration be listed along with leprosy and scurvy? Let us hope so.

“Oh, yes, Virginia. There was a disease that caused people’s noses to rot off. And do you know what? There was even a disease in which people could not see faces! How strange!”

All this also made me wonder about the state of visual impairment in 1953. In 1953 the United States developed the hydrogen bomb. Walt Disney released Peter Pan and Chevrolet built the first Corvette. Technology marched forward.

In 1953 the estimated prevalence of the blind in the United States was approximately 2%. As compared to today, a larger percentage of that percentage was children. A list in Epidemiology of Neurologic and Sense Organ Disorders (Kurland, Kurtzke & Goldberg, 1963) contained a whole laundry list of causes of blindness in children. The data were from the 1930s until the 1950s. The list included toxoplasmosis, rubella, syphilis, tuberculosis, and something called ophthalmia neonatorum.

I looked that last one up. It is conjunctivitis contracted from an infection in the birth canal. A little antibiotic ointment applied at birth takes care of that one now. And those of you in the developed world, when was the last time you heard of a child congenitally blind from TB? If that happened here, it would be an outrage!

You are intelligent people; you get my point. We have come light-years from where we were the year I was born. Some of it has been delightful progress and some has been scary ‘progress’ but it has happened in one, short life time.

As children, many of us escaped blindness because of the research being done on infectious diseases. Now that we are a bit older, we are helping to advance the cause by helping with the new medical research. Do I think we are going to find a cure, or at least an effective treatment, for dry AMD in the next 30 years or less? Absolutely. I am counting on it.

All in all, this is the best time yet in history to be going blind.

Written 7/17/2016

Continue reading “Yes, Virginia”

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Welcome!

You are here to follow the journey & misadventures of a woman named Sue who became visually impaired with Age-Related Macular Degeneration (AMD or ARMD) seemingly overnight.   Join in the tears and laughter. Join in the discussion. Learn more about Age-Related Macular Degeneration. Find resources for your own journey or that of someone you know.

We’re going on a bear hunt….can’t go over it, can’t go under it, got to go through it.

Sue is a psychologist trained in Dialectic Behavior Therapy (DBT) and is using it to help her cope with this vision loss. Her trusted and invaluable friends bring computer, research and occupational therapy skills to this endeavor. Yeah team! We hope you benefit from the fruits of our labors.

We are not offering free psychological therapy.  We are not medical people.   Please read the disclaimer.

This website is divided into 4 parts:

  1. If you have just been diagnosed or if you are beginning your research, here’s a place to start in I Have Macular Degeneration…Now What?
  2. Sue’s journal pages which are like chapters in a book
  3. Highlights & News which are basically blog posts
  4. Links to helpful resources (still under construction)

For those of you who aren’t familiar with websites or blogs like this, to ensure that you will be notified when information is added to the website, you must subscribe by email.  On a laptop & most tablets, you’ll find the place where you can do this in the right-hand column.  On a smart phone, you will find it below the content for the page that you are looking at.

We are still learning, we don’t know everything about this awful disease.

Thanks!

Thanks to Lesley B., Sally R., Dave M. and Gerry M. for going through the website looking for links that didn’t work, things that didn’t read well and typos.  We couldn’t have done it without you.

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Resources

Please read the disclaimer.  I will also admit that I have not read every word of every reference.  I’m just trying to provide resources to help you do your own research in addition to what we have found. – Linda…

updated August 27th, 2017

Navigating: There are a lot of links here.  I’ve set up this page so that when you click on a link (words that are underlined & in blue or green), a NEW tab will open in your browser and this page STAYS WHERE IT IS.  When you are done with the new page you opened, just close it.  You do NOT need to use the back option.  If you click on a link and the new page replaces this one, I’VE MADE A MISTAKE so please let me know by sending me an email at light2sight5153@gmail.com.  Let me know exactly which link or links do not open a new tab or window.

Errors: If you click on a link and you get a ‘page not found’ error, please let me know by sending me an email at light2sight5153@gmail.com.  Let me know exactly which link or links do not open a new tab or window.

Additions: If you have a link you’d like to add, please email at light2sight5153@gmail.com.


Topics-click below to move to a topic

Links We Like

  • Click here for a GREAT resource where you answer some simple questions and you get a customized guide based on your responses
  • Click here for a great glossary
  • Click here to take several quizzes to test your knowledge of the disease
  • Click here for Low Vision Resources: A List of Lists (such as 8 ways to slow AMD, 15 tips for family and friends, etc)
  • Videos
    • Click here for several videos
    • Click here for the UK Macular Society’s Say Hello to Mac
    • Click here for one that uses illustrations and animation (explains how wet AMD progresses and how the injections work)
  • Click here for a description of dry vs. wet AMD (we are not recommending any products in this article)
  • Click here for an article about depression after diagnosis
  • Click here for a very comprehensive page about wet AMD
  • Click here for a very comprehensive page about dry AMD
  • Click here for a FAQ (Frequently Asked Questions) that answers a long list of questions such as ‘will resting help my eyes?’, ‘Can I see for myself if my retina or macula shows any signs of damage before I have symptoms?’, ‘why don’t new eye glasses help?’, ‘what is meant by degeneration?’, ‘is a macular hole the same as macular degeneration’, ‘I have had dry MD for years. Does this mean I’m going to get wet MD too?’, ‘No one else in my family has MD. Why did I get it?’, ‘can drusen be treated?’, ‘I have changes on the Amsler Grid, does this mean I have MD’, ‘I have Wet MD but my Doctor says there is nothing he can do or no treatment available. Why is this?’
  • Click here for a short introduction to stems cells, what they are and how they can be used.
  • Click here for a summary of AMD research and developments in the past 12 months (posted June 2016)

See what vision is like at the various stages of AMD

Click here to find ways to see simulations of what vision loss due to AMD is like at various stages.


Glossary

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Websites devoted to AMD

listed in no particular order

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Websites containing information about AMD

listed in no particular order

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Support

Message Boards including ones from
By postal mail
  • Association for Macular Diseases
    210 E. 64th Street
    New York, NY 10021
    (212) 605-3719
    – Offers education and information on macular disease through seminars, newsletters, and a hotline. Offers counseling to patients and their families.
  • Macular Degeneration International
    is now a part of Foundation Fighting Blindness
    Toll Free Helpline 1-800-683-5555
    EMail: MDInfo@blindness.org
    – Provides support for people affected by inherited macular degeneration including Stargardt’s disease.
Start Your Own
  • Vision Support Group-download video presentations  This group provides free information and support through presentations to groups of senior adults affected by macular degeneration and related retinal diseases.  You can join & get access to their materials so you can use them in your own group.
On the phone/telesupport

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Where to find services

  • In the US: click here to find a low vision center, retina specialist, state agency, ophthalmologist
  • In the UK: click here to support services (listed on the right side of the page) such as skills for seeing, counseling, access to treatment…and more
  • In the US: click here to search for a wide variety of services (more than the link above)
  • In Australia: click here to find an ophthalmologist and optometrist
  • Worldwide: click here for resources worldwide

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Books and reading materials

Specific Titles

Sources of Books

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Videos

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Personal stories of living with AMD

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Online newsletters

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What is AMD?

Wet Form
Dry Form
How fast does AMD progress?
  • A good article about how difficult this is to answer
  • Great video that explains why early detection is important especially when detecting the change from dry AMD to wet

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What is Stargardt’s Disease?

Also called Stargardt’s Disease (SD) or Stargardt Macular Dystrophy (SMD) or Juvenile Macular Degeneration (JMD), it’s an inherited, juvenile macular degeneration. The progressive vision loss associated with Stargardt disease is caused by the death of photoreceptor cells in the central portion of the retina called the macula.

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The Science Stuff

Role of RPEs

Geographic Atrophy

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Symptoms

Charles Bonnet Syndrome/Visual hallucinations

Other problems with vision & AMD

  • problems with visual acuity, photostress, blindspots, color vision, sensitivity to light, depth perception
  • eye problems that have similar symptoms as AMD:

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Possible causes/contributing factors

Age

  • Age is a large factor but can start earlier
  • Much less common are several hereditary forms of macular degeneration, which usually affect children or teenagers. Collectively, they are called Juvenile Macular Degeneration. They include Best’s Disease, Stargardt’s Disease, Sorsby’s Disease and some others.  See Stargard’s Disease section above.

Diet/nutrition (working on this section)

  • diet low in various nutrients & high in others have been linked to AMD.
  • See Nutrition and Vitamins/Supplements under Self-care/self-maintenance below.

Race

Gender

  • AMD more common in women perhaps because women live longer than men

Uncontrolled high blood pressure

Uncontrolled high cholesterol

Smoking

Genetics

Blue Light

Eye Color

Aspirin & other medications

Other possible causes

  • Biological Process in Wet AMD – some evidence that the photoreceptors are starved by the lack of food (oxygen & nutrients in the blood) and the growth of blood vessels is to compensate for that.

Connection between AMD and Alzheimer’s Disease

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Treatments

  • FDA approved options in the US, injections, implantable telescopes, laser treatment (also outside the US)
Injections for Wet AMD
Telescopic implants
Are there new treatments in the pipeline?
Vitamins (see Self Maintenance/Self Care section below)

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Research/Clinical trials

 

How can I become a part of a clinical trial?

  • A list of sources of information about clinical trials and how to find out for you to participate in.
  • You can search for clinical trials from the links above
  • There are registries where you sign up and enter information about the status of your eyes.  Researchers will use this information to find people that match their research and contact you.  Click here for more information about these registries in the US and elsewhere

Gene Therapy

Bionic Eye/Retinal Implants

  • What is a bionic eye?  It’s also called retinal implant or retinal prosthesis.   Implant is put in retina, camera worn by person sends image to implant which stimulates optic nerve
  • Click here for overview of retinal implants including videos of how it works & interviews with people who have them.
  • March 21, 2016 UK Bionic eye being tested
  • Here’s an article about one being developed at Carnegie Mellon institute in Pittsburgh, PA.

Nutritional Supplements

  • See Vitamins/Supplements section below.

Stem Cells

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Coping with low vision

Low Vision Aids

Wearable Technology

  • coming soon!

Suppliers of low vision aids

Financial Help

Sunglasses

Lamps

Transportation

  • A website for the US where you enter your zip code and transportation options for your area will be shown.

Bioptic Driving

Depression

Checking vision

Amsler Grid

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Self maintenance/self care

Low vision rehabilitation

Vitamins/Supplements

Nutrition

Exercise/Activity

 


More to come, you can check out these posts now

Video: Overview of Assistive Technology for People with Low Vision

Highlight: How do I use Zoom for Apple products?

Highlight: What about Apple’s accessibility features?

News: Top 10 Low Vision Aids for AMD

 


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Research

Not being one to be told there’s nothing I can do about something, I went back to my research. There seem to be a couple of different avenues of research. They were working on lasers to blast the drusen, aka piles of eye-poop but it looked to me like a hoarder intervention. Somebody comes in and cleans up the mess one time. Problem solved for now but not later. They would have a clean place to live but would eventually start to become messy again. The second thing I found looked more like the Merry Maids that were cleaning up regularly. However, it did not solve the problem of who is going to feed the Master photoreceptors? The third option was to essentially put the RPE Servants that were left on steroids. The live ones would work harder but would that not mean they wear out more quickly?

Click here for a list of clinical trials studying dry AMD

There’s research focused on cleaning up the ‘eye-poop’ called drusen.

There was one I liked, OCATA, originally known as Advanced Cell Therapy (ACT) , that was trying to replace RPEs. They were actually giving the little guys some help in order to save the Master photoreceptors. The way they were doing this was with stem cells.

There’s research using stem cells to replace the RPEs.

Although some people see stem cell research as cutting up dead babies, this is not the case. There are several lines of stem cells that have been derived from fertilized eggs that were never implanted. Some of these lines of stem cells are 20 years old. They have been massaged and manipulated so that there would never be the possibility that they could become functioning human beings. If they were not being used for research they would be flushed down the proverbial toilet.

Stem cells can be harvested from old fertilized eggs not dead babies.

The research that interested me–and still interests me–involves stem cells that have been developed specifically to become RPE cells. The theory is that replacing RPE cells with new ones and giving the little Servant guys some help will allow more photoreceptors to live and turn light into sight.

So where, pray tell, does one find someone to do this procedure? The problem is that this is very new research. It has worked on rats and other traditional lab animals (and you college psychology students, I am not speaking of sophomores). However, work on human subjects is just beginning. At the time of this writing, hospitals in Florida, Massachusetts, California and Pennsylvania as well as in foreign locales such as London and China have only completed phase 1 research. Phase 1 of any clinical study is the safety and tolerability portion.

Warning: there are doctors and clinics in the US that are offering costly stem cell treatments that have NOT been proven safe or effective through research.  Before you enter into any stem cell treatment, please do your homework!  Click here for an excellent article called Nine Things to Know About Stem Cell Treatments.

Click here for current research using stem cells for Macular Degeneration

Phase 1 results have been extremely promising. For those who are capable of using the web, there is a Lancet article by Schwartz and Regillo that summarizes the study. Essentially, they found the stem cells did not do anything strange or different when implanted in eyes. Preliminary data suggested that it was safe and tolerable. Even more exciting, they found positive therapeutic effects. A great number of the people who had volunteered and participated in the study showed cessation of deterioration and even improvement.

Phase 1 trials using stem cells is VERY promising.

So why not replace the photoreceptors as well as the RPEs? After all, when the RPEs die, the photoreceptors die. Would it not be reasonable to replace them both?

Unfortunately, medical science is not to this point as of yet. They have been successful in growing photoreceptors in the lab. They have been successful in implanting photoreceptors in the eyes of rats. The only problem is that these will not connect into the neural net. It’s sort of like having invented a cell phone without having a tower for it to work through. You can talk on your phone all day but the message goes nowhere.

They can grow photoreceptors in the lab, implanting them in rats but they won’t connect to the neural net.

That said, they are still working on it very diligently. Some of the literature suggests that it will be quite awhile. However, it will be coming.

If you are interested in seeing some of the studies that are being done on eyes and other medical research, I would invite you to go to the clinical trials website. It is a government website that lists all sorts of fascinating things. Many of them are looking for clients.

You will discover that there are dozens, if not more, of studies that are related to eyes. There are multiple studies related to Age-Related Macular Degeneration. So why would that be?

Someone, I am not remembering who at the moment, has launched the Audacious Goal Project. The Audacious Goal Project is aiming to eradicate blindness in the lifetime of some of you younger folks.

Click here to learn more about the Audacious Goal Challenge in Vision Research and Blindness.

Like the name says it is an audacious goal!

Why now?

And questioning again, why now? What is happening that vision is such a hot topic that we need a national program to deal with blindness?

The truth of the matter is, the pig through the population python is getting towards the end. We baby boomers from the 50s and the 60s have always presented challenges. We have always been very popular and our hot topics have been the topics of the nation. When I was a little girl, they were building elementary schools left and right. Then everything was sweet 16 and on through my lifespan. Right now, everything is security call buttons and retirement accounts. We drive the economy.

We baby boomers from the 50s and 60s have always presented challenges.

Because there are so many of us, our concerns are essential. One of our big concerns is vision. According to my research, AMD is the leading cause of blindness in the developed world. In the United States alone there are as many as 11 million people who have some form of AMD.  They are predicting there will be 22 million by 2050! 

This is going to be a massive drain on the country. When somebody suddenly realized what the numbers were going to look like, they decided they had better do something to ameliorate the problem. Thus, all the research.

Click here for more facts & figures

As many as 11 million people in the United States have some form of age-related macular degeneration. This number is expected to double to nearly 22 million by 2050.

Continue reading “Research”

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