Low vision? You can get upper hand

For people with low vision, the road to usable sight can start with the correct diagnosis, the right equipment and hard work.

Recent developments in treatments and technology reflect a growing unwillingness to let age-related loss of vision turn into the end of sight and mobility, specialists say.

"People are healthier; people are living longer," said Dr. Elana Scheiner, an Apex optometrist. "They are used to functioning at a very high level, and when their independence is questioned or compromised, it is really deemed unacceptable."

Low vision -- limited sight that can't be completely corrected by conventional glasses, contacts or surgery -- often brings on increased incidence of loneliness and depression in patients, academic studies have shown.

"It's the most vital sense we have," said Renee Halberg, a licensed clinical social worker at the Duke University Eye Center. "It's how we are oriented to our world."

One of the most common causes of low vision among older Americans is age-related macular degeneration, a disease in which patients lose vision in the central part of the eye. Vision loss related to macular degeneration affects about 1.8 million Americans over 40, a number projected to rise to 2.9 million by 2020, according to the National Eye Institute.

"It's as if you have a small hole in the middle of your vision," said Dr. Henry Greene, an optometrist and clinical professor in the department of ophthalmology at UNC-Chapel Hill School of Medicine.

But new tools and techniques are being developed to help people adjust, enabling low-vision patients to read, see faces at a distance and see signs, Greene said. Among the solutions are magnifiers, which blow up objects so big that they can't get lost in the vision hole, Greene said. Magnifying devices come hand-held, mounted, light-intensified or computerized.

Also available: nonoptical devices such as "talking" appliances -- microwaves, watches and glucometers, which offer users spoken cues.

Learning to see again

Others use self-focusing or manually focused telescopic glasses. Raleigh native J.B. Tollison, 90, a former textile executive, first developed degeneration in his right eye about 40 years ago.

When the disease started severely restricting his vision in both eyes during the past five or six years, Tollison kept fighting. He said the telescopic glasses allow him to read, but not without effort.

As a patient of Greene, he had to learn to look through the lenses and hold reading material very still.

"It's not like picking up another pair of glasses," Tollison said. "Some people, particularly older people, aren't patient enough to use them."

And they're expensive. The high-powered glasses, some of which are made by a company in which Greene is a principal, can cost as much as $2,600.

Training people to see through an unaccustomed part of the eye, called eccentric viewing, is often used in combination with different levels of magnification. It takes practice and determination.

"If someone with macular degeneration is looking straight at you, they can see your shoulder, some aspects of the environment around you, but they can't see your face," said Tim Holmes, an occupational therapist at UNC-CH. "You have to find out what area works best."

Some patients progress to where they can check the amount due on an electric bill, but fewer are able to dig into a novel, Holmes said.