NEW POSTS WILL RETURN

IN JANUARY 2016

 

DOES MARIJUANA CAUSE VISION IMPAIRMENT? DOES IT HELP TREAT GLAUCOMA PRESSURE?

Typical discussions of marijuana and vision usually concern pot’s ability to help people with glaucoma and related legal or political issues. Now, according to a report from UPI [link], frequent marijuana use may be linked (to a limited degree) to vision impairment.  

Preliminary results of research from France, published in the December 2016 issue of JAMA Ophthalmology, centers on the brain’s ability to receive incoming visual information. The study found that some frequent pot users experience a slight delay in the retina-to-brain nerve functioning. The researchers say the delay could indicate the presence of low vision.

The French study is based on research involving just 52 participants, 28 of whom were regular marijuana users. “Regular marijuana users” are folks who said they used marijuana at least seven times a week. The experts stressed that the findings are preliminary and further research is needed before conclusions should be made.

Scientists have known for some time that marijuana has an impact on nervous system communications. However, the current study did not necessarily prove that regular smokers do actually experience vision impairment. Most of the participants in the study did not complain of any vision issues before the study began.

Critics of the French study said it used an extremely small pool of patients, visual impairment symptoms of participants were not known prior to the study, and other lifestyle factors, such as diet and cigarette smoking, were not included in the research.

RESEARCH ABOUT MARIJUANA’S ABILITY TO LOWER GLAUCOMA PRESSURE IS MORE CONCLUSIVE

Legal recreational and medical use of marijuana has made it easier for people to “self medicate” their glaucoma treatment without consulting a doctor. This means marijuana participants are easier to find for research.

The notion that marijuana can be helpful in treating glaucoma dates to the 1970s. Studies conducted then showed that smoking marijuana lowered the internal eye pressure of people with glaucoma. Additional studies have concluded that the active ingredient in pot – THC – does make internal eye pressure lower. However, it only lowers internal eye pressure for a short period of time, typically three or four hours.

This short period of time is considered a drawback for the use of marijuana as a glaucoma treatment. Because glaucoma needs to be treated 24 hours a day, a person medicating with pot could become too impaired to drive or operate equipment.

WANT TO KNOW HOW IT FEELS? START WITH BLIND

Little Kenny Wonder

In late 2014 when I started my quest to understand my declining vision, I asked someone: Where should I start my training? 

Her response was:  

Start with blind and work backwards to your current low vision reality. If your vision continues to deteriorate you will be dealing with blindness sooner or later.

This was sobering advice, not something I wanted to hear, but I am glad I heard it. 

Around the same time, I started my training with a cane. I pretended I was blind.  I had a washcloth over my eyes. Then I ran into a wall!

Last Friday I had an Orientation and Mobility (“O & M”) training session with my coach John Higgins of Invision Services, Inc. I told John I want to blind for an hour to see how it feels. 

Being blind (in this case pretending to be blind) is terrifying. John told me that he offers blind training but few people ask for it. It is too scary. 

We started.  John gave me a blindfold (which I still have BTW).  I put it on blindfold and the world was totally dark. I walked a few minutes to get more comfortable with my cane. I was disoriented and unsure of myself. 

Then John taught. me the basics of coping:

First a safety measure: My arms and hands were extended to become bumpers on a car. 

Hopefully I could feel an object or barrier in front of me before I ran into it. That is what I am doing in the picture on the right.

Then John had me try a basic move: SQUARING OFF. I stood with my back against a known “landmark,” in this case a favorite chair. 

Next I imagine a landmark I want to go to. I want to walk in a straight line towards it. The destination is a desk on the other side of the room.  But when I got there I ran into it.

Lesson: Distances seem different when you are blind. Auditory cues and the sense of touch become dominant. I have lived in same place for over 18 years.  and thought I knew the layout like the back of my hand. 

But, I was wrong. Distances are different when you are blind.

I regained my composure and SQUARED OFF to begin walking to the kitchen.  I maneuvered through one familiar object after the other. I touched a sofa.  Then I touched a kitchen cabinet. I felt my way to stove.   

I SQUARED OFF at the stove and walked across the kitchen to my destination: The fridge.  Mission accomplished! Then I reversed the trip and got back to my chair. I did it on my own which is a great feeling.

The most important thing I learned from my being blind for an hour is concentration. At one point during the session my mind began to wander. 

BANG! I almost knocked over a lamp.It could have been worse.

I feel like a fish out of water.  This experience makes me thankful for the remaining vision I do have.

SALUTING LEADERS OF LOW VISION SERVICE

INVISION SERVICES, INC.

 

When a person has low vision, sometimes the choices seem overwhelming when looking for technology and training. Some providers are specialists, some are like a big box store and others are only in it for the money.

Today we are saluting a company with terrific people and a real sense of purpose: Invision Services, Inc. They sum it up in their company mission:

As we serve the needs of our clients, 

we serve each other’s growth.

I recommend Invision based on my own experience. A few weeks ago I published a post my cane training [link].

John Higgins

Invision Services [link] was founded by John Higgins in 1992. For more than two decades, Invision has enhanced and enriched the lives of visually impaired students and adults across the country.

Invision puts extra emphasis on serving folks in North Carolina. In 1985 Higgins became the first O&M Specialist to be hired by the North Carolina Public School System.  This assignment led Higgins to start Invision. Today, Higgins and his team at Invision have an Orientation & Mobility Specialist, a Teacher of the Visually Impaired, a Low Vision Specialist and a Certified Braillist.

Invision collaborates with schools to provide one-on-one instruction for their students. Evaluations, consultation, IEP development, material production, and direct instructional services help meet the needs of students.

Invision’s adult clients are referred by ophthalmologists, eye centers, social workers, and other sources, including family members. Adults can receive consultations, evaluations, and direct services customized to meet client’s unique daily living needs and goals.

NOW ON FACEBOOK

Invision’s public service extends to its Facebook page [link].

One of the things I like the most about Invision’s page is the “news ticker.” New posts appear frequently with information about job opportunities in the vision disability industry, the work of landmark programs such as the Perkins School for the Blind and other providers they recommend.

WHY I AM SO THANKFUL TODAY

Sometimes having low vision takes me to dark places in my mind. Why did this happen to me?  What is my future? Is life with a major disability worth living?

LINDA CARTER & KEN MILLS

I’ve learned that such periodic pity parties will always be part of my life. These moods will pass. To me the glass of life is half full and each day brings renewal and hope.

A big reason for my positive spirit is the companionship of my wife and soul mate Linda Carter.  She is my rock, my best friend and my guide as my vision has deteriorated.

 A few weeks ago Linda surprised me with a short story she had written about when she first noticed the impact low vision was having on my life. I appreciate her point of view (pun intended) because I spent ten years denying my vision problems.

Linda’s story is about our trip to Hawaii in March 2004, approximately a year after the eye surgeon burned the retina in my right eye. She is kindly letting me share her thoughts today:

Hawaii. God the air smelled good. I remember that. Ken and I popped off the plane at the Honolulu airport in March 2004. We got our stuff and headed to the Marriott Waikiki hotel. We checked in. We were hungry, so we went looking for something unique to eat.

We didn’t have to go far.  Across the street from the hotel there was a café that was filled with people. I welcomed the scent of My Tai’s.

We were descending a staircase into the café.  I noticed Ken was having trouble negotiating the stairs.  He seemed hesitant and off balance. This was the first time I noticed how Ken’s sight was affecting his life.

The bottom line is when you are full sighted, like me, you can easily miss the clues of your partner’s disability. It would be a couple of years before I truly understood what was happening with Ken’s vision. After all he still has crystal blue eyes that I have always adored.

 I learned to take our time when we walk together. I learned that streets, hallways and rooms have obstacles that could create a problem for Ken. I made him aware of cracks in the pavement, oncoming traffic and what to expect from the next staircase. I see how his hands do not always meet my hands when he is trying to pass an object, like a glass or maybe a picture.

I became Ken’s chauffeur whenever I could, lessening our worry over traffic and busy streets. I drove him to his surgeries and waited patiently but anxiously for the report. I took him to his follow up appointments at the University of Minnesota Eye Clinic. I got to know his brilliant surgeon Dr. Martha Wright. I bought him flashlights and read all I could about coping with low vision.

I am doing everything I can to meet Ken’s needs, but I told him early on that I would never understand what he was seeing or not seeing.

What I can do is listen and learn and remember to laugh in the face of adversity. Together, we are sight and light.

Linda Carter

Linda, I am so thankful for your love and support.  It literally means the world to me. I love you and I believe in you.

My advice to you, dear reader, is tell the helpers in your life that you love them. Do it today.  Don’t take them granted. Cherish these moments and be grateful for the blessings your helpers provide every day.

WAYS TO HELP PEOPLE HELP YOU

Sometimes when I tell people about my vision challenges, they are ask if there is anything they can do to help me. Though I am tempted to say Yes, please rotate the tires on my car, I usually can’t think of anything specific.

Most people who ask are gracious and sincere but sometimes helpers can overdue it.  The key is to practice low vision etiquette. 

A friend recently recommended an article [link] called Blind Etiquette: Six Ways to Be Gracious Around People with Visual Impairments. 

The article, written by Stefanie Clouter, has tips that also apply to people like me who experience low vision. 

Clouter begins with this advice:

There’s no ‘secret’ to interacting with people who are blind. They just want to be treated like everybody else, with courtesy and respect. So relax and act naturally.

Clouter’s etiquette tips for the blind (shown in the image on the right) are adaptable to low vision situations. 

 Here is my version of Clouter’s list:

KEN’S ETIQUETTE TIPS TO ASSIST FOLKS WITH LOW VISION

1.) If you think someone who has low vision may need help navigating the route from here-to-there, ask first.

Folks with low vision often don’t see a person approaching them. Touching or bold offers of help can be jarring. So, it is best to be calm and polite.  Ask the person with low vision if they need help. That way the person has a chance to say “yes please” or “no thank you.”

• If your help is accepted, tell this person to grasp your arm just above the elbow and then lead the way.

It is easy to guide the person because they feel your movements. Walk at a comfortable pace as you get the person on the road to their destination.

• If you see someone who is visually impaired about to encounter a dangerous situation, be calm and clear when you warn the person.

Don’t yell Hey you, watch out!

Use clear descriptive language such as “You are approaching a curb. It is right in front of you.”  Use directional language that is specific such as “to your left” or “directly behind you” rather than “it’s over there.”

• Even if you know the person, identify yourself when you are approaching someone with impaired vision.

The person may not recognize you by your voice.  In a group setting, address people by name.  Announce when you are leaving the area so the low vision person doesn’t continue talking to an empty room.

• Use respectful language and avoid terminology that stereotypes the person with low vision. Like you, they are people who want a human connection.

It is better to say "a person who is blind" rather than "a blind person." If you are in doubt, ask the person.

THE TROUBLE WITH FLOATERS

Eye floaters - technically muscae volitantes (Latin for “hovering flies") - are tiny, oddly shaped objects that sometimes appear in your vision, often on a sunny day. They look like black spots, cobwebs, threads or a squishy little amoeba. They seem to drift aimlessly in your field of view. If you try to catch one, it disappears.

Simulation of Floaters

The trouble with eye floaters is that you don’t know if they are real or an illusion. They might annoy you, but they usually do no harm.

Floaters are actually small bits of matter inside the vitreous, the gel-like substance that fills about 80 percent of the eye. When the vitreous shrinks, small bits of waste are created. The particles cast tiny shadows on the retina. These are floaters.

Most people have experienced floaters, even The Family Guy:

MY FLOATERS

I can’t recall experiencing eye floaters until after the botched surgery on my right eye. After the surgeon’s light burned my retina, little pieces of the damage began showing up frequently in my sight.

The first time I remember a posse of floaters arriving was a couple of weeks after my “eye jab.” I was reading a newspaper. All of a sudden I was attacked by flies. At least that was what I was seeing.  I batted at the flies and they vanished. Then they reappeared. Did I leave a window open?

I got up to check the windows and noticed that the flies had reappeared all around the room.  Then I realized the flies were an illusion.  What was going on was going on inside my eye.

I told a friend about this experience and he had his own floater story to tell. He said a few years ago he got stoned on a sunny afternoon and drifted off to sleep. He suddenly woke up and saw what he thought were locusts all over his body. Holy glaucoma!

SOMETIMES FLOATERS MEAN THERE ARE PROBLEMS

Most of the time floaters are part of the natural process of aging. However, there are more serious causes of eye floaters. If they appear in large numbers and/or all of a sudden, get professional help. Floaters might be a warning of infection, hemorrhaging, retinal tears, and (in my case) injury to the eye.

LEARN BY PARTICIPATING IN LOW VISION RESEARCH

I am always looking for new ways to learn about low vision and how it affects folks like me. A couple of weeks ago I had the chance to participate in a research project being conducted by the Minnesota Laboratory for Low-Vision Research at the University of Minnesota. The topic is Visual Reading Technology. So I registered to become a “test subject.”

Visual Reading Technology is an important and growing area of interest because new devices and techniques have been found to be very helpful to people with vision loss. In this type of research the “test subject” is more than a mouse in a Skinner Box.  Participants like me get to express themselves and contribute to a body of knowledge that helps people cope with the challenges of low vision.

I contacted Christina Granquist, the research coordinator, and she told me how to get started. (Complete contact info is provided at the bottom of this article.)

Christina first checked to make certain I was qualified to participate. The Minnesota Laboratory for Low-Vision Research is looking for adults with low vision who read with the assistance of reading aids. The goal of the research are to improve understanding of the use of reading technologies and learn which devices and systems people prefer.  Think of it as a “baseline” for future research and product development.

Christina told me the study involves filling out an online survey. The task may take as long as an hour to complete it. Christine provided me with the web address for the survey and I was off and running.

TAKING THE SURVEY

On Saturday morning (10/29/16) I went to the survey page while sitting in an easy chair working on my laptop. Participants can take the survey

on any device Including computers, smartphones and tablets. 

The first part of the survey asks questions about the causes, circumstances and degree of my low vision.  Then it goes through a list of reading technologies and devices.  This is followed by a series of questions based on my ability to see and use sample text (an example is on the right) with various levels of magnification and fields of view. Over all, I found the survey to be easy to navigate. I completed it in around 40 minutes.

Survey participants are compensated with $20 gift cards for Target Amazon, iTunes or Starbucks. I chose Starbucks.

If you are interest in participating or want more information please contact Christina Granquist, the research coordinator, at lowvis@umn.edu.

The study is being conducted at the Minnesota Laboratory for Low-Vision Research at the University of Minnesota [link]. The project director is Dr. Gordon E. Legge.

DRIVING, LOW VISION & THE DMV

Most people, regardless of their vision status, like to drive. Being able to hop behind the wheel and take off is important to one’s identity and independence. I used to take this mobility for granted. That changed on December 26, 2014.

That cold, wintry night I came inches from hitting a parked car. It was my Come-to-Jesus moment. I had been living in denial for over a decade. Over this time my vision continued to decline but I kept telling myself: “My vision isn’t really that bad.” This was despite ample proof to the contrary. The truth was that my vision problems were putting me and other folks at risk.

Since then I have become a student of low vision. I do drive now but only in limited situations. I never drive at night or during days that are cloudy, misty or dark. I limit my driving to three miles or so around my house. I know these streets and two freeways like the back of my hand.  I never drive outside this zone. (I’ve become an avid Uber customer.)

ENTER THE DEPARTMENT OF MOTOR VEHICLES – "THE DMV”

One day I received an unexpected notification (shown on the left) from the Minnesota DMV that said: It is necessary that your doctor express an opinion as to whether your vision will permit the safe operation of a motor vehicle.

The next sentence really got my attention: Failure to comply with this request by November 25, 2015 will result in the cancellation of your Minnesota driving privileges.

My first thought was that my private medical records must have been compromised. That wasn't what happened.  When I registered with Minnesota State Services for the Blind (SSB) their policy was/is to notify the DMV.

I was angry at first but I realized it was a logical thing for SSB to do. When someone applies for assistance from SSB, it is reasonable to ask if they have the necessary vision to drive safely.

Fortunately, I have an eye doctor. He examined me and filled out the form on the right. The key question was whether he would sign it. He told me: "It was close, but you made it!" Whew...

A couple of months after this happened I received a notification from the DMV that it was time for my Driver’s License to be renewed. Apparently this notification was not related to the incident above.

So I went to a DMV office near me and had no problem renewing my license. I passed the five-second eye test and no questions were asked.

Once you go public with your low vision you will be labeled by some as "disabled." I was in denial about my fading eyesight for many years. So, I don't tell many people about my low vision unless it is brought up.

PROTEST LOW VISION NEGLECT

My wife and I live in Golden Valley, Minnesota [link], a first-ring suburb located just west of downtown Minneapolis. Golden Valley is considered one of the best communities in the Twin Cities for many reasons: a stable tax base, diverse neighborhoods and progressive city leadership. Over 47% of residents over the age of 21 have a college degree, far above the national average.  

However, even though the people who live here in GV are bright, that doesn’t mean they are inclusive of people like me with low vision.

Case in point: Recently I received a postcard in the mail from the City promoting their annual Fall Clean Up. Here is a high-resolution scan of the postcard (actual size is 3.5” by 5”):

See any problems (pun intended)?

The postcard fails to communicate with folks like me who are experiencing low vision because it neglects the basics:

• TYPE SIZE: Too small.

• BACKGROUND: Too dark, doesn’t provide enough contrast.

• LAYOUT: Confusing, some sentences tilt for no reason, too much information.

• EFFECTIVENESS: Very poor.

Anyone with low vision knows the frustration of small size type found on labels of products, etc.  But this is an example of neglect by a governmental entity that we support by paying taxes. As citizens we aren’t getting our money's worth.

The City of Golden Valley failed to realize that a good number of its citizens can’t read this notification. Some people are left out.

LOW VISION NEGLECT AND MY PROTEST

Shep Harris

It is important that those of us with low vision speak up when we see messages we can’t read. I decided to notify Shep Harris, the Mayor of Golden Valley.  Here is my email to him:

DATE: October 21, 2016

FROM: KEN MILLS <publicradio@hotmail.com>

TO: SHEP HARRIS <sharris@goldenvalleymn.gov>

SUBJECT: Couldn’t Read Your Fall Clean Up Postcard

Hi Shep – I’ve been a resident of Golden Valley for over 18 years.  We met during your recent re-election campaign. I am the public radio fellow on Kelly Drive. You gave me your contact info and asked me to be in touch any time I had questions about the City.

In addition to working in public radio, I am also a blogger. I publish WELCOME TO LOW VISION [http://welcomelv.blogspot.com/http://welcomelv.blogspot.com/] where I report news and commentary about people like myself.  I have “low vision.” I am not blind but I do have impaired vision. In day-to-day life, I can’t read messages that are not legible and clearly presented. There are millions of other people like me with similar challenges.

My reason for contacting you is because of the City’s recent Fall Clean Up postcard.

I was not able to read the City’s postcard because of my low vision. Whoever designed the postcard failed to realize that many people also could not read it. I have detailed the reasons on my blog [http://welcomelv.blogspot.com/http://welcomelv.blogspot.com/].

I hope you will read my blog post and take steps to make certain printed pieces from the City can be read by citizens of the city.  If/when I get your reply, I will share it with my readers.

Thank you, Ken Mills.

MEET MY NEW CANE

I realized I was experiencing Low Vision in December 2014. While searching for more information, I became aware of Minnesota’s State Services for the Blind (SSB). SSB operates a program in conjunction with Minnesota Employment & Economic Development to provide folks like me the tools, training and technology to live independently and keep working [link].

One of the first steps provided by SSB is learning the basic skills of dealing with vision loss on a practical level. One of these basic skills is learning how to use a cane.

I never imaged that I would ever use a cane.  I had the common (and misinformed) opinion that a cane was only for people who are totally blind. I thought using a cane meant the user was “old and in the way.” Certainly that is not me!  Using a cane didn’t fit my rock n roll lifestyle or my self-identity. I was wrong.

LEARNING THE BASICS OF USING A CANE

SSB put my in touch with an Orientation & Mobility (O&M) specialist and coach: John Higggins from Invision Services [link] for my cane training. John and his associates at Invision provide a variety of service to enhance and enrich the lives of visually impaired kids and adults.

I learned from John that even though my low vision condition doesn’t require me to use a cane in most situations now, learning how to use a cane is important for my safety. In the future, as my vision loss progresses, using a cane will be imperative for my mobility.

LESSON: A cane is also a “defensive” tool.  It signals to folks that a “disabled” person is in their midst.

Think about it.  If you see a person using a cane entering a crosswalk, you (hopefully) will give them the right-of-way. I was amazed when I first used my came at the grocery store. Customers moved out of the way so I had clear access to the isles. A store employee asked me if I needed help finding something. This gave me a sense of comfort, control and belonging.

CANE BASICS

Sometimes I feel I am being so overloaded with information and that I might forget a valuable lesson.  So, I asked John Higgins if we could make a few short videos to preserve the techniques he had taught me about using a cane.  With his permission I’d like to share the videos with you.

1. The proper way to hold a cane.

2. Using the slide technique to find my way.

 

3. Using the touch technique to find my way.

4. Using the diagonal technique to find my way.

5. Using the cane to ascend stairs.

6. Using the cane to descend stairs (version one).

7. Using the cane to descend stairs (version two).

8. How to keep my can out of the way when I am standing still.