Arletta Shenfeld

The leading cause of vision impairment for individuals over 50 is Age-Related Macular Degeneration (AMD). Approximately 15 million Americans are affected by this, with 200,000 new cases reported annually.

What is AMD?
AMD is a progressive condition which causes blurry or blank spots in your central vision when the macula is damaged. The macula is a small spot near the center of the retina. There are two types of AMD – dry (the most common) and wet (which only affects 10% of those inflicted). Dry AMD is caused by the aging and thinning of the macula’s tissue as well as the development of drusen (yellow deposits under the retina). Wet is caused when abnormal blood vessels develop and leak fluid or blood under the retina. While neither form of AMD will lead to total blindness, the wet form progresses more quickly and causes more damage.

What are the symptoms?
As AMD is a progressive illness, you might not notice a change in vision for some time. If dry AMD develops in just one eye, there might not be symptoms as your healthy eye will compensate for the change in vision. Your peripheral vision is not affected.

Some symptoms of AMD include:
• Blank or blurry spots in your central vision
• A need for brighter lights for up-close reading
• Colors don’t seem as bright
• Sizes and colors are seen differently by each eye
• Distorted vision (straight lines seem to bend)
• Difficulty seeing when moving from brightly-lit to darker areas
• Trouble recognizing faces

Am I at risk?
Age-Related Macular Degeneration is most likely to occur after age 60, but it can develop at a younger age. Caucasians are more at risk than other races, and women more than men. Smoking doubles your risk. Other factors include heredity, high blood pressure, and obesity. Some studies indicate that those with light-colored eyes also have a greater risk.

Is there a cure?
Unfortunately, at this time there is no cure for AMD. Studies show that the progression of AMD may be slowed by eating a healthy diet, exercising, and wearing sunglasses. Antioxidant vitamins and zinc might slow the progression as well. You can monitor changes in your vision by using an Amsler Grid every day.

Your eye care professional can give you more information during your annual eye exam.

Beth was almost done with her holiday shopping list, but she was struggling to find her final few gifts. Her grandparents posed the biggest shopping challenge. They still lived independently in their own home, although they both had some degree of vision impairment and weren’t as active as they once were. Beth decided that she wanted their gifts to be items that could improve their daily lives, something they could use year-round.  After talking it over with family and friends, as well as getting idea from her own optometrist, she came up with the following idea list.

Watches and clocks. Both are available with large numbers and easy-to- read high-contrast faces. Some models talk. Others have tactile dots for reading by touch. (Image: Ladies Tel-Time Chrome Talking Watch with Leather Band – $29.95)

Calculators. There are talking calculators as well as models with large print displays. Even the printing calculators are available with large print. (Image: Reizen 8-digit Talking Calculator with Alarm – $10.95)

Bump Dots. These are self-adhesive raised dots that come in different sizes and colors. They can be used to mark a variety of items, such as the home keys on a computer keyboard, the start button on a microwave oven, or the power button on a TV remote. (Image: Mixed Bump Dots – $8.95)

Reading Aids. These colored sheets of clear plastic provide eliminate glare caused by bright white paper. A book stand or easel could also eliminate glare by changing the angle of the book. (Image: Transparent Yellow Reading Aid – $3.95)

Writing Aids. For those individuals who find it difficult to read pre-printed lines, there are stencils custom made for signature areas, envelopes, checks, and even full pages of writing. Individuals with low vision would benefit from paper and notebooks with extra dark lines. (Hack: You can produce these on your home printer as well.) (Image: Check Writing Guide with Memo Space – $6.89)

Large print items. Many items are printed with large type, such as books, calendars, check registers, diabetes logs, playing cards and address books. You can also purchase large print computer keyboards. (Image: Large Print Register for Diabetes – $3.19)

Lamps and lighting. OttLite lamps and bulbs provide natural lighting with low glare and low heat, perfect for those with low vision. (Hack: OttLite’s “Edison” replacement bulbs can be used in lamps you already own. Don’t purchase a new lamp – simply replace the bulb! Save even more by purchasing from your local arts & craft stores with one of their weekly coupons.) (Image: OttLite Tulip Desk Lamp – $34.95)

Phones. There are large button landline phones which light up for incoming calls. (Hack: Purchase large-print telephone number stickers to cover the existing numbers.) (Image: Reizen Big Button Speaker Phone – $21.95)

Kitchen items. Measuring cups are available with large print markings. Kitchen timers are available in jumbo sizes and high-contrast colors.  There are battery operated level indicators, such as the Say When ™, which hang over the edge of a cup and indicate by tone or vibration that the liquid is near the top. (Hack: Keep a sterile ping pong ball in the kitchen drawer. Drop it in the cup, when the ball reaches the top the cup is filled, and then simply wash the ball and put it back into the drawer till the next time.) (Image: Extra Large Magnetic Kitchen Timer – $19.95)

For your health. Medicine bottle magnifiers make it easier to read the labels. Weekly and monthly medication organizers have clear markings and are easy to open. Some systems, such as the one pictured, help you easily identify the current day’s medication by having contrasting colors on each end of the daily dose case. (Image: Monthly Medication Organizer – Low Profile – $32.95)

*Pennsylvania Association for the Blind is not affiliated with MaxiAids. These items may be available from other vendors, including your local blind association.

When we were children we learned to read with simple stories. Our first books were filled with colorful characters having great adventures – all in 20 pages or less. As our reading skills improved, the stories became more complex, and we graduated to chapter books. A chapter tells one part of the story – just a piece that weaves with the others until the full story is revealed.

And just like a book, your health also has chapters. Some seem to stand-alone – like the sprained wrist you had when you were 10. But, decades later arthritis develops in that joint, and you realize that chapter is still a part of a bigger story.

Such is the case with diabetes, which can lead to kidney disease, amputations, and blindness.  According to the CDC, two out of every five Americans are at risk to develop Type 2 diabetes. Also, more than one out of every three Americans (86 million adults)  have prediabetes.

Diabetes results when your body either doesn’t make enough insulin or can’t process it properly. This results in a build up of sugar (glucose) in the blood. A prediabetic person has higher than normal blood glucose levels. This person is at a higher risk to not only develop Type 2 diabetes, but also suffer strokes and heart disease.

You have an increased risk of developing diabetes if any of the following apply:

• You are overweight and/or physically inactive

• An immediate family member (parent or sibling) is diabetic

• You are of African American, Hispanic/Latino, Native American, Asian American or Pacific Islander descent

• You’ve had a baby weighing more than 9 pounds, or you were diabetic while pregnant

• You have high blood pressure, low HDL, or high triglycerides

Paging forward in our book of health, we find the chapters of related illnesses: heart attack, stroke, kidney disease, amputation, and diabetic eye disease (which can lead to blindness). The American Diabetes Association states that hospitalization rates resulting from heart attacks and strokes were higher for those adults with diabetes (1.8 times and 1.5 times, respectively). Diabetes is also the leading cause of kidney failure. And, among adults age 20 to 74, diabetes is the primary cause of new cases of blindness. In fact, during 2005-2008, more than 28 percent of Americans (over age 40) with diabetes also had some degree of diabetic retinopathy.

So, what can be done? First, make sure you get a yearly physical so that you are aware of your blood glucose and cholesterol levels.  If you are prediabetic, the CDC recommends regular physical activity, a healthy diet, and modest weight loss (5%-7%) to help prevent or delay the development of Type 2 diabetes. Try to walk a total of 30 minutes a day. Talk to your physician about a meal plan which is best for you. Don’t smoke.

For more information, visit the American Diabetes Association’s website (www.diabetes.org) as well as the Centers for Disease Control (www.cdc.gov/diabetes/).

With information and prevention, your book of health can have a happy ending.