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What Happens When Eyeglasses Don’t Work?

October 20, 2014, 12:00 PM
What Happens When Eyeglasses Don’t Work?
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Many Americans with vision issues see just fine thanks to eyeglasses, corrective surgery or medication. But what happens when these remedial measures don’t work?

Approximately 3 million people in the United States have untreatable vision loss called low vision. Under the best of circumstances, their vision is 20/60. This means that at 20 feet they’re seeing what someone with 20/20 vision sees at 60 feet. But, it’s typically much worse.

With the aid of magnification devices that can enlarge text, many people with low vision are able to excel in their academic, professional and personal endeavors.

Those with low vision include 13-year-old Alexis “Lexie” Capps of Spring, Texas. Despite having limited vision in her only functional eye, she takes advanced eighth-grade courses, volunteers at an equestrian center, swims at the neighborhood pool and rides a skateboard down the cul-de-sac in front of her house.

As if that is not enough, Capps can do a gymnastic maneuver called a round off that some consider harder than a cartwheel.

“Lexie is an inspirational young woman,” says Capps’ low vision specialist Bhavani Iyer, O.D., who is on the faculty of the Ruiz Department of Ophthalmology and Visual Science at The University of Texas Health Science Center at Houston (UTHealth) Medical School and is a physician with the Robert Cizik Eye Clinic. “She stays busy all the time.”

When Iyer asked Capps if she would be willing to share her story in the hopes of encouraging others with low vision, Capps jumped at the opportunity. In fact, she is featured in a medical education video.

Iyer directs the Center for Visual Rehabilitation at the Cizik Eye Clinic at Memorial Hermann-Texas Medical Center, which provides comprehensive vision rehabilitation for children and adults of all ages. She wants to make sure everyone with low vision knows that help is available.

“Children need to know that they can be successful at school and participate in extracurricular activities,” Iyer says. "Parents of children with vision loss should not think they are beyond help. Magnification devices and vision rehabilitation can make all the difference in the world, and they are available for people in need.”

Examples of low vision aids

Examples of low vision aids include miniature telescopes that are attached to eyeglasses or held by hand as well as electronic magnifiers. Magnification devices for reading can be attached to eyeglasses and stands.

When patients meet with Iyer, she assesses their functional vision and determines what can be done to maximize their residual vision. Based on her recommendations, the center’s occupational therapist (OT) implements an individualized training program.

In addition, the OT can help patients make their homes more “low vision-friendly” and provide the training for everyday chores like cooking.

Iyer and her colleagues in the Ruiz Department of Ophthalmology and Visual Science also conduct research designed to help people with eyesight issues such as low vision.

“Our department has one of the nation’s most dynamic and productive research programs,” says department chairman Robert Feldman, M.D., the Richard S. Ruiz, M.D., Distinguished University Chair at UTHealth. “It is composed of basic and clinical researchers. Together, they work to find cures and successful treatments for eye diseases and conditions.”

Capps was born with low vision but it often occurs later in life. For example, it is sometimes a complication of macular degeneration, glaucoma, diabetes or stroke.

Unfortunately, the numbers are rising, with the National Eye Institute predicting that approximately 9 million will have low vision by 2050.

“We were originally told that she would only be able to see shadows,” recalls her father, Randy Capps, who maintains cranes on offshore oil rigs. “But, she proved them wrong. She can tell certain colors and spot individual items.”

To prove his point, the elder Capps asked Lexie to pick up items scattered across a floor, and she got a lot of them. “They may have to rewrite the medical books for my daughter,” he says.

His daughter’s right eye never developed and was replaced with a prosthetic eye. Her left eye has a misshapen cornea, which makes vision difficult but manageable.

Harris County Low Vision Project

Help is available for people with eyesight issues through the Harris County Low Vision Project.

Funded with a three-year, $164,645 SightFirst grant from the Lions Club International Foundation, the project is providing outreach programs as well as education and training for the thousands in and around Harris County (Texas) with low vision.

This is the first such grant to be awarded in Texas and the third largest in the country. The project has received an additional $20,000 in funding from local sources.

Educational programs and support services are offered at two low vision centers in Houston:

For information, call 713- 559-5269 or visit the low vision page on www.cizikeye.org.

Memorizing paths

Not one to sit inside, Capps’ favorite activities include riding Arabian horses — including one called Pebblebrook — at the Cypress Trails Equestrian Center. She volunteers, assists customers and gives instructions on how to ride.

Laura Bird, who is Capps’ nanny, can attest to that. “It only took her two riding lessons from me to begin trotting and posting with the rhythm of the horses. When she is riding, she and the horse are one,” Bird says.

Because of her limited vision, Capps relies heavily on both her memory and hearing, Bird says.

“Lexie knows where every stick of furniture in the house is,” she adds. “That is why it is important not to move anything. This is one of the ways she compensates for her vision.”

Bird says Capps also uses her hearing to help locate objects when riding a horse across a trail or walking the four blocks to school. “The sounds help keep Lexie aware of the things going on around her,” she explains.

Capps’ best case scenario is to maintain the vision she has. Thinking ahead should her vision fail, she’s learned Braille and can read 80 words a minute.

“Horses memorize their paths. That’s what I do,” says Capps, who hopes to be an interior designer one day.

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