A 50 plus year old patient came to me once with very poor vision. She has Retinitis Pigmentosa (RP).
RP is a degenerative disease of the eye that results in loss of vision, even blindness. It involves the light receptors of the eye called the rods and cones. The rods are responsible for night and peripheral vision while the cones are responsible for central vision and color vision. In RP, the rods are affected first so that the most common symptom of the patient would be night blindness. Then there is loss of peripheral vision that eventually deteriorates further and ends up in tunnel vision. Patients with early signs of RP would be having difficulty at night, and would be bumping into things in the surroundings. In the later stage, they may have tunnel vision. Imagine looking through a keyhole, So on examination, the patient may be seeing 20/20 but actually is just seeing through a tunnel or keyhole. Some patients however progress to blindness. This is often hereditary although may be sporadic.
This patient that came was already Light perception. She could only see light, nothing else. She came in with her son who guides her when she walks. In a low vision exam, we concentrate on the patients function. So I ask the patient her history, what used to do before, when did she stop her job and if it was vision related, and what she would like to do for now. This patient came too late for low vision gadgets to work. She would need more audio devices.
She goes on to say that her doctors told her nothing can be done for RP. So as she was losing her sight, she had to look for ways to cope with it. She researched and she found Resources for the Blind, that taught her how to walk around with a white cane. She now tutors her children at home but her children have to read the assignments to her. So I asked how I could help her.
These were her simple requests. I was taught to walk with a cane indoors, but outdoors are a problem as there are many obstacles. Are there canes that vibrate so I would know when I have to avoid something instead of bumping into them? Next request was she wanted to know where she can learn massage therapy for the blind. Third request was to find a support group for Retinitis Pigmentosa. Three simple requests that would make her happy. Her complaint: If I only knew there were low vision specialists who could have helped me cope with my vision loss.
AND HERE LIES THE PROBLEM. Many doctors diagnose Retinitis Pigmentosa and tell the patients that there is no treatment and that they would go blind. Nothing more can be done for the eye.
Here are some truths about people who are blind or almost blind:
Technology today has made accessibility better for the blind.
There are audio books, smartphones that talk. There are free audiobooks in the App Store and in You tube.
There is a computer school for the blind and visually impaired called ATRIEV (Adaptive Technology for Rehabilitation, Integration, and Empowerment of the Visually impaired). The school helps the blind and low vision people learn how to use the computer and eventually find jobs that are computer related. (atriev.wordpress.com)
Resources for the blind has services for the blind and low vision. They have a school for blind children, and they have training for orientation and mobility with a white cane, and training for some job opportunities. (blind.org.ph)
There are many innovations now that help the blind incorporate into society. Accessibility is the key and accessibility is here.
So even if it may be true that nothing can be done for the eye, IT IS NOT TRUE THAT NOTHING CAN BE DONE FOR THE VISUALLY IMPAIRED PERSON.