Legally blind cardiologist finds
new beat in low vision rehabilitation
in Jupiter, Florida
A LEGALLY blind cardiologist with central vision loss involving
both maculae, whose visual acuity is 20/260 in the left eye and
even worse in the right one, would be expected to abandon his busy
practice and retire at 64. But not Alabama-based Joseph Fontenot
MD. Instead, he decided to switch careers.
“I am changing from practising cardiology to practising low
vision rehabilitation. I’ve been interested in doing this
for several years and have been planning to do it for the last few
months,” he told EuroTimes.
left to right: James Guildford, Joe Fontenot and Richard (Scott)
Fontenot’s peripheral vision is still good and with the help
of nurses who accompany him on his rounds and relying on devices
such as closed-circuit television (CCTV), magnifiers, computers
and screen readers, he has been able to continue practising medicine
and stay up to date with medical literature for the last 14 years.
His only concession to impaired vision was to stop performing heart
catheterisation and interventional procedures, such as angioplasty.
recently addressed a large group of elderly Floridians with macular
degeneration and diabetic retinopathy.
Many were patients of M. Richard (Scott) Hearing OD, FAAO, Director
of the Low Vision Clinic, Stuart Eye Institute, Florida. The centrepiece
in his office is a large painting, entitled ‘God’s Hand
Giving Light’ by a 79-year-old blind artist.
Edythe Piccione used one of the low-vision devices which are becoming
available to many legally blind people attempting to retain sufficient
vision to read, watch television, operate computers — or learn
how to paint.
Jordy (Joint Optical Reflecting Display) was the device the elderly
artist used. Named after a blind character in the popular science
fiction television series ‘Star Trek’ who was able to
see with an electromagnetic visor, Jordy is derived from LVES (Low-Vision
Enhancement System) developed more than a decade ago by researchers
at the Wilmer Eye Institute, Baltimore in collaboration with US
space agency scientists.
LVES was a bulky headset weighing more than a kilo. Dr Hearing said
Jordy is lighter, offers greater contrast and magnification, as
well as better colour and displays.
“The advantage of the Jordy system is that you can use it
in two ways. One is a headband which gives you portability and can
be used for near or distance viewing. You can also simply attach
it to a stand, hook it to a computer or a video monitor and use
it like a closed-circuit TV system,” Dr Hearing said.
But he cautions that for all its portability, Jordy was not designed
for driving a car or even walking on the street.
“But you can take it with you to the grocery store to help
with your shopping. We are trying to get the headset technology
down to the size of a pair of sunglasses,” he said.
The latest entry among the video magnifiers is called Merlin. It
looks like a computer monitor attached to an optical reader. The
newspaper, book, hand-written note — whatever the visually
impaired person wants to read — is placed in the reader which
then projects a greatly magnified image on the monitor.
According to Dr Hearing, Merlin has several advantages over other
systems. It has voice activation so that you can speak to the system
while your hands are doing something else. You can make the image
larger, change the contrast, or make it smaller.
It also gives you a voice feedback while you are making the change.
It has automatic focus so things always remain clear, irrespective
of what you are looking at or how you change the magnification.
Dr Hearing has been treating patients with low vision for more than
a decade has made several trips to underdeveloped countries to assist
in the visual rehabilitation of blind and visually impaired people.
He has some 300 patients from South Florida and Latin America who
use the Jordy system where it costs around $4,000. It is also available
in Europe. The Merlin, which is new on the market, ranges from $2,000
to $2,800. One of the first systems was purchased by Dr Fontenot.
He intends to use it to help people with problems similar to his
own, particularly adults who recently lost their vision and who
would benefit from consultation and examination to determine what
measures might help them see better.
“Visual rehabilitation involves occupational therapists, counsellors;
people who can work with computers and help these patients learn
how to use technology to their advantage.
“To those with vision loss, try to continue what you have
been doing, or actually do more, and try to cope with your problems
just as you would with any other physical or mental problem,”
Dr Fontenot advised.
Joseph Fontenot MD
Mobile, Alabama, US
Richard (Scott) Hearing OD, FAAO
Jupiter, Florida, US