ESCRS Homepage

March 2003
IN THIS ISSUE

New ESCRS trial in bid to cut endophthalmitis rate to 0.01%


Lasik corrects refractive errors after PK in selected patients

Africa-Luz mobilises to provide eye care in regions riven by poverty

Multifocal IOL
choice hinges on patterns of daily routine

Anti-histamine drug mitigates risk of developing DLK after Lasik, says study

Untreated eyelid inflammatory disorders pose risk for postoperative complications

Thermotopography shows ‘enormous promise’
for diagnosis and treatment of eye diseases

Lasik offers ‘very effective treatment’ for
refractive errors after PK, says US specialist

Good results with PRK and Lasek rival Lasik for top spot in refractive excimer laser surgery

Orbital lymphomas respond well to local, systemic therapies, says study

Laser technologies still beam but economy and consumer demand will determine future of refractive surgery

Legally blind cardiologist finds new beat in low vision rehabilitation

‘Pivotal’ anti-TGF antibody therapy reduces
filtering bleb wound formation, says report

Neuroprotective agents stem optic nerve damage
by ‘offering a solution’ to open-angle glaucoma

Echothiophate iodide shortage leaves US specialists struggling to find alternative for acute cases

Postoperative complications of PK will have serious consequences unless tackled 'aggressively’

Private refractive clinics claim young specialists as public waiting lists grow in Canadian eye surgery

German doctors’ helpers oil the cogs of the private ophthalmic practice

Study of 900 ICLs reveals good safety and long-term refractive results, says Spanish specialist

New toric IOL corrects high corneal astigmatism after cataract surgery, Austrian study reveals

IVF children run increased risk of developing
retinoblastoma, claim Dutch researchers

Suture-free DLEK preserves corneal surface topography and ensures faster wound healing

The day I said goodbye to cataracts and hello to the world without glasses

Retina specialists and trauma ophthalmologists
prepare to trade notes at joint Hungarian conference

Night blindness casts bogeyman into the shadows

Erbium laser phaco requires longer time but less energy for moderately hard cataracts

FEATURES
From The Editor
Reflections on Refractive Surgery
In Your Good Books
Bio-ophthalmology
In The Driving Seat
Prime Site
The Collector's Eye
Regulatory Matters



Legally blind cardiologist finds new beat in low vision rehabilitation

Laszlo Dosa
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.

From left to right: James Guildford, Joe Fontenot and Richard (Scott) Hearing.

Dr 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.

The cardiologist-turned-certified-low-vision-rehabilitation-specialist 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
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
Email: jlfontenot@earthlink.net

Richard (Scott) Hearing OD, FAAO
Jupiter, Florida, US
Email: Mrhearing@cs.com

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