Who Can Bioptics Help?

Can Ocutech bioptics help me?

If you can answer YES to these 4 questions than an Ocutech Bioptic telescope may be helpful to you.

Ocutech Bioptics can help people of all ages

Seniors who have enjoyed normal vision until later in their adult years may first notice difficulty reading small print and needing to move closer to see faces or to watch television. Social events may become less enjoyable and individuals may feel more isolated. Bioptics can help you see more clearly and further away, helping you to see and do more things and stay engaged.

Adults with reduced vision from acquired or congenital disorders seek to maximize their potential to be independent. This often includes maximizing educational opportunities, travel needs, seeing at work, connecting with friends and colleagues in both vocational and social settings. Bioptics may also allow individuals to drive!

Children who are born with visual impairments may have never known normal vision. Their visual world may not extend much further than arm’s length, and, as a result it may be difficult for them to fully engage in important childhood socialization activities. Problems seeing in the classroom can make academic success more challenging. Socialization, which benefits from the ability to see at a distance for activities such as sports, drama, movies, TV, video games, and just “hanging-out” can make visually impaired children feel left out. Bioptics can help children engage with the world around them

Ocutech Bioptics can help
for a range of eye conditions

Mild changes in pigmentation in the macula area of an individual with achromatopsia.

 

Achromatopsia and Rod/Cone Dystrophy

The retina, the rear membrane of the eye that converts the image inside the eye into neural impulses that are transmitted to the brain, contains photoreceptor cells called rods and cones. Rods, which work most well in low light and are sensitive to motion, are mostly concentrated in the periphery of the retina. Cones, which are mostly concentrated in the central macular area, are most sensitive in bright light and provide our color and detail vision. We read using the macula.
 
Individuals who are born with achromatopsia (lack of color vision) have cones that do not function properly, leaving them with reduced visual acuity, reduced color vision and difficulty seeing in bright light. The degree of visual impairment can vary between “incomplete achromatopsia” where some color vision is retained and visual acuity may be as good as 20/80, or “complete achromatopsia” where none of the cones are functioning, there is no color vision, and visual acuity may be 20/200 or worse.
 
Individuals with achromatopsia often show mild to moderate changes in the macula area of the retina. However, especially early in the disease there may be no obvious changes in the appearance of the retina. Individuals with Achromatopsia often have a pendular oscillating movement of the eyes called nystagmus. Symptoms of achromatopsia do not worsen over time and do not typically lead to blindness. Researchers have discovered several genes that may cause achromatopsia, however the CNGB3 is known to cause approximately 50% of known cases.
 

Low Vision care can make a big difference

Low vision care can be very effective to help individuals with Achromatopsia to lead very normal lives. Vision loss from Achromatopsia responds very well to magnification which can make reading, seeing signs, faces, the computer, TV and even driving a possibility.
 
There is a wide range of optical, electronic and software magnification options to address virtually every need. Every individual with Achromatopsia should have a low vision examination by a doctor skilled in low vision rehabilitation to help identify the most appropriate options to enhance their visual functioning, academic and vocational potential and their personal quality of life.
 

Achromatopsia is also known as:

  • Stationary Cone Dystrophy
  • Rod Monochromatism

Patients with Albinism are great candidates for bioptics.

 

Albinism

Albinism is a genetic defect that makes the body unable to produce or distribute melanin, a natural pigment that gives color to hair, skin, and the iris of the eye.  About one in 17,000 people have Albinism. In one form of albinism, called Oculocutaneous albinism (OCA) people will have white or pink hair and skin, a very light blue iris, as well as difficulty seeing. Much more rare than OCA, Ocular albinism (OA) affects only the eyes. Skin and hair will be similar to family members or just slightly lighter.
 
Individuals with albinism do not have clear vision due to an underdevelopment of the central part of the retina called the macula. The macula is responsible for sharp, detail vision which works most well in bright light. The retina is very pale because of the lack of pigment.
 
 

Excellent response to low vision aids

Fortunately, individuals with albinism respond very well to low vision care and especially to bioptic telescopes. A bioptic telescope may provide them with close to normal vision allowing them to see friends and family at a distance, the teacher and blackboard in school, signs at a distance, and even the computer. They may even offer the opportunity for obtaining a driver’s license!

Coloboma

When the eye is developing, the fetal neural eye structure wraps around and joins together in what will become the bottom of the eye. If the two sides do not combine completely there can be gap in the iris (the colored part of the eye) called a coloboma which produces a keyhole-like appearance in the pupil. This incomplete closure can also affect the layers of the back of the eye (choroid and retina) and the optic nerve. The disorder can occur in one or both eyes. It is estimated that coloboma occur in 0.5 to 0.7 per 10,000 births.

Vision loss from Colobomas may vary from mild to severe depending upon its size and location. Occasionally other ocular malformations or disorders may be associated with coloboma including microphthalmia (a very small eye), glaucoma, nystagmus,strabismus (turned eyes), or blind spots in the visual field.

Low Vision Treatment

While there is no medical or surgical treatment available to treat the disorder, low vision care can often provide significant functional gains for the individual. Generally, magnification and illumination control are used to enhance visual functioning for individuals with colobomas.

Reading

Strong reading glasses, optical and electronic magnifiers, and software to enlarge text on computer screens can all be helpful to read.

Illumination Control

Proper lighting that increases contrast but reduces glare can be very helpful in many circumstances. Specially tinted wrap-around sunglasses that reduce brightness but increase contrast are often helpful out of doors. These are also available in versions that fitover prescription eyewear that may also be required.

Distance Vision

Conventional eyeglasses, while maximizing the focus on the back of the eye, may not provide adequate vision for seeing at a distance. The only options are to move close or to use telescopic devices to bring things closer optically. Telescopic devices can be either handheld or spectacle mounted (bioptics). They can be very helpful to improve distance vision for TV, signs, the classroom, recognizing faces and social engagement, and even for driving.

Special Artificial Iris Contact Lenses

In addition to the range of magnifying devices available for the visually impaired, special contact lenses with an artificial iris can produce a normally sized pupil that can help make vision sharper and reduce glare and light sensitivity.

Diabetic Retinopathy

Diabetic retinopathy is a condition that occurs in people who have diabetes. It causes progressive damage to the retina, the light-sensitive lining at the back of the eye.
 
Diabetic retinopathy is a serious sight-threatening complication of diabetes. Diabetes interferes with the body’s ability to use and store sugar (glucose). The disease is characterized by too much sugar in the blood, which can cause damage throughout the body, including the eyes.
 
Over time, diabetes damages the blood vessels in the retina. Diabetic retinopathy occurs when these tiny blood vessels leak blood and other fluids. This causes the retinal tissue to swell, resulting in cloudy or blurred vision. The condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness.
 

Treatment

Treatment of diabetic retinopathy varies depending on the extent of the disease. People with diabetic retinopathy may need laser surgery to seal leaking blood vessels or to discourage other blood vessels from leaking. Your optometrist might need to inject medications into the eye to decrease inflammation or stop the formation of new blood vessels. People with advanced cases of diabetic retinopathy might need a surgical procedure to remove and replace the gel-like fluid in the back of the eye, called the vitreous. Surgery may also be needed to repair a retinal detachment. This is a separation of the light-receiving lining in the back of the eye.
 

Low Vision Aids can help vision loss from Diabetic Retinopathy

Vision loss from diabetic retinopathy and from diabetic macular edema (swelling) can benefit from magnification, proper lighting and increased contrast. Low Vision experts can help individuals with diabetic vision loss identify the proper equipment and techniques to help address the individual’s specific visual needs and goals.

Macular Degeneration

There are many other types of disorders that can be called “macular degeneration” including Juvenile Macular Degeneration (Stargardt’s Disease), Macular holes, Best’s Disease, and Epiretinal membranes (Macular pucker). There are also numerous other disorders that can also affect central vision including Albinism, Achromatopsia, Diabetes, MS, Optic Atrophy, Nystagmus, Micro-ophthalmia, Coloboma, Rod-Cone Dystrophy, and Myopic degeneration to name just a few.

Fortunately, macular degeneration is limited to the central retina, so that the peripheral retina, responsible for side (peripheral) vision and motion detection remains intact. Individuals with Age-Related Macular Degeneration will never go totally blind. In fact, individuals can usually walk and engage in most domestic activities with little difficulty due to their vision.

Learn more about Macular Degeneration from the National Eye Institute

Why don’t regular eyeglasses help macular degeneration?

When macular degeneration damages central vision detail vision its reduced, making print and signs difficult to read and faces difficult to identify. While at first one might assume that an eyeglass prescription may need to be changed, it’s not the eye’s focus that is the problem. It’s the retina, the “screen” at the back of the eye that receives the image and converts it into neural impulses, that’s not working properly.

Imagine visiting a movie theater and seeing the picture perfectly well. Now imagine that black paint is spread across all of one of the actor’s faces. Will changing the focus get rid of the black paint? Of course not. Now imagine that the camera zooms in for a close-up and now the actor’s face is 4 times larger. Now the black paint will cover just the actor’s nose, or cheek or eye, and as a result much more of the face becomes visible. So, what helps individuals with macular degeneration see better is making things larger, and for seeing at a distance, bioptic telescopes can offer a great visual solution.

Telescopic options for low vision

As discussed above, patients complain that they cannot see far enough away to perform whatever activity they have in mind. They must move closer in order to see it adequately. Of course, we may not always be able to move cose enough. That’s where telescopic low vision aids become so important. They bring thing closer optically without the user having to move closer.

Low vision bioptic telescopes can either be positioned above the user’s line of sight so that they can alternate their view between the carrier lens and the telescope (Bioptic), or in a straight-ahead position for convenient use at closer distances.

In either event, attaching telescopic lenses to eyeglass frames makes magnified vision easy and convenient to use!

Macular Holes

A macular hole is a small break in the macula, located in the center of the eye’s light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail. A macular hole can cause blurred and distorted central vision. Macular holes are related to aging and usually occur in people over age 60. The size of the hole and its location on the retina determine how much it will affect a person’s vision.

Image

Is a Macular Hole the same as Age-related Macular Degeneration?

No. Macular holes and Age-related Macular Degeneration are two separate and distinct conditions, although the symptoms for each are similar. Both conditions are common in people 60 and over. An eye care professional will know the difference.

What causes a Macular Hole?

Most of the eye’s interior is filled with vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape.

The vitreous contains millions of fine fibers that are attached to the surface of the retina. As we age, the vitreous slowly shrinks and pulls away from the retinal surface. Natural fluids fill the area where the vitreous has contracted. This is normal. In most cases, there are no adverse effects.

Some patients may experience a small increase in floaters, which are little “cobwebs” or specks that seem to float about in your field of vision. However, if the vitreous is firmly attached to the retina when it pulls away, it can tear the retina and create a macular hole. Also, once the vitreous has pulled away from the surface of the retina, some of the fibers can remain on the retinal surface and can contract. This increases tension on the retina and can lead to a macular hole. In either case, the fluid that has replaced the shrunken vitreous can then seep through the hole onto the macula, blurring and distorting central vision. Macular holes can also occur in other eye disorders, such as high myopia (nearsightedness), injury to the eye, retinal detachment, and, rarely, macular pucker.

Is my other eye at risk?

If a macular hole exists in one eye, there is a 10-15 percent chance that a macular hole will develop in your other eye over your lifetime. Your doctor can discuss this with you.

What are the symptoms of a Macular Hole?

Macular holes often begin gradually. In the early stage of a macular hole, people may notice a slight distortion or blurriness in their straight-ahead vision. Straight lines or objects can begin to look bent or wavy. Reading and performing other routine tasks with the affected eye become difficult.

How is a Macular Hole treated?

Although some macular holes can seal themselves and require no treatment, surgery is necessary in many cases to help improve vision. In this surgical procedure–called a vitrectomy–the vitreous gel is removed to prevent it from pulling on the retina and replaced with a bubble containing a mixture of air and gas. The bubble acts as an internal, temporary bandage that holds the edge of the macular hole in place as it heals. Surgery is performed under local anesthesia and often on an out-patient basis.

Bioptics can help improve Vision.

Since the size of the macular hole is small and it’s edges are usually sharply defined, magnification can be very effective in helping individuals with macular holes see better. While conventional eyeglasses usually do not offer significant visual improvement, telescopes for distance vision, and very strong reading glasses, optical magnifiers and electronic magnifiers can be very helpful. Ocutech bioptics are particularly useful for distance and arm’s-length visual activities.

Myopic Degeneration

People with severe nearsightedness (high myopia) are at greater risk for myopic degeneration. Myopic degeneration commonly occurs during young adulthood and can lead to a gradual decrease in central vision. Vision can decrease more abruptly in a small percentage of patients.

Although central vision may be lost, side (peripheral) vision usually remains unaffected. Remaining sight can still be very useful, and with the help of low vision optical devices, people with this condition can continue many of their normal activities.

The causes of Myopic Degeneration are not clearly understood, but they may include biomechanical abnormalities or hereditary factors.

Low vision care can be very effective to help individuals with Myopic Degeneration to lead very normal lives.

Vision loss from Myopic Degeneration responds very well to magnification which can make reading, seeing signs, faces, the computer, TV and even driving a possibility. There is a wide range of optical, electronic and software magnification options to address virtually every need.

Every individual with Myopic Degeneration should have a low vision examination by a doctor skilled in low vision rehabilitation to help identify the most appropriate options to enhance their visual functioning, academic and vocational potential and their personal quality of life.

Nystagmus

Nystagmus is a term to describe fast, uncontrollable movements of the eyes that may be:
  • Side to side (horizontal nystagmus)
  • Up and down (vertical nystagmus)
  • Rotary (rotary or torsional nystagmus)

The term “dancing eyes” has been used to describe Nystagmus. Perhaps the most famous individual with Nystagmus is flutist James Galway. It hasn’t seemed to hamper him!

The involuntary eye movements of Nystagmus are caused by abnormal function in the areas of the brain that control eye movements. The part of the inner ear that senses movement and position (the labyrinth) helps control eye movements.

There are two forms of Nystagmus:

Congenital Nystagmus:

Individuals are born with this condition such as in Albinism

Acquired Nystagmus:

Develops later in life because of a disease or injury.

Nystagmus eye movements can either be pendular (roughly equivalent speed in each direction) or jerk (where there is a fast movement in one direction and a slower recovery movement in the opposite direction). Pendular Nystagmus is usually found in Congenital Nystagmus, while jerk Nystagmus is present in Acquired Nystagmus.

Improving Quality of Life with Distance Vision Aids

Telescopes (monoculars) and versions mounted into eyeglasses (bioptic telescopes) can make distance vision almost as good as normal, allowing individuals to see the teacher, classmates and blackboard in class, read signs while shopping and traveling, read the computer and play music, cards and board games at normal distances. For many individuals bioptic telescopes may also make them eligible to drive (see your state’s regulations to determine your eligibility and requirements).
 
Nystagmus does not usually interfere with the effective use of telescopic devices. If the angle of movement is quite large, often Galilean telescopes with large eye lenses are most effective. If the angle of movement is less dramatic, Keplerian telescopes that offer wider fields of view, especially at higher powers, can be very useful.

In Optic Atrophy, the optic nerve appears very pale.

 

Optic Nerve Disorders

The Optic Nerve, which contains 1.2 million fibers each, carries the neural impulses created by the retina to the brain to enable us to see. Disorders of the optic nerve are caused either by developmental (genetic or abnormal development) or acquired factors (trauma or disease). Optic nerve disorders will always impact vision in some way and can affect one or both eyes. The optic nerve fibers from each eye combine at the optic chiasm located above the pituitary gland, located in the skull about 1 inch behind the bridge of the nose. Defects to the optic nerve in front of the chiasm will affect vision in only that eye, while defects at the chiasm and beyond (toward the back of the head) will affect vision in both eyes. Optic nerve atrophy can be diagnosed during an examination of the eyes. In optic atrophy patients will show a:
  • Reduction in visual acuity
  • Loss or reduction in color vision (especially to red)
  • Pupil response abnormality (the pupil of the affected eye will not perform normally- called an afferent pupillary defect)
  • The Optic Nerve will appear pale in color

How Low Vision Care Can Help

Low vision care can be very effective to help individuals with Optic nerve Disease to lead very normal lives. Vision loss from Optic Nerve Disease responds very well to magnification which can make reading, seeing signs, faces, the computer, TV and even driving a possibility. There is a wide range of optical, electronic and software magnification options to address virtually every need.
 
Every individual with Optic Nerve Disease should have a low vision examination by a doctor skilled in low vision rehabilitation to help identify the most appropriate options to enhance their visual functioning, academic and vocational potential and their personal quality of life.

Retinitis Pigmentosa

This retina has Retinitis Pigmentosa. Note the dark “Bone Spicule” deposits in the peripheral retina.

Retinitis Pigmentosa is a disorder of the rods, that reduces night vision and the ability to see to the side (Tunnel Vision). Macular vision can remain near normal for a long period of time so often individuals with Retinitis Pigmentosa can read and walk in bright sunlight. Devices that expand the visual field (Image Minifiers and Field Viewers) can help individuals with “Tunnel Vision” see more to the side, helping with mobility and other activities.

Tunnel Vision

A normal visual field of each eye extends to approximately 80 degrees nasally (to the nose) and 90 degrees temporarily (to the ear). With both eyes together a normally sighted individual can see an almost 180 degree field of view. (To understand what a degree is, extend your arm fully at shoulder height and bend your hand upward to the ceiling at the wrist—the width of your hand is approximately 10 degrees in diameter.) The peripheral retina is most sensitive to motion and sees best in low light (scotopic vision). It does not have the resolving power (highest visual acuity) of the macula (which is designed to provide our sharp, detail vision and works most well in bright light [photopic vision]).

Individuals with tunnel vision from disorders such as Retinitis Pigmentosa, Choroideremia, Glaucoma and strokes of the optic nerve (Ischemic Optic Neuropathy) will note that they see more poorly at night and tend to bump into objects (for example door jams and low hanging branches) in their side vision. Tunnel vision usually develops slowly and individuals can learn to scan more to help them walk and move safely. When fields of view become very narrow (perhaps 10 degrees diameter or less) sighted guides, long canes, and guide dogs become very helpful.

The Ocutech image minifier (IM) creates a crisp, undistorted wideangle view, reduced by 50% of the normal size.

Optical devices that minify the image (like hotel room peep holes), sometimes called reversed telescopes, may also be of value. These make the image smaller allowing more to be seen in the same amount of space. Ocutech makes three versions of optical minification devices—the Image Minifier, Field Viewer, and the Field Expander. As compared to reversed telescopes that produce barrel distortion and an unnatural image, Ocutech minification systems are designed to provide a sharp, flat image that is more natural, and easier to use.

Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is a disease of the eye affecting prematurely born babies generally having received intensive neonatal care, in which oxygen therapy is used on them due to the premature development of their lungs. It is thought to be caused by disorganized growth of retinal blood vessels which may result in scarring and retinal detachment. ROP can be mild and may resolve spontaneously, but it may lead to visual impairment and occasionally blindness in serious cases. As such, all preterm babies are at risk for ROP, and very low birth-weight is an additional risk factor. Both oxygen toxicity and relative hypoxia can contribute to the development of ROP.

During development, blood vessels grow from the central part of the retina outwards. This process is completed a few weeks before the normal time of delivery. However, in premature babies it is incomplete. If blood vessels grow normally, ROP does not occur. If the vessels grow and branch abnormally the baby develops ROP. These abnormal blood vessels may grow up from the plane of the retina and may bleed inside the eye. When the blood and abnormal vessels are reabsorbed, it may give rise to multiple band like membranes which can pull up the retina, causing detachment of the retina and eventually blindness before 6 months.

How does ROP happen?

During development, blood vessels grow from the central part of the retina outwards. This process is completed a few weeks before the normal time of delivery. However, in premature babies it is incomplete. If blood vessels grow normally, ROP does not occur. If the vessels grow and branch abnormally the baby develops ROP. These abnormal blood vessels may grow up from the plane of the retina and may bleed inside the eye. When the blood and abnormal vessels are reabsorbed, it may give rise to multiple band like membranes which can pull up the retina, causing detachment of the retina and eventually blindness before 6 months.

Low Vision care can make a big difference

During development, blood vessels grow from the central part of the retina outwards. This process is completed a few weeks before the normal time of delivery. However, in premature babies it is incomplete. If blood vessels grow normally, ROP does not occur. If the vessels grow and branch abnormally the baby develops ROP. These abnormal blood vessels may grow up from the plane of the retina and may bleed inside the eye. When the blood and abnormal vessels are reabsorbed, it may give rise to multiple band like membranes which can pull up the retina, causing detachment of the retina and eventually blindness before 6 months.

There is a wide range of optical, electronic and software magnification options to address virtually every need. Every individual with ROP should have a low vision examination by a doctor skilled in low vision rehabilitation to help identify the most appropriate options to enhance their visual functioning, academic and vocational potential and their personal quality of life.

Stargardt’s Disease

Retinal Photograph of Stargardt’s Disease.

Originally described by German ophthalmologist Karl Stargardt in 1901, for whom it is named, Stargardt’s Disease is a retinal disorder that affects the macula early in life and hence is often called Juvenile Macular Degeneration or Early Onset Macular Degeneration. Unlike Age-related Macular Degeneration, there is never a leakage of blood or fluid, though the same area of the retina (the macula) is affected.

The macula is the central part of the retina that is responsible for providing sharp detail and color vision. As in Age-related Macular Degeneration, Stargardt’s Disease does not affect the peripheral retina and as a result individuals do not lose all of their vision. They can usually walk and engage in general activities with little difficulty. Reading and seeing details such as signs and faces at a distance are however affected. Stargardt’s disease affects over 30,000 individuals in the US and occurs in approximately one in 10,000 individuals.

Stargardt disease is the most common cause of Macular Degeneration and central visual loss in young people. It often develops in the teens or twenties, in both genders, but may develop in younger children and even sometimes later in life. It affects both eyes, though one may be worse than the other. In certain more rare types the peripheral vision may also be affected. Vision loss tends to progress rapidly at first, but usually stabilizes at about 20/200 (6/60) visual acuity.

Low vision care can be very effective to help individuals with Stargardt’s Disease to lead very normal lives. Vision loss from Stargardt’s Disease responds very well to magnification which can make reading, seeing signs, faces, the computer, TV and even driving a possibility. There is a wide range of optical, electronic and software magnification options to address virtually every need.

Every individual with Stargardt’s Disease should have a low vision examination by a doctor skilled in low vision rehabilitation to help identify the most appropriate options to enhance their visual functioning, academic and vocational potential and their personal quality of life.

Stargardt’s Disease is also known as:

  • Juvenile Macular Degeneration
  • Juvenile Onset Macular Degeneration
  • Stargardt Disease
  • Fundus Flavimaculatus
  • Stargardt Macular Dystrophy