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Helping macular degeneration patients adapt

August 01, 2019 | UCI Health
uci health physician rebecca kammer

Rebecca Kammer's clinic at Gavin Herbert Eye Institute helps low-vision patients adapt to their changing eyesight.

While promising research is underway to cure and prevent eye diseases such as macular degeneration and retinitis pigmentosa, the UCI Health Gavin Herbert Eye Institute (GHEI) is working with low-vision patients to help them see the best they can.

Each Friday, the eye institute holds a clinic for low-vision patients. It is run by optometrist Dr. Rebecca L. Kammer, who is a volunteer faculty member of the eye institute and a researcher working with jCyte, a company created to commercialize treatments based on GHEI research using regenerative stem cells to treat retinitis pigmentosa.

The goal of the clinic is to help low-vision patients develop adaptive strategies as well as conventional and leading-edge treatments that will allow them to maintain their usual daily activities, Kammer says.

Referral to rehabilitation specialists, such as occupational therapists, to help people make adjustments in their lives and living environment, is another important part of the process.

Diagnosing macular degeneration

Most patients come to Kammer with a diagnosis of macular degeneration, an age-related disease that damages a part of the retina called the macula. Although it isn’t painful, macular degeneration effectively blurs the central vision needed for activities such as reading and driving.

To help them, she says it’s not enough to know that a patient has 20/60 vision, for example.

Some patients may have sight in the middle of their field of vision and good peripheral vision, but are unable to see in a ring between the two. These patients may drop a pill and see it at first then lose sight of it if they don’t understand where their blind spot is.

Locating the blind spot

“For people with the doughnut blind spot, lighting makes a big difference, as well as maybe a little bit of magnification,” Kammer says.

“We also advise them to choose or make a dark surface for taking their medication. With that contrast, a pill is easier to spot.”

For other patients whose vision loss is at the center of their field of sight, magnification may offer the most benefit. This may mean prescribing magnifying glasses to implanting miniature telescopes.

Still other patients may need special lighting or help filtering light that bothers their eyes.

One problem many patients encounter is that such adaptive equipment isn’t covered by insurance, so Kammer may also help them locate lower-cost items.

Adapting lifestyles for new reality

Perhaps the biggest challenge is that many patients with macular-degeneration need to adapt their homes and habits for optimal vision gains.

Kammer coordinates her care with that of other community professionals to help patients create sustainable rehabilitation plans.

This also means that patients are as responsible for improving their vision situation as their doctor is, and in some cases more. That’s clearly not always easy, she says.

“This is all about the change process, and change means they actually have to work at it.”

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