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    Disability's in Eye of Beholder

    With the right training and adaptive equipment, people with limited vision don't have to lead limited lives.

    Learning to Cope continued...

    An important but little-appreciated aspect of low-vision services is training in activities of daily living: teaching patients how to continue doing what they have always done -- cooking, cleaning, shopping, reading.

    "If you live alone as I do, the kitchen and trying to cook is a problem, because you could get burned or you're going to have a mess," Cole says. "They were able to show me what to do just in everyday living. One of the technicians came and saw me at home, and saw how I lived. She showed me everyday stuff: how to pour hot water into a cup for coffee without getting burned, how to reach into an oven without getting burned, how not to spill -- small techniques that make life much easier for a person who has any vision problems."

    Ann Marie Turo, OTR/L, an occupational therapist who works with low-vision patients at Massachusetts Eye and Ear, says patients with loss of vision in the central visual field, as occurs with macular degeneration, can use a technique known as decentered viewing, in which they are trained to use their peripheral rather than central vision to see images. Astronomers use a similar technique to pick up fine details in telescopic images of distant faint objects.

    Putting Technology to Work

    In addition to learning new ways of doing everyday chores, people with low vision often benefit from the use of adaptive techniques and technologies, ranging from simple but powerful handheld and stand-mounted magnifying glasses to prescription drug bottles that announce their contents when placed in a special reader.

    "The most effective thing is the closed-circuit TV system for reading; it's a fantastic device, " says Eliezer Peli, OD, a senior scientist and specialist in low vision at the Schepens Eye Research Institute in Boston. Stationary or portable CCTV systems provide high-power magnification of even small-print items, allowing users to read their mail, newspapers, books, and other materials. A low-end system costs about $1,800.

    In addition, computer users can choose from among a growing number of magnification programs, some of which incorporate speech recognition technology, allowing users to read documents on screen or surf the web.

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