Eyeworld

APRIL 2023 | EYEWORLD | 99 G Contact Kaleem: mkaleem1@jhmi.edu Mohiuddin: omar.mohiuddin@duke.edu Rosdahl: jullia.rosdahl@duke.edu He said that he does not demonstrate high tech wearables, such as smart glasses and augmented reality headsets, frequently because there is often a learning curve. "I find that lighting solutions are often the most important thing I can recommend, and while my recommendations are individual, an LED gooseneck task lamp with adjustable brightness and color temperature and a Lil Larry flashlight are versatile tools that help many people with low vision see to complete different tasks," Mr. Mohiuddin said. From a contrast standpoint, Dr. Kaleem said making things brighter can be helpful, as can something as simple as switching the background setting on a phone, making it have a dark background with white text instead of white background with black text. Bathrooms, Dr. Kaleem said, are often a location for falls, in part due to contrast issues. Many bathrooms have white tubs, white floors, and white sinks, making it difficult for people with contrast sensitivity issues. She recommends using high contrast, bright colors for bathmats on the floor near the step for the tub. Smart technology solutions Mr. Mohiuddin said that while the range of available assistive technologies has come a long way in the last few decades to help the visually impaired, the greatest difference has been the introduction of smartphones. "Our smartphones are capable of not only taking calls and pho- tos but come equipped with digital assistants to help tell the time, weather, compose text messages through dictation, and accessibility features, such as voiceover, and may allow users to access emails and information on the web and different apps," he said. Mr. Mohiuddin said there are apps that now use machine learning and AI that can help users identify objects, barcodes, and read print materials with text-to-speech (optical character reading) capabilities. "As technology improves and things become lighter weight, less conspicuous, and more affordable, that should help with the adoption and use of devices," he said. "I find that my patients are more open to adopting and using mainstream technologies, such as smartphones and tablets, rather than proprietary low vision devices as they are more readily available and easier to learn to operate. No one size fits all While new technologies are always rolling out, Mr. Mohiuddin cautioned that no technology is one size fits all. "Not every new aid is going to help ev- eryone, as it depends on their familiarity with technology, their level of vision, and what goals or tasks they are looking to accomplish," he said. "When recommending aids and technolo- gies, it's important to understand that it's often the low tech solutions that are easiest to adopt, and it depends on the individual and what tools they are most comfortable with learning to use and adopting to help do what it is they need to do." Jullia Rosdahl, MD, PhD, also spoke about how personalized visual aid recommendations need to be. She stressed early referrals to vision rehabilitation services. Dr. Rosdahl offered a few simple helpful elements for patients depending on their stage of vision. For patients at an earlier stage of vision loss, she said it's helpful for glasses prescrip- tions to be kept up to date, with lined bifocals or separate single-vision glasses being used in- stead of progressive lenses. Tints can be used to reduce glare and improve contrast, and atten- tion should be paid to ocular surface optimiza- tion. Dr. Rosdahl said task lighting at this stage can be useful. For patients with more advanced vision loss, especially if the vision loss is in the inferior visual fields where falls could be more of an issue, Dr. Rosdahl said a walking stick might be needed, and it's important for the physician to review strategies for the patient to move their head and neck instead of just their eyes when walking around. Dr. Rosdahl, Dr. Kaleem, and Mr. Mohiuddin mentioned the resources on Hadley.edu, which is a website with learning opportunities for pa- tients dealing with vision loss or blindness. Top- ics on the website cover daily living, technology, adjusting to vision loss, working, and more. Reference 1. Deemer AD, et al. Approaching rehabilitation in patients with advanced glaucoma. Eye. 2022. Online ahead of print. Relevant disclosures Kaleem: None Mohiuddin: None Rosdahl: None

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