January 20, 2016

VAPAHCS Notes National Glaucoma Awarness Month

Photo: A VAPAHCS Optometrist completes an eye exam with a Veteran
The VAPAHCS Website noted National Glaucoma Awareness Month this January, which is the best time to remind all Veterans to take preventative measures to maintain good eye health. 

Glaucoma is the second leading cause of blindness in the world. As one of the leading causes of blindness, glaucoma affects more than three million people in America and more than 280,000 Veterans. It is also known as the "sneaky thief of sight" because a person may not be aware that they have glaucoma and have lost a significant amount of vision irreversibly before they are diagnosed and treated.

What is glaucoma?

According to the Glaucoma Research Foundation, glaucoma is a group of eye diseases that cause progressive and irreversible damage to the optic nerve. The optic nerve is similar to a cable with millions of connections, carrying images from the eye to the brain. Glaucoma can gradually steal sight without warning. Characteristically, the loss of vision is in the peripheral vision, but if untreated and uncontrolled, the vision loss progresses to “tunnel-vision,” and can lead to total loss of vision in end-stage glaucoma.

There are two main types of glaucoma: primary open-angle glaucoma and angle-closure glaucoma. They are determined by the anatomy of the patient’s eye and treatment is dependent on the type of glaucoma. Secondary glaucoma is the result of another disease that causes or contributes to increased eye pressure that may damage the optic nerve.

Regular Eye Screening is Important

Dr. Patricia Ferrell, an ophthalmologist who specializes in glaucoma treatment at the VA Palo Alto Health Care System, recommends everyone to have your eyes screened regularly, especially if you are at high risk for glaucoma. High risks include a family history of glaucoma, being African-American, and aging. “Having your eyes dilated is an important part of your eye exam, which can help to detect glaucoma early,” says Dr. Ferrell.

While more common among older adults, glaucoma can occur at any age for various genetics or disease-related reasons or from trauma. Early diagnosis and good follow-up in those who have glaucoma or are suspected of having glaucoma are key ways to maintaining vision and preventing permanent loss of vision from glaucoma.

How Does VAPAHCS Contribute to Glaucoma Awareness and Treatment? 

VAPAHCS offers glaucoma treatment along with general and other specialized care within Optometry and Ophthalmology services. 
According to Dr. Ferrell, the VAPAHCS services are able to provide full care for the various types of glaucoma. This can be difficult for patients dependent on the private sector to obtain due to costs. However, at VAPAHCS, treatment options are available to the Veteran without worrying if the patient can afford them. This is usually true for many VAPAHCS services because issues of dealing with insurance companies or copays are either minimal or non-existent for most Veterans. 

What Services Are Available if I do have Vision Loss?

If you are a Veteran or Active Duty Service Member who has Glaucoma or any type of vision loss, the VA has a variety of vision rehabilitation services available.  The first step is to contact a Visual Impairment Services Team (VIST) Coordinator to see what services and benefits are the best fit for you and your needs.  The Palo Alto VIST Coordinator, Elizabeth Silowitz, is available by phone at 650-852-3431. 

One of the services provided to visually impaired individuals is the Annual VIST Review. This is a yearly examination to assess the Veteran's adjustment to sight loss, current vision, hearing, and health. Based on information collected during the VIST review, Veterans may be referred for training and/or services to address their needs. The Palo Alto VIST Program also offers benefit reviews, support groups, community activities, and presentations to agencies regarding vision loss. For individuals who have experienced vision loss due to a brain injury or stroke, the Palo Alto Polytrauma VIST program provides referrals to specialty training programs to address vision loss caused by brain injury.
Many of the rehabilitation programs offered at the VA assess, train, and issue to Veterans with vision loss adaptive items which may include magnification devices, a large print or talking computer system, adaptive technology, canes, watches, talking paper currency identifiers, audible prescription readers, and adapted recreational equipment and both inpatient and outpatient treatment is available.
Referral Services
Referrals for services may include, but are not limited to:
  • VA Inpatient Blind Rehabilitation Training (WBRC)
  • VA outpatient services (VICTORS & BROS)
  • Comprehensive Neurological Vision Rehabilitation (CNVR)
  • Low Vision Services
  • Adapted Computer Technology Training
  • Community/State Agencies
  • Library of Congress Talking Book Program
  • Paratransit Services
  • Adapted Recreational Programs
CLICK HERE to learn more about VIST

CLICK HERE to learn more about the WBRC

January 18, 2016

January is National Glaucoma Awareness Month

January is National Glaucoma Awareness Month.  Glaucoma is a group of eye diseases in which the normal fluid pressure inside the eyes slowly rises.  There are often no noticeable symptoms in the early stages.  Left untreated, it can lead to vision loss and blindness.  It is one of the main causes of blindness in the United States.  Although anyone can get glaucoma, the following people are at higher risk:
•African Americans over age 40
•Everyone over age 60, especially Mexican Americans
•People with a family history of glaucoma

Photo: A picture of two boys as seen by someone with 'normal' vision

Photo: The same picture as it might be seem by someone with Glaucoma

Open-angle glaucoma is the most common form of the disease.  Normally, clear fluid flows in and out of small space at the front of the eye called the anterior chamber. This fluid bathes and nourishes nearby tissues.  If this fluid drains too slowly, pressure builds up and damages the optic nerve.  Though this buildup may lead to an increase in eye pressure, the effect of pressure on the optic nerve differs from person to person.  Some people may get optic nerve damage at low pressure levels while others tolerate higher pressure levels.  Please click on the image below for a short video about the cause of glaucoma:
If you are being treated for glaucoma, be sure to take your glaucoma medicine every day. See your eye care professional regularly.

You can also help protect the vision of family members and friends who may be at higher risk for glaucoma—African Americans over age 40; everyone over age 60, especially Mexican Americans; and people with a family history of the disease.  Encourage them to have a comprehensive dilated eye exam every one to two years.  Remember that lowering eye pressure in the early stages of glaucoma slows progression of the disease and helps save vision.
The Western Blind Rehabilitation Center (WBRC) is a 27-bed residential facility located at the Menlo Park Division of the VA Palo Alto Health Care System. Approximately two hundred veterans and active duty service members of all ages participate in the program each year. More than three quarters have usable vision for which specialized treatment is provided. Adjusting to and managing visual impairment is the major objective of the program. If you are in the area and are interested in a site visit, please call (650) 614-9952 to make arrangements.

January 11, 2016

January is National Braille Literacy Month

Photo: A person's hand trailing a line of Braille cells

January is National Braille Literacy Month.  Braille is a tactile reading and writing system, consisting of arrangements of up to 6 raised dots representing letters, numbers, and even musical notes created by Louis Braille.  Using different combinations of these dots allows for 64 different characters to be represented.  It is commonly mistaken for a language; however it is simply a form of a language that can be read tactually. 

Image: A portrait of Louis Braille, inventor of the Braille system

Louis Braille was born in Coupvary, France on January 4th, 1809.  He lost his sight as a young child, commonly reported between ages 3 and 5, after an accident with a leather working awl which resulted in infection and a total loss of vision in both of his eyes.  At age 10 he was accepted to the National Institute for Blind Youth in Paris.  At the time the school was using books with large raised letters.  Although the students could read these books, the complexity of producing the raised letters prevented their ability to write using this system.  At age 15, inspired by a presentation at the school by Captain Charles Barbier of the French Army about his night writing method (a system using raised dots and dashes allowing soldiers share information on the battlefield without having light or needing to speak), Louis Braille had largely developed the Braille system allowing students not only to read material but also write in a accessible medium.  

Photo: A person's index finger on the Braille noting the 'open door' button of an elevator

Today Braille is used in a variety of ways including books, on ADA accessible signs, menus, elevator buttons, ATMs, ticket machines, and even on some currencies.  Braille-users can read computer screens and other electronic supports thanks to refreshable Braille displays.  They can write Braille with a slate and stylus or type it on a Braille writer, such as a portable Braille note-taker, or on a computer that prints with a Braille embosser.  Computer software is available to translate text into Braille.  

Image: A representation of the Braille Cell arrangements for letters A through Z

Anyone can learn to use Braille, though most people who use Braille tend to be partially sighted or blind and therefore read Braille by touch.  Braille is written using cells. Each cell compromises of 6 dots, which are either present or left blank. Braille readers memorize the pattern of dots and the letter that it corresponds to. There are several grades of Braille, from beginner to advanced.  Braille can be self-taught using books or the internet and there are several free resources available.

Some benefits of being able to read Braille are:
  • It allows persons to read and write print in a non-visual way.
  • A wide choice of books and magazines are available in Braille.
  • Braille can be used for labeling items such as food, medicine, DVDs and CDs.
  • There are a variety of items available for purchase such as Braille playing cards which may enhance a person’s ability to participate in social games and activities.
  • Many companies now offer newsletters and menus in Braille.
  • Knowing some basic Braille could allow persons with reduced vision to access information such as elevator button numbers without the need of adequate lighting or magnification.

Braille is one of the many skills available through training at the Western Blind Rehabilitation Center.  Many people choose to learn through local agency classes or using distance learning courses.  Below you will find some links to resources for learning Braille and for Braille reading materials.


CLICK HERE to learn about distance courses through HADLEY SCHOOL FOR THE BLIND

CLICK HERE to learn about courses through LIGHTHOUSE FOR THE BLIND in San Francisco

CLICK HERE to learn about courses through the SANTA CLARA VALLEY BLIND CENTER in San Jose 

Braille Reading Material:

January 5, 2016

January Construction Update

Photo: Front of B500 as of January 2016
WBRC continues to watch the construction progress of B-500, the highly anticipated new home of the Polytruama and Blind Rehabilitation services on the Palo Alto VAPAHCS Campus.  Some of the building's features will include private bedrooms and bathrooms for inpatients, 3 large shared courtyards, a ‘green’ living roof, a greenhouse, and solar panels on the roof. 
Photo: The front entry to the glass atrium of B500
At 174,000 square feet, this new facility is the largest consolidated rehabilitation center in the VA and will include 24 beds for the polytruama program, 32 beds for the blind rehabilitation program, and 12 beds for the polytruama transitional rehabilitation program.  Currently construction crews are nearing completion of both the interior and exterior of the building.
Photo: The main courtyard of B500 as seen in the early evening with night lighting

The center will also have an outpatient physical therapy/occupational therapy clinic, an outpatient physical medicine and rehabilitation clinic, and clinical programs for Operation Enduring Freedom/Operation Iraqi Freedom Veterans.  Construction is anticipated to be 100% complete shortly, with the building becoming operational in the Spring or Summer of 2016.  

CLICK HERE for construction updates

CLICK HERE to read the project's news release