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.

CLICK HERE to learn more about Glaucoma from the National Eye Institute

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.

CLICK HERE to learn more about the WBRC

November 20th is the Great American Smokeout

Graphic: Great American Smokeout with no smoking
logo and American Flag Background.

The American Cancer Society marks the Great American Smokeout on the third Thursday of November each year (Nov. 20) by encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. By quitting — even for one day — smokers will be taking an important step towards a healthier life – one that can lead to reducing cancer risk.

Tobacco use remains the single largest preventable cause of disease and premature death in the US, yet about 42 million Americans still smoke cigarettes — a bit under 1 in every 5 adults. As of 2012, there were also 13.4 million cigar smokers in the US, and 2.3 million who smoke tobacco in pipes — other dangerous and addictive forms of tobacco.

Cigarette smoke is extremely toxic, containing as many as 4,000 active compounds, including tar, polycyclic aromatic hydrocarbons, formaldehyde, carbon monoxide, and heavy metals. Its effects on the lungs and heart have been well established by medical researchers and are well known.

Not as well known are the detrimental effects that smoking can have on your vision. Smoking has been directly linked to two of the leading causes of vision loss, cataracts and macular degeneration. In fact, researchers believe smoking also causes or contributes to a number of other eye health problems.

Research has found that smokers have double the risk of developing cataracts compared with non-smokers. This risk is triple for heavy smokers. In fact, doctors have discovered a specific relationship between cataracts and the amount that you smoke — the more you smoke, the more chance you have of developing cataracts.  Doctors believe smoking contributes to cataracts by altering the cells of the lens through oxidation. There is also evidence that smoking leads to the accumulation of heavy metals like cadmium in the lens.

Smoking also increases a person's risk of developing macular degeneration. Studies have found that smokers face a risk of developing macular degeneration that is two to four times greater than that of people who have never smoked. As with cataracts, doctors have found that the risk increases the more a person has smoked. Researchers have also found an increased risk of macular degeneration in people who don't smoke but are frequently exposed to environmental cigarette smoke.  Doctors believe that smoking promotes macular degeneration by interfering with blood flow to the retina. Smoking might also increase the deleterious effects of oxidation on the cells of the macula.

Studies also have linked cigarette smoking to eye problems such as:

• Diabetic retinopathy
• Dry eyes
• Optic nerve damage
• Lazy eye
• Conjunctivitis

Vision Problems and Smoking: What You Can Do

There is hope for smokers who want to avoid smoking-related vision loss. Research has found that quitting smoking does improve their chances of avoiding eye disease. For example, studies show that people who quit smoking will have a 6.7 percent reduced risk of developing macular degeneration after one year. After five years, the risk drops by another 5 percent.  The same goes for cataracts.  Doctors say people who have quit smoking for 25 years have a 20 percent lower risk of cataracts when compared with current smokers.

Ready to quit smoking?

Make a Quit Plan. The VA has resources available to make sure you succeed. The first step is to S.T.A.R.T.

Set a quit date.

Tell your family and freinds.

Anticipate and plan for challenges.

Remove cigarettes from your home, car and work.

Talk to your doctor.

Your doctor can counsel you and prescribe medication to help you. Counseling and medication are tools that give you the best chance of quitting smoking for good.

Counseling will help you build smoke-free habits. Once you quit, it continues to help you avoid tobacco for good. Medication such as nicotine replacement therapy and other medications will ease the physical symptoms of withdrawal. Counseling and medication work together to help you cope with cravings and deal with triggers.

Counseling and medication have higher success rates compared to counseling alone. Together, the number of counseling sessions (up to 8) increases your success. 32.5% of people successfully quit using medication together with 8 or more counseling sessions compared to only 12.4% who quit without any help.

The VA can help you with your quit plan.

Counseling: Talk to your doctor. Attend a tobacco cessation group. Call 1-855-QUIT-VET.

Medications: Talk to your doctor about using the patch, gum, lozenge & other meds to help you quit.

Self Help: CLICK HERE to find other tips for quitting and VA resources

Support: Talk to your family and friends. Text the word VET to 47848 for tips and help quitting.

VA TeleQuit Smoking Cessation Program

TeleQuit is the VA’s smoking cessation program that is coordinated by telephone. Telephone-based care means no in-person clinic visits for patients. Since its launch in 2007, TeleQuit has managed the smoking cessation care of over 8,000 Veterans and a growing number of VA employees throughout Northern California and Western Nevada.

The TeleQuit Program offers education, counseling, and smoking cessation medication. Free, confidential, one-on-one telephone counseling is provided by the California Smokers' Helpline and Nevada Tobacco Users' Helpline. Veterans and VA employees receive brochures with great ideas about how to quit smoking.

How to contact the TeleQuit Program:

Veterans and VA employees can call us at our toll-free number: 1-650-493-5000, ext. 60557 (Palo Alto Division). Coordinators are available to take calls Monday-Friday, 8:00 AM - 4:30 PM. Veterans and VA employees may call us after 4:30 PM and leave a message on our voice mail.

What is the long-term abstinence rate with TeleQuit?

TeleQuit's 6-month abstinence rate is 25%. This outcome is comparable to quit rates in an excellent in-person smoking cessation clinic.

Quitting smoking is the single best thing you can do to improve your health. You have the power to quit smoking and to stay smoke free, and the VA has resources available to help.

Get started now ...

CLICK HERE to learn more about the Great American Smokeout

CLICK HERE to learn more about how the VA can help Veterans to Quit Smoking

CLICK HERE for Veteran TeleQuit Information

CLICK HERE for VA Employee TeleQuit Information

Alumnus Interview: Pete Chavarria

Photo: Mr. Chavarria at the 2014 Golden Aged Games

Pete Chavarria, WBRC Alumni, recently participated in his first Golden Age Games in Arkansas.  He competed in the Horseshoes, Shuffleboard, and Bowling events bringing home two Bronze medals.  His coach Rachel Smith, WBRC Recreation Therapist, reports that Pete was not only an enthusiastic athlete, but also a wonderful cheerleader for his team.  Pete participated in the WBRC Basic Program and the WBRC iProgram in 2014.  He reports that both his time at the WBRC and his experience at the 2014 Golden Age Games have been life changing events and he graciously agreed to be interviewed in order to share his experiences here on the WBRC blog.

Pete, please tell us a little about yourself and about what got you interested in participating in the 2014 Golden Age Games.

I was born in the state of Texas, "Hook ‘em Horns", raised on the farm and went to school there during the Dr. Martin Luther King Era.  Then I went to Durham Business College.   I am a Vietnam war veteran from 1968/1969. I am 68 years old.  I got interested in the Golden Age Games cause two certain people said that I could do it, and that was bowling, that had been my sport for many years, so I decided to give it a try.

What type of vision loss do you have and how has it changed your approach to recreation activities (like bowling)?

My vision loss is with my right eye, lost my right field due to glaucoma, for a while I thought I was done, but a great doctor at PAD did surgery in my right eye.  It has taken more than a year to heal, and I think it is still healing and all for the good.  To be honest with you, the vision loss had nothing to do with me participating in a sport like bowling, it took three great persons to tell me that I could do it.  Maybe all I needed was a little push from certain people and you know who they are.  The WBRC had great!!! instructors with no doubt.

This was your first experience at the Golden Age Games.  What was your experience as an athlete and teammate?  Did participating in the games change you in any way?

It was  my first time at the games, I did not know what to expect, but I was willing to see what the games would give me.  As an athlete I was thrilled to be there with other veterans and just talking with them.  They came from all over the USA.  I had not seen that many veterans together.  I was excited to compete with them.  There was never a bad moment, everything was great.
Rachel Smith and her assistant Charles Davis, those two coaches kept us together and supportive of each other, from the begining to the end, they were always there for us while we were at the games. I feel that they do not get enough credit they deserve for their outstanding work. They should be recognized for excellence.   
Like I said before all I needed was somebody to tell me that I could do it.   All I needed was practice and that stayed in my mind.  Now that I am back and have those metals I know I can do it.  I will not let my vision loss stop me on anything that I want to do cause I know that I can do it, it was proven.


You completed two Blind Rehabilitation programs at WBRC this year.  Did you use any devices or techniques that you learned at WBRC for the Golden Age Games?
I used my long cane, I went down-stairs, up-stairs, and even rode in the transit buses.  I went up on the elevators and into the airplane carried my own luggage.  All the techniques that were shown to me at the WBRC were put to use every day.

You won 2 medals at the Games which you are planning to present to the WBRC.  What is your motivation to do this?

When we were getting ready for the games I came with the idea to do it, I talked to my boys [sons] and they thought it was a good idea on my part.  My motivation for this is that some time when I was there for my iProgram I talked to the director of the WBRC and I told her that if I could or would win any metals, that they were going to be presented to the director and the WBRC, all that for one reason, and the reason being that it was the place I got my first go at changing things in my life.  The center with all the great staff from top to bottom were great in helping me thru my ordeal and took out the negative out of my mind.  The WBRC will always be my second home and they deserve the metals as a symbol that it can be done no matter what your medical condition is.

What advice would you share with other veterans or persons experiencing vision loss?
The only advice that I can give other veterans, is stay positive.  I know that is easier said than done, but if you do that you will get thru your anger.  Remember it is all up to us the veteran to do it that nobody is going to do it for you.  You need to regroup and continue with life.  If you do that everything is going to be ok.  Never give up, keep pushing forward, and The Lord will help you. The motto is as follows, ‘YES YOU CAN DO IT’!

My final note to this is that I am getting ready for next year’s Golden Age Games.  I would love to be at the WBRC - if I could I would be there every day! There are very good staff working there.

CLICK HERE to learn more about the Golden Age Games

Thank you Pete for sharing your experiences with us on the WBRC Blog.  Best of luck in your future endeavors and next year’s Golden Age Games!

May is Healthy Vision Month

Photo: A closeup of a human eye

May is Healthy Vision Month.   Even after vision loss there are things that people can do to take care of their remaining vision.  Here are some tips from the National Eye Institute:

 

Get a dilated eye exam. Getting a dilated eye exam is the only way to catch eye diseases early, because with many, there are no warning signs.  Even after being diagnosed with vision loss, it is still important to monitor your eye health for changes. It is also equally vital to continue to be screened for other potential eye diseases. An annual eye exam is your opportunity to learn from your eye doctor if there have been any recent advances in treatments or rehabilitation that may benefit you.  Talk to your eye care professional about how often you should have an exam.

 

Live a healthy lifestyle. Eating healthy foods, maintaining a healthy weight, managing chronic conditions, and not smoking can lower your risk of eye disease and maintain your current level of vision.  If you have diabetes, closely monitor your blood sugar.  Take all of your medications as recommended, including medications for you ocular health.  Talk to your doctor, especially if you notice any changes in your vision.

 

Know your family history. Talk to your family members about eye health history. It’s important for you and them to know if anyone has been diagnosed with an eye disease, since many are hereditary. This will help to determine if you or they are at higher risk for developing an eye disease.

 

Use protective eyewear. Protect your eyes when doing chores around the house, playing sports, or on the job to prevent eye injuries from happening. This includes wearing safety glasses, goggles, safety shields, and eye guards that are made of polycarbonate.

 

Wear sunglasses. Make sure your sunglasses block out 99 to 100% of both UVA and UVB radiation, so you can keep maintain your vision and eye health.  Be sure to properly care for the lenses as this UV protection is often a coating on the lenses.  Always place sunglasses in a case if you are not wearing them.  If the UV coating is scratched you may be letting UVA and UVB radiation leak through the lenses and damage your vision.  A hat with a brim of at least 3 inches can offer further glare reduction as well.  And remember, if you have been issued a pair of sunglasses from the VA you can contact your VIST Coordinator for repairs and/or replacement as needed.

 

CLICK HERE to visit the National Eye Institute's Healthy Vision Month Website to view the free resources available, including videos, shareable social media content, and more.

 

CLICK HERE to learn more about services through the Western Blind Rehabilitation Center

 

CLICK HERE to lean more about how to locate a VIST Coordinator

 

 

VisionAware Publishes Article About WBRC's CNVR Program

Photo: John Kingston works with a veteran on the NVT light panel for scanning training.

VisionAware has published an article by Mary D'Apice about the WBRC's Comprehensive Neurological Vision Rehabilitation (CNVR) program  for veterans and active duty service members with Traumatic Brain Injury (TBI) related vision loss.  The article included a review of some types TBI related vision loss and some of the specialized treatment that the WBRC provides to enhance the ability of people with TBI related vision loss to use their remaining vision. 

CLICK HERE to read the VisionAware Article

CLICK HERE to learn more about the WBRC CNVR Program

WBRC Website Launches Update

Photo: A screen shot of the updated WBRC Website

The Western Blind Rehabilitation Center (WBRC) is proud to announce the launch of our new and improved website.  The new WBRC site includes updated information regarding the program and services provided, the setting, admissions, scheduling a visit, 2012 outcome measures, and research.  There are fresh photographs and links to the WBRC Blog, newsletter, and construction updates. WBRC hopes this site will serve as a gateway to care as well as a resource for Veterans, their family members and friends, medical and care providers, and other stake-holders. 

Please CLICK HERE to view the new WBRC Website

January is National Glaucoma Awareness Month

January is National Glaucoma Awareness Month.  Glaucoma is a group of eye diseases that gradually cause vision loss without warning.  Although the most common forms primarily affect the middle-aged and the elderly, glaucoma can affect people of all ages.  There are two main types of glaucoma: primary open-angle glaucoma (POAG), and angle-closure glaucoma.  These are marked by an increase of intraocular pressure (IOP), or pressure inside the eye which can damage the optic nerve.  This nerve acts like an electric cable with over a million wires and is responsible for carrying images from the eye to the brain. 

Photo: A scene with two children viewed with unimpaired vision

Glaucoma is the second leading cause of blindness in the world, according to the World Health Organization.  In the most common form, there are virtually no symptoms.  Vision loss begins with peripheral or side vision, so if you have glaucoma, you may not notice anything until significant vision is lost. 

Photo: A scene with two children viewed with a Glaucoma simulation

Those at higher risk include people of African, Asian, and Hispanic descent.  Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics, and people who are severely nearsighted.  Regular eye exams are especially important for those at higher risk for glaucoma, and may help to prevent unnecessary vision loss.

The best way to protect your sight from glaucoma is to get a comprehensive eye examination.  Then, if you have glaucoma, treatment can begin immediately. There is no cure for glaucoma—yet.  However, medication or surgery can slow or prevent further vision loss.  The appropriate treatment depends upon the type of glaucoma among other factors. 

Over 2.7 million Americans, and over 60 million people worldwide, have glaucoma.  Experts estimate that half of them don’t know they have it.  If you have glaucoma, or any other type of vision loss, don’t keep it a secret.  Let your family members know and help raise awareness about the importance of regular eye examinations to preserve vision.

CLICK HERE to learn more about Glaucoma

The information above was gathered at www.glaucoma.org

WBRC Staff First Clinician in the U.S. Qualified as an 'NVT Trainer'

Photo: Niki Sandlan, Service Chief for Blind Rehabilitation Services, and John Kingston, CNVR Supervisor, standing in front of the NVT Light Panel with Mr. Kingston's framed certification as an 'NVT Trainer'.  This is the first NVT Trainer certification obtained by a clinician in the United States.  Photograph by Brian Higgins.


John Kingston, the supervisor of the Comprehensive Neurological Vision Rehabilitation (CNVR) Department at the Western Blind Rehabilitation Center has become the first person in the United States to have obtained certification as an NVT Trainer.  This certification will allow Mr. Kingston to train other clinicians at the Department of Veterans Affairs in the use of the NVT system for veteran treatment. 

An excerpt from the letter that accompanied Mr. Kingston's certification follows below:

'On behalf of NVT Systems, Gayle Clarke and Allison Hayes would like to congratulate John on becoming the first clinician in the US to qualify as an “NVT Trainer”… John’s enthusiasm and professionalism is a credit to him and staff trained under his guidance will receive an excellent understanding of the concepts behind the program.  We look forward to supporting John in the future training programs and are confident that his expertise will enable more veterans with neurological vision deficits to maximize the use of their remaining vision, to become as safe and independent as possible.'

What is the NVT system?

Neuro Vision Technology ("NVT") is based upon compensatory scanning training in conjunction with rigorous, standardised assessment of the nature and extent of the Neurological Vision Impairment. 

Veterans with neurological vision loss are assessed and then trained to become familiar with the extent of their field loss and other neuro-visual problems, and to compensate by employing learned scanning strategies to ensure that their remaining visual field is utilized to its best extent. The best scanning strategies in each case depend not only on the origin of the field loss but also on other cognitive and behavioural aspects such as visual neglect and issues with visual processing speed.  This is completed with assessment and training using the NVT Scanning Device.

Photo: The NVT Scanning Device being used for assessment and training for neurological vision loss

What is the NVT Scanning Device?

The NVT Scanning devices consists of coloured lights (LEDs) displayed on a horizontal panel placed at eye level approximately one foot from the patient. The panel of lights is placed centrally and extends to the right and left of the veteran, through the peripheral (or side) vision. In the presence of field loss and other neurological vision deficits the veteran is required to use both head movement and eye movement towards the affected visual field in order to detect the light stimulus.


The device documents the presence of:

• Neurological vision impairments, such as a homonymous hemianopia, quadrantanopia, relative field loss etc
• Visual spatial neglect or inattention
• Speed of visual processing
• Visual memory
• Visual spatial deficits

How do you use the device to train veterans?

The results of the functional evaluation then form the basis of a vision training program to improve the veteran's awareness and understanding of the nature of their vision impairment. The NVT Scanning Device is used to teach a pattern of systematic visual search strategies to maximize efficient use of remaining vision. These training exercises use patterns of lights that reinforce an efficient and functional speed of scanning to allow for accurate detection of all stimuli. The aim is to teach the compensatory scanning skill until it becomes an automatic response.  The NVT therapy program then transfers visual scanning strategies established using the NVT Scanning Device into all aspects of activities of daily living and mobility.

CLICK HERE to learn more about WBRC's CNVR Program

CLICK HERE to learn more about the NVT System

CLICK HERE to learn more about the NVT Scanning Device

National Eye Institute Launches On-Line Video Resources

Photograph of an eye chart with a pair of glasses

Nearly 14 million Americans experience vision problems, ranging from nearsightedness to blindness. The National Eye Institute (NEI) recently launched a new series of video resources on the leading eye conditions and diseases affecting many Americans. Users can watch video ‘Vodcasts’ using their computer on topics such as Age-Related Macular Degeneration, Cataract, Diabetic Eye Disease, Comprehensive Dilated Fundus Exams, Dry Eye, and Glaucoma. These video resources could be used by persons wishing to understand their own or a loved one’s vision loss.

CLICK HERE for a Link to the NEI Vodcast Video Resources

DEPRESSION AND VISION LOSS

By: Merideth Smith, M.S., Psychology Intern and Laura J. Peters, Ph.D., Staff Psychologist

Photo: Silhouette of a person sitting in a chair with their head in their hands

With vision loss, it is normal to experience periods of sadness, stress, or grief; however, these feelings will often lessen over time. For some individuals, these feelings do not go away, and when this happens it is called depression. Depression is characterized by feelings of sadness, hopelessness, loss of pleasure in previously enjoyed activities, guilt, worthlessness, helplessness, fatigue, problems sleeping or oversleeping, isolation, irritability, or restlessness that last for most days for two weeks or longer. Unfortunately, people with vision loss are at higher risk of developing depression. Of the 5.7 million older adults in the United States with vision loss, 57.2% are at increased risk for mild to moderate depressive symptoms and 6.2% are at risk for severe depression. Those with mild to moderate depression are 4 to 6 times more likely to experience worse health as well as problems with functioning (e.g., walking, shopping, and socializing). Those with severe depression are 18 to 23 times more likely to have worse health and problems with functioning. This increased risk for depression and poorer functioning in older adults with vision impairment is a significant public health concern and can have a negative impact on an individual’s quality of life and physical health.


Although adults with vision impairment are at an increased risk for depression, there are steps that can help someone cope with the symptoms of depression. Engaging in vision loss rehabilitation can help individuals feel more capable and in control of their lives. Seeking out social support through family, friends, organizations, or support groups can be very effective in improving quality of life and can help with the adjustment to changes in health. Rehabilitation can also support people's ability to resume pleasurable activities that they have abandoned due to their sight loss. Engaging in pleasurable activities can improve a person’s mood. Exercising on a regular basis can also help with problems with sleeping or feelings of fatigue.

However, sometimes the depression is severe and significantly interferes with a person’s life. People with depression can even have thoughts of hurting or killing themselves. This is referred to as suicidal ideation. In fact, white males over the age of 85 have the highest rates of death by suicide, 45 deaths out of 100,000. Unfortunately, this population is also the least likely to seek help if they experience depression. A national hot line is available for individuals who have suicidal thoughts, or for family and friends who are concerned about a loved one. This hot line can be reached at 1-800-273-TALK (8255).

For additional information please see the website: http://www.suicidepreventionlifeline.org/.


When depression becomes this crippling, professional help may be needed. Currently there are effective forms of treatment for individuals who are experiencing depression and these treatments continue to improve with ongoing research. Treatment can take the form of psychotherapy, which can include talking about stressors, learning to use healthy coping strategies, improving relationships, or learning to incorporate pleasurable activities back into everyday life. Antidepressant medications can also be used to effectively treat depression. These medications do take time to work and the first medication you try may not be effective. There are several different types of antidepressant medications, so do not give up if the first medication is ineffective. It is important to communicate with your doctor if you experience side-effects or do not notice a change in mood after 3 to 4 weeks.

Depression can be physically and mentally debilitating and adults with vision impairment are at an increased risk. However, there are effective resources and treatments that can improve mood and give the person the skills necessary to successfully adapt to these significant life changes. If you notice you or someone you love have prolonged periods of sadness, loss of pleasure, or depression, do not hesitate to talk with your doctor.