It has been a great run on Vision Viewpoint! Since July of 2013, the Council has written articles that gave perspective into our work and the people’s lives we touch. It is with great joy we embrace a new creative space for our readers to come to know and love.

We are excited to be endorsing Outlook from Here, a blog  dedicated to sharing stories of living in Wisconsin with blindness, visual impairment, or disability, started in partnership between the Wisconsin Council of the Blind & Visually Impaired and Annika Konrad, a Ph.D. Candidate in English at UW-Madison and new Board Member of the Council.

The Outlook from Here has over a dozen contributors who are blind or visually impaired who recount moments of excitement, fear, loss, and triumph in their own lives as it relates to their vision. If you are interested in becoming a contributor to our blog, please contact Annika Konrad at annikakonrad@gmail.com. Currently, the Outlook from Here is accepting new writers and fresh ideas.

All of the past articles on Vision Viewpoint will stay archived on this site, but to read more about the lives of people in Wisconsin affected by blindness or visual impairment, please visit Outlook from Here.

Thank you to all of our readers and we hope to continue serving you at our new blog!

From Loretta Himmelsbach, Executive Director:

Eat well for healthy eyes—the more color on your plate, the healthier it is!

From Brent Perzentka, Sharper Vision Store Manager:

Keep active and get moving with a talking pedometer from the store.  This nifty item tells the current time, and it keeps track of your steps and the total distance you traveled.

From Jean Kalscheur, Vision Rehabilitation Teacher:

When in your car, protect your eyes from the sun’s ultraviolet (UV-A and UV-B) rays.  A handy item is the “slip-in” sun shield for prescription eye glasses.  They are inexpensive, and I carry three colors in one eye glass case.  This way, I can choose the color that works best for the particular weather condition.

From Patrick Sweeney, Director of Information Technology: I really like this tip from the Mayo Clinic’s website: Take eye breaks. Throughout the day, give your eyes a break by forcing them to focus on something other than on your computer screen. A good rule of thumb is to follow the 20-20-20 rule: Every 20 minutes, take your eyes off your computer and look at something 20 feet away for at least 20 seconds. Find more tips for preventing eyestrain at http://www.mayoclinic.org/diseases-conditions/eyestrain/basics/prevention/con-20032649

From Marshall Flax, recently-retired Certified Low Vision Therapist:

Take good care of your eyes by scheduling an annual, comprehensive eye exam.  Your eyes are the only place in your body that provide a clear view of your blood vessels, arteries, and a cranial nerve that can tell your doctor a lot about your overall health.

Council Board member Deen Amusa presented Dave Schuh with the 2014 Friend of the Council award.

Council Board member Deen Amusa presented Dave Schuh with the 2014 Friend of the Council award.

Dave Schuh, owner of Accessibility Pros LLC, has been dubbed “Wisconsin’s adaptive technology guru to the disability community” by the person who nominated him for the 2014 Friend of the Council Award.  It’s easy to see why.

Dave has vision loss from Retinitis Pigmentosa, so he understands firsthand the challenges of the people he works with face.  For 10 years, he served as an assistive technologist at a local technical college in Wausau where he taught technology to students with vision loss and other disabilities. “With   a Master’s in Computer Information Systems and being visually impaired myself, I had extensive knowledge with accessible technology.  I used screen reading programs, magnification programs and accessible books everyday, and I could help students with practical applications for school  and work.”

Setting out on his own

Dave’s other master’s degree is in business administration. In 2005, he launched his own business. “It was challenging to start my own business, but I was good at assistive technology, and I relate well to people.  I thought I might serve as a role model for others who have disabilities.”

Dave’s office is conveniently located in his Wausau home where he offers a lot of his training. Most of his clients live in northcentral Wisconsin; however, some live in other locations like Eau Claire, Green Bay and Rhinelander.  A typical training session lasts three to four hours.  If someone has traveled a considerable distance, the training session could be modified to meet the person’s needs.  To provide additional flexibility and convenience, Dave also provides training at a person’s home or work site.

Individualized instruction for people with vision loss

Part of Dave’s success is that he tailors technology training to the needs of each person.  “I begin by asking the person what he or she wants to accomplish.”  He has helped one writer convert files, import images and do routine editing.  Right now, a few of his clients want to become human service professionals, so he is teaching them how to work with online resources and report writing using various types of assistive technology.  Dave sees a number of older adults who have recent vision loss and who need to learn computer basics such as keyboarding, word processing and

E-mail.  These individuals use their new skills for going back to school or for a different job. He also has opened up the wide world of reading for many people who thought they had to give up this pastime.  His youngest client was 7 years old and his oldest one was 92.  “A lot of my clients are students, and there are others who have lost jobs because of an injury or health issue. Assistive technology training helps them remain competitive in the marketplace.”

The importance of a positive attitude

Dave knows it can be a challenge when a person loses part or all of his or her vision.  He recounts, “When I was losing my sight, I was concentrating on what I couldn’t do anymore, not on what I could do.  A skiing experience at the Colorado Ski School for the Blind for a week in Vail, Colorado, totally changed my outlook. I was able to do something very challenging. If I could do that, then I knew that I could push myself to do new things.  I realized that there’s a lot I haven’t done yet and that I still want to do.”

In addition to his computer training background, Dave brings another important skill to the work that he does—listening.  “I listen to each person’s story and I ask questions to help him or her determine the kind of training needed.  I think people are encouraged by me because they see that I have vision loss AND I have a successful business, a family and a nice home. I encourage people to focus on what they can do and build on their past experience.”

When Dave’s not helping people with vision loss

Dave’s clients might be surprised to learn that he and his wife Donna are ballroom dancers.  “It all began with five dance lessons before our daughter’s wedding. Donna and I have been dancing for almost five years now, and this year, we competed in three national dance competitions. People didn’t know I had vision loss until I walked with my dog guide around the ballroom after we competed!”

In his work, Dave has dispensed valuable advice because he understands many of the feelings that individuals with vision loss are experiencing.  “I wish more people knew about all the resources that are available, including the programs and services of the Wisconsin Council of the Blind & Visually Impaired.”

It’s a job Dave loves

Dave enjoys getting to know each person with whom he works and helping them reach their personal goals.  “The best part of my job is being able to make a difference in the lives of others.  Nothing beats that!”

Marshall Flax

Marshall Flax

Note: Marshall Flax, Certified Low Vision Therapist and Certified Orientation and Mobility Specialist at the Wisconsin Council of the Blind and Visually Impaired, is retiring this month.  We asked him to share a few reflections about the changes he has seen in the vision health field and what his work meant to him.

How it was.  How it is.  How it will be.
Retirement Reflections by Marshall Flax

After 33 years in the field of vision rehabilitation (23 of them at the Wisconsin Council of the Blind and Visually Impaired), I will retire at the end of this year. Since I started working in this field, I have seen some important changes that have affected consumers and professionals.

One of the most significant has been the evolution of certification standards for low vision therapists, orientation and mobility (O&M) specialists and vision rehabilitation therapists. This is a cause I have been working on for nearly my entire career because I strongly believe that consumers deserve to know the qualifications of the person who is working with them.

Certification is also a first step toward obtaining third party reimbursement through health care insurers for the services we provide, something that just about everyone who is on Medicare would appreciate. I continue to volunteer with the Academy for Certification for Vision Rehabilitation and Education Professionals (ACVREP) to improve the certification process.

Another change I have witnessed is the broader inclusion of people with low vision into the world of services for those who are blind. In the United States, approximately 75 per cent of people who are legally blind have some usable vision. When I was hired in 1992, the organization was The Wisconsin Council of the Blind. It took many years of lobbying for the name to be changed so that it more accurately reflected the population we serve.

For the Council itself, there has been quite a bit of change. In 1992, the staff consisted of the Executive Secretary Jack Malin, Store Manager Pat Burmeister, part-time office staff Ann Schroeder and Caryl Sloane, and me. Now, we have an Executive Director and 15 full and part-time staff. The growth in staff and services necessitated selling the building on West Main Street and moving to the current location on Williamson Street.

What started as a small “Low Vision Day” event at the Council office in the mid-90s grew to become a significant opportunity for people with vision impairment to see and compare many of the newest and latest products all under one roof. Educational seminars were later added and a partnership with the UW-Madison Department of Ophthalmology & Visual Sciences helped the program grow until it attracted more than 900 attendees. Our symposium on macular degeneration (and this year, diabetic eye disease) continues to be our biggest public educational event.

Providing low vision rehabilitation and orientation and mobility services has been a rewarding career. Generally speaking, most of us are capable of making the necessary changes when confronted with disability.  What makes the process faster and, hopefully easier, is working with a skilled and compassionate professional.  I’m glad that I had the opportunity to help others and to do it in a community-based, non-profit organization.

Best wishes to the Council for a productive future that continues to enhance the lives of people who live with vision impairment!

By Erin Schambureck

Note: Erin Schambureck is an Assistant Professor of Interior Design at Texas Tech University.  A member of the McPherson Eye Research Institute, she has worked with Marshall Flax at the Wisconsin Council of the Blind & Visually Impaired and Dr. Barbara Blodi at the UW Hospital’s Eye Services Clinic as part of her research on improving design practices for low vision. 

We asked Erin to write about her research for this blog.  Here is Part 2 of her two-part series.

Last week, I wrote about lighting and some of the ways it can negatively impact your perception. Glare and unpredictable lighting patterns can hinder your ability to navigate a space, especially if it is unfamiliar to you. As I mentioned previously, my low vision design research suggests that there are four major causes of visual discomfort in building environments: luminance contrast, luminance placement, color contrast, and object location.  I’ll address the last two in this entry.

Color contrast

Color contrast, or more specifically, value contrast is what allows us to distinguish an object from its neighbor. It is measured in a greyscale value from light to dark. Lighter values reflect more light towards the eye, while darker colors absorb the light. The contrast between these values allows us to distinguish the edges of an object or obstacle. Color (hue) is not as important a factor in distinguishing objects as their relative value is. For example, a red and blue object may seem very different colors, but with impaired vision, they may seem very similar if they are both very dark values or light pastels.

Signage Colors

Signage Colors

Our brain uses contrast cues in the environment to identify tasks and obstacles. Typically, more contrast is better.  A dark sign on a light wall makes it easier to identify where the sign is and allow a low vision person to move toward it more confidently. White letters on the dark sign offer reverse contrast which reduces reflected glare and makes the lettering easier to read for most users.

Wayfinding

Wayfinding

Contrast can make environments safer. Using a contrasting edge at ALL stair treads makes them safer to navigate in an emergency. A monochromatic stair with no special edge band blends into one dangerous obstacle for those with vision loss. The same is true for other, less dangerous, interior spaces. A neutral lobby or office with no distinguishing colors or features does not offer any clues as to the location of the reception desk for someone trying to move through it.

Object location

Inconsistent building and furniture layouts are the last major obstacles to low vision persons in public places. As we move through space, humans create cognitive maps that help us understand our relative position as we move along. We note architectural landmarks, signs, people, and furnishings. If your ability to note these features is impaired, it is harder to create this mental map and easier to become disoriented. Buildings with irregular shapes, curving hallways or inconsistent layouts from floor to floor are hard to navigate. Bathrooms that alternate between men’s and women’s on each floor are prime opportunities for embarrassment. Also consider whether the pertinent information or feature is in a location where a low vision user can reach it. Overhead wayfinding signage is inaccessible, but if high contrast signage is repeated at eye level on an adjacent wall, more people will be able to access the information.

Confusing layouts extend to furniture placement as well. Freestanding signs are easily missed and may be a hazard. It is easy for low tables and furniture to become trip hazards, especially if they are near a circulation path.

Solutions for safer navigation

Always allow for a clear path of travel, at least 36” wide for a single person, or 60” wide for two people to safely maneuver through a space. Use consistent furniture layouts with materials that contrast with their surroundings to create a low vision friendly space.

Erin Schambureck

Erin Schambureck

 

Erin Schambureck is an Assistant Professor of Interior Design at Texas Tech University.  A member of the McPherson Eye Research Institute, she has worked with Marshall Flax at the Wisconsin Council of the Blind & Visually Impaired and Dr. Barbara Blodi at the UW Hospital’s Eye Services Clinic as part of her research on improving design practices for low vision. 

We asked Erin to write about her research for this blog.  Here is Part 1.

About four years ago, I had the opportunity to work with a colleague, an optometrist and a low vision specialist, as we tried to remodel his vision clinic to meet the needs of the patients he saw struggling in this space every day.

As his interior designer, I found that there is not a lot of good design guidance available for building managers, employees and users to draw upon when developing spaces with visually impaired users in mind. We did our best to make recommendations based on what we knew.

Shortly after this, I had the opportunity to join the Low Vision Design Committee of the National Institute of Building Sciences. This group is currently working on developing “Design Guidelines for the Visual Environment.” With input from doctors, low vision users, designers, lighting engineers, and architects, we are well on our way to making recommendations that can have significant impact for millions of people living with vision loss.  You can find a draft of the guidelines on their website:http://www.nibs.org/?page=lvdc

When I returned to graduate school at the University of Wisconsin-Madison, I wanted to more broadly identify the major design problems that inhibit a low vision person’s ability to navigate public spaces. My research identified four major problem areas. The first two that I’ll address in this post are luminance contrast and luminance placement. Luminance is a fancy way of saying the amount of light entering the eye. You probably are not surprised to find that lighting is a major problem source. It’s everywhere, except where you need it!

Luminance contrast is the ratio of the brightest part of our field of view compared to the dimmer, adjacent surroundings. Our eye adapts to the brightest spot in our field of vision.  It can take seven minutes or more for the pupil to fully adjust from a bright exterior to a dimly-lit elevator lobby.  Most buildings could account for this by providing seating near the door, or vestibules with adjustable lighting to ease the transition between varying light zones.  An elevator lobby is especially important for this task. If your eyes haven’t adjusted and the doors close, it’s difficult to find the right button.

Lighting contrast can also exist within a room. If accent lighting is adjusted poorly, it can scatter in the eye and cause glare. A large window can also become the brightest spot in the room and make it difficult to distinguish anything else. Shading the source from view and raising the ambient light level is the best way to counteract this.

Silhouette Glare

Silhouette Glare

The second most common lighting problem is poor luminance (lighting) placement. Poorly-planned lighting can create a pattern of light and shadow down a corridor. If the light is behind you in the hallway, your shadow may obscure signage as you lean in close to read. A good lighting plan developed by a lighting designer addresses three kinds of light: ambient, task, and accent.

Ambient light is the general room light. This is usually best if it is directed up at the ceiling and allowed to reflect downward in a diffused pattern. Harsh down-lights can cause more shadows and glare. Task light brings the light close to the source and provides adjustable light where needed. Accent lighting can help identify places and features to help us understand where we are in the building. A reception desk usually has extra lighting so we can head toward the bright spot in the field of vision and find information there. Accenting a feature wall or circulation node can also help us remember a place better so we can identify it, even if obscured, when we’re navigating unfamiliar buildings.

Robin's Nest Accent Lighting

Robin’s Nest Accent Lighting

Appropriate light contrast and placement can enhance the visual environment for sighted and low vision users alike. If you’re looking for more information on good lighting practices, check out the Low Vision Design Committee’s Guidelines as well as the Illuminating Engineering Society’s ANSI RP-28-07 “Lighting and the Visual Environment for Senior Living.” This is a great document that addresses large residential spaces. The Center of Design for an Aging Society also features many low vision friendly recommendations on their website–http://www.centerofdesign.org/index.html

If lighting is not your thing, check out part two of this blog series where I will share the other two major factors that affect visual perception: color contrast and object location. If you’re into signage and wayfinding, stay tuned!

      

 

Chad and Laura

Chad and Laura

Editor’s note: in previous blog posts, Chad Nelson reflected on getting Laura, a dog guide from the Seeing Eye in New Jersey.  Now back in Madison, we asked him to let us know how he and Laura are getting along.

On October 9, I returned home with Laura.  Training at the Seeing Eye was complete, and now it was up to Laura and me to bond and work together.

Coming home presented its own set of challenges and frustrations. First, Laura didn’t know where she was, and she didn’t know anyone except me. Even I was still sort of new in her life. The first few weeks in Madison presented a few snags that we needed to smooth out with time and patience.

The first time I took Laura for a walk in her new surroundings, she obviously didn’t know where she was going or even how she needed to get where she knew I wanted to go. She started out by wandering around in the parking lot and testing me by not doing what I asked.

The second challenge was Laura’s potty schedule. She sometimes refused to go outside. When she got back in the house, she promptly went on my carpet. Needless to say, she got in trouble.  After I worked through this with her, she hasn’t had an accident.

One of the many things a dog guide learns during training is how to approach a curb cut.  This is the ramp or street crossing. During the first few weeks, Laura didn’t identify these.  She crossed in the middle of a street, didn’t cross straight when she did find the curb cut, or she wove between cars to get to the other side of the street.

Now that I have had Laura for more than a month, things are improving tremendously.  She crosses streets at least 99.9% correctly. She has her potty schedule figured out, and she is becoming more familiar and comfortable with her surroundings.

Having a dog guide is a major blessing, but it sure isn’t stress free. The dog will test you, challenge your authority and sometimes seem to be annoying on purpose. Although I am sure that Laura isn’t trying to do this deliberately, it seems as if she likes to have her own way, go where she wants and ignore me– especially when I am running five minutes late for the bus.

Even though Laura gave me more than a few headaches and challenges after I brought her home, she is a wonderful addition to my life, and she is proving to be a very good friend.  I would never undo my decision.

If you have questions or comments about dog guides, please share them at the end of this post. I’ll do my best to answer them, and maybe other readers will offer advice and insights from their own experience.

Jo GroveRecognizing that I was losing my sight and then accepting the implications vision loss would have on my life is one of the hardest things I have ever done. It was not easy and certainly not pretty as I sobbed uncontrollably for weeks. I began to notice subtle changes in my vision in my thirties but it was only after years of denial that I had to come face to face with the fact that I was going blind.

As a registered nurse, keen eyesight is an imperative if patients are to be cared for safely, so I left nursing and a lucrative career in my early fifties. As a single mother of four, I had to work and since I had already earned an MBA, I began a new career in higher education. I loved teaching, except for the days when I had to drive around the state to recruit students. Those were terrifying days due to my vision loss, but I was afraid to let others know about my vision for fear of losing my job. To cope, I would leave home before sunrise and return from work after dusk in order to avoid bright sunlight.

Driving at night was out of the question by the late nineties. Then came the day in 2004 when I realized I could not tell the difference between the colors of stoplights.  I knew my driving days were over. By this time, I was an empty nester which also meant there was no one to drive me around. I began the ritual of “relying on the kindness of strangers” as I sought to remain independent. Friends are a wonderful blessing, and I am eternally grateful to have met so many giving friends.

I am in my early seventies now and probably more independent than ever before. With the help of agencies like the Wisconsin Council of the Blind and Visually Impaired, I learned to embrace my blindness, ask for help when needed (I used to dread asking for help) and live my life doing many of the things I enjoy. I should tell you that I am a lifelong learner and while teaching university classes online, I am also at the end of my doctoral studies and expect to earn a PhD early next year.

I guess the moral to this story is to never give up. Whenever I hear of a blind person achieving goals designed for the sighted, I am inspired to keep going, stay focused, and live life with great joy.

By Jean Kalscheur, Vision Rehabilitation Teacher Wisconsin Council of the Blind &Visually Impaired

About 37% of Americans aged 60 and over use five or more prescription drugs, not including over-the-counter medications, vitamins, or supplements.  Managing medications can be a challenge when you have low vision.

Safety and accuracy when taking pills can be improved once you learn some helpful strategies.  These range from identifying pills by color, size and shape, to using contrast color surfaces that make it easier to see pills, to setting alarms on a phone as reminders to take your medications.  Many strategies have been detailed in “Take Your Pills, Safely,” a booklet available from the Wisconsin Council of the Blind and Visually Impaired.  You can obtain a copy by calling 1-800-783-5213.

This article will describe audio devices that may improve pill-taking safety for people who have difficulty seeing written information.

You can gain confidence in managing your medications by learning about them.  This may require that you inform staff at your doctor’s office and the pharmacy that you cannot read print easily.  Insist that information be read aloud and fully explained.  Ask questions.  Be sure to understand why, how and when you are to take a pill or use an ointment.

Some pharmacies can package medications for easier use by a person with visual impairment.  Examples include filling a weekly pill box, providing large print instructions, or putting pills in blister/ bubble packaging.  These services may come with an additional cost.

Scrip Talk Reader

Scrip Talk Reader

Audio devices are helpful when you can’t see to read.  They can provide information about dosage, side effects and special instructions.  Several national pharmacies, including Wal-Mart and CVS, and some independent pharmacies use an audio prescription label called ScripTalk™.  The pharmacy uses software to input audio information onto a smart label placed in the prescription container.  As a customer, you need to have a ScripTalk™ Reader at home.  When the prescription container is placed on the Reader, the recorded information is heard.

talkingrx

Talking RX

If the pharmacy doesn’t use audio labeling, you can find talking devices and record your own information.  Talking Rx® is one example of a digital memo recorder in which a pill bottle sits.  Pressing a button on the base starts the recording.  You can record up to 60 seconds of information.

Information can also be recorded onto a re-usable self-adhesive voice label that can be attached to a wide variety of items, including medicine containers.  When the player/pen touches the voice label, the recorded information is played.  An example of this adaptive device is PenFriend.

PenFriend

PenFriend

If you have low vision and need strategies to improve safety and accuracy when taking pills, a vision rehabilitation specialist can guide you in finding options.  To locate the vision rehabilitation specialist in your county, contact the Office for the Blind and Visually Impaired at 1-888-879-0017.

After staying at the Seeing Eye for two weeks, getting to know and working with my new guide dog Laura, and having lots of fun and laughs with the instructor and other students, it was time to think about “real world” travel scenarios.

After the first week, when students and new dogs, along with their instructors, traveled a route in Morristown to work with the dog, and become familiar with each other, things changed. Once the “solo” (where the dog and handler work a route without instructor intervention) was complete, it was time to do what is known as “freelance work.”

Freelance is a fun time because if there is something I want to do, or a place I want to go, we will do it if it is reasonable.   I traveled to Wal-Mart to buy a Blue Tooth headset for my phone, and to a drugstore to pick up something for the instructor.  We even walked through the Morris County Courthouse. This courthouse is very old and it has a maze-like atmosphere, with lots of twists and turns, stairways, and a lot of people in the halls as they go about their business or attend court hearings.

Laura and I also took the bus from Morristown to Summerset where we took the light rail back into Morristown. The bus was no big thing since I ride one every day when I’m at home. The train, on the other hand, was a really different experience.

Near the end of our training period, I took a trip into Midtown Manhattan with my instructor and a new friend who had just received his next dog.  We wanted to walk around and experience New York City. It always sounded like a fun city with lots of quaint shops and people from all walks of life and backgrounds.

We parked at the Port Authority plaza and walked up 8th Avenue.  Along the way, we stopped in a small shop that sold t-shirts, and I bought a purple shirt that had the Empire State Building, Statue of Liberty and the New York skyline on it.

On the way back to the Port Authority, we decided to take the subway instead of walking. I had taken the subway once before when I was in New Jersey 13 years ago when I trained with Pete, my first dog.  The subway is a totally unique experience if you haven’t ridden one before. Being underground, the trains are very loud and they move at high speed.

New York was really fun to visit.  It’s great to work a dog in the city because he or she will weave around people and things on the sidewalk.

All in all, the experience at the Seeing Eye was very rewarding.  This time around, it was a much more pleasant experience than my first time, when I was dealing with some personal issues.

If you have ever thought about getting a dog guide, I think the Seeing Eye is one of the very best places to go. The staff is very helpful and friendly. By the end of the training, it feels like you are leaving behind some wonderful old friends.

If for any reason I wouldn’t get another dog, I will always have very fond memories and a deep respect and love for the Seeing Eye and its entire staff.

 

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