Tips for Living with Low Vision

BrightFocus Foundation
"Tips for Living with Low Vision"
Transcript of Teleconference with Mary Jo McGuire, M.D., Ph.D.
July 29, 2015
1:00 – 2:00 p.m. EDT

Please note: This chat has been edited for clarity and brevity.

GUY EAKIN: Hello, everyone, and welcome to our monthly BrightFocus Chat, presented by the BrightFocus Foundation (BFF). My name is Guy Eakin; I’m the Vice President for Scientific Affairs at BrightFocus. It’s been a busy week at BrightFocus: we just announced this week, if you are on our list, $11 million in new grants for Alzheimer’s disease, macular degeneration, and glaucoma.

Of course, the subject for today is talking about macular degeneration and practices that we can have at home and help that we can get from occupational therapists. So our speaker today is Mary Jo McGuire, who is a registered licensed occupational therapist and is in private practice and specializes in working with people who have low vision. Mary Jo, thank you so much for joining us from Ohio today.

MARY JO MCGUIRE: Well it’s a pleasure. Thank you so much for inviting me, Guy.

GUY EAKIN: Before we get in to the call, I want to remind people on the call that if you have a question that you would like to ask Mary Jo at any time you can press *3 and you can submit your question to an operator. And if for any reason you are disconnected from the call, there is a number to call back in. That number is 877-229-8493, and you will be asked to punch in an ID code of 112435.

So, Mary Jo, as you already know, we host these chats on a monthly basis, and because they focus on macular degeneration and low vision, we frequently hear from ophthalmologists and retinal specialists who focus on clinical topics. So we are excited to shift gears a little bit today and talk about living life with low vision to the fullest. Maybe before we start, I’d like to ask you to give some background on what occupational therapy is, or OTs and the role that they are playing in a treatment plan, and any view that you may have of what occupational therapists can offer to people living with low vision.

MARY JO MCGUIRE: Thanks Guy, I’d love to. As a matter of fact, I’ve been asked to describe what OT is for over 40 years. I’ve been a therapist for almost 40 years, and throughout that time it used to be people had never heard of occupational therapy. But now I hear people going, “Oh, my cousin or my granddaughter.” People have heard a little bit about it, but still aren’t quite sure who we are or what we do.

First off, we are medical health care professionals. So, when you think about therapy, there are three skilled services from Medicare’s point of view that they will pay for: physical, occupational, and speech language pathology. And so, PT and OT, people often ask the difference there, and I’m not going to get into that. I’m going to focus on OT and low vision today. The therapists are educated as entry-level masters’ or as entry-level doctorates, so people come out with masters’ or doctorates in occupational therapy and their background is in health sciences, anatomy, physiology, all the pathologies, what can go wrong with the body, what goes wrong with the eye, from the eye down to the GI system, the neurological system. So, we study the health of the body and we also study the health of the mind. , Occupational therapists have been trained in psychology and sociology, and study the impacts of disease and disease processes on the human mind. And, in particular, on the ability of the individual then to do things.

So, when we say “occupation,” it’s not work, it’s not vocational rehabilitation; “occupation” from the OT’s point of view is everything a person does, from getting out of bed in the morning to finding the toothpaste and toothbrush to getting dressed, and then walking the dog and taking out the garbage, and—if they work—all of their work roles. It’s a very broad field, and it goes across a lifespan.

My work is primarily with older adults—and actually with brain injured clients, too, but we are going to talk today on primarily the older adults with low vision and what an OT does when they come into their life. That’s what I’m most excited about in being able to have this opportunity to share a little bit, because many times ophthalmologists and optometrists and retinal specialists really don’t know about OT, whereas Medicare says it’s a benefit for someone with macular degeneration. If the doctor doesn’t know about us, then the individual doesn’t receive the services.

GUY EAKIN: That’s an interesting point and you mentioned Medicare as one insurance provider that covers it, and I think people would be interested in knowing whether other insurances typically cover OT. But there is another question of any referrals needed, and if your doctor isn’t aware of services that provide it, that’s something that you would like to explore. How do you go about finding the services of an OT and getting the necessary trail in order to make sure that you can be covered by your insurance?

MARY JO MCGUIRE: Well, first, if we talk about insurance, most of the major insurance companies go along with Medicare, and so occupational therapy is covered in all the major insurance companies. Folks can check, but typically people will have 20–40 occupational therapy visits covered. Sometimes it depends on the insurance, whether or not it’s at 80 percent. For us, we can go into the people’s homes and have it covered at 100 percent, and if you’re in the Medicare Advantage program, quite often it’s a benefit sitting there that people don’t know about.

And so, I think at this point I would love to talk about what would an OT do, what benefit OT has. So, when I go to do an occupational therapy evaluation for a low vision client, my big question is: How has this impacted your life? And it’s an overwhelming question for some people who are very early on. But, by the time I get in, it’s, “My life has totally changed, I can’t do this I can’t do that, I can’t do XYZ, or this is more difficult, or whatever.” And I take very careful notes about what the concern is.

It may not be that the person can’t do something. They can get dressed, but whether finding the right pairs of socks in the laundry or being able to make sure you are buttoned right or getting the jewelry on right, for some people that’s a concern. For other people, it’s, “I can’t read the newspaper and an important part of life is reading the obituaries.” To be honest, this is a stage of life over 60 years old, where we don’t want to miss something important like someone passing. That can be a concern. Or, “I can’t adjust the thermostat, I even put the big letters or big numbers on it, and I can’t do that.” My approach is not to come in with a checklist: can you do this, can you do that? I have a low-vision questionnaire that I go through that kind of covers typical things that people have problems with, but I’m most interested in hearing from the individual’s point of view, how low vision has impacted their ability to participate in life. Then we get into equipment and strategies, etc., related to those specific occupations.

GUY EAKIN: Well, Mary Jo, I really love your philosophy about how an OT can help increase enjoyment by making a few course corrections and how a person approaches their day, and before the talk we were having a conversation about the intersection between our vision and our mind, and you had a couple of observations about how people enjoy their life in the context of mental health as it relates to vision. I wonder if you mind sharing that with the audience.

MARY JO MCGUIRE: Oh sure Guy, thank you. As I was thinking about the clients I have served, one of the things that I feel has been really valuable to help relieve them in a way is to talk about how vision, visual impairment, impacts our memory. When you think—this is a very important thing, because once you start losing your eyes, if you’re forgetting things, you feel like, “Oh my gosh, I’m really falling apart, now is there some dementia, and what’s happening to me?”

The reality is that our memory is—we encode information through our senses and then we can remember it. When someone’s vision is impaired, you can imagine the brain is not getting as much information as it used to. So they’re working with less encoded information, so it causes people not to remember things, because they didn’t see it. If someone shows them something and is talking about it, perhaps they’re only picking up a part of what is being seen so they are depending more on what they hear.

And actually, that’s a strategy that I will put out there for folks, too: that’s to make sure that if someone is trying to show and tell you something and you’re not seeing it as well as you would like, to have it described in a little more in detail or to even talk about it so you give yourself an extra auditory cue. So that was Thursday, August 4th, for instance, so you say it out loud and that helps your brain to remember, even though someone is showing it to you. So the decrease in vision causes a decrease in encoding the information.

The second thing with the folks I serve who are going through this change in vision is there’s a lot more on your plate to remember. Memory has been described as a stove top with six burners, and you know when you were in your 30s you could go on vacation and take everything off the burners and everything was great, you could remember everything that was put on. But at this point in life, now there’s a disease process, and now you’ve got all this other information that you have to keep in your working memory. For instance, what’s your doctor’s name, what’s the name of the medication you’re taking, when do you take it, how much do you take, where’s your medication stored, and your listeners can probably tell you where their medications are stored and where’s their doctor’s office, how do you get there, what’s the name of the nurse or receptionist there, when’s their next visit. I do this, just listening to these questions.

All that information is now on your fingertips, that’s in working memory and that’s important information. Well, guess what? It takes up a burner. So it’s not that you’re having necessarily dementia going on. You really do have less working memory power because you’re holding on to significant information. And the last thing I would say is that—you may not even know this—the most common strategy for remembering things is writing things down. Folks with macular degeneration—and especially as it goes on and other eye disease too—writing things down is not a good strategy anymore, because it’s hard to write it, it’s hard to read it, you only put fewer words and you can’t even understand what you meant, it’s so frustrating. The key strategy that you have used all your life to remember something is now sort of being removed so without getting—I’m not getting into a lot of details—there are other strategies now that need to be used to remember things. So I just hope that this will help perhaps some of the listeners who may be feeling like, “My eyes, and now I can’t remember”—no, no be careful, your memory might be fine, it’s just that you’re not encoding it well enough or you are not using the other strategies to help you remember.

GUY EAKIN: Well I think that’s a wonderful description of that intersection between memory and vision, which is so important to us at the BrightFocus Foundation. I think the most important thing is that you talked about the overarching problems—you got into a few of the tactical things that people can do, queuing up auditory clues to help memory—but I think one of the more important things we can do today is get down to the brass tacks in making suggestions to help people make the most of their remaining vision and help ensure that they are able to do some of the things that they love: reading, playing cards. You have a whole arsenal of equipment and you have a whole arsenal of personal strategies. What are the things that a client most commonly comes to you and says, “I’m having trouble doing this in my life,” and would you give some examples of the type of suggestions that an OT might provide and things that people might try at home?

MARY JO MCGUIRE: Certainly. The first two that probably come to my mind when I come into a home—and that haven’t been adjusted—are the washer and the dryer and the thermostat. When we talk about what the OT does, we look at three things: the lighting, the size of what you are looking at, and contrast. Those are the three key things that we will come in and try to adjust. So on the washer and dryer, most people will say, “well this is the setting I usually use,” so we will go in and make sure that we either put on a bright orange fluorescent dot or a bump, a colored bump, or I may use big, bright fluorescent arrows to point to a couple different settings and then to add light. Even though there is light on and you may think the light is bright enough, when we add very specific task lighting, it can just pop those colors or pop those dots, and then suddenly turning the washer or dryer on is just not a problem anymore.

That’s, I think, the joy of working with folks with low vision. When we find the activity that’s the problem, we become bulldogs in trying to figure out how to make this easier for you. So Lowe’s has—I have no stock in Lowe’s—a variety of different types of light, and they have the little pop up lights with LED lights. And you have to be careful, because some of them will only have 3 LED and some of them will have 5. I had one client who had arthritis who couldn’t push the light, and so we went to a different type of light that actually had a motion sensor in it so she didn’t even have to turn it on, and we had it spotted right on the dials of the washer so that if she put her hand back the light went on so she could dial it. So, it’s tiny little things like that that can make a big difference, and make you not frustrated with a vision loss because you’re using your other senses. The other one that I would add—this one was really helpful for one client—is that baseball cap with LED lights—have you seen those Guy?

GUY EAKIN: I own one.

MARY JO MCGUIRE: Do you?

GUY EAKIN: My kids gave it to me for camping, but let me hear where you find them, because I have no idea where they got it.

MARY JO MCGUIRE: Well, you know what, you can find them online. So, if you Google there’s a lot of different stores that would have them. If you just Google “baseball cap with LED lights,” there’s a variety of types of them out there now. Actually, the one I purchased for a client was at Lowe’s. And so, the baseball cap, some of them have several—they have a variety of types out there now, it has really taken off. A little niche industry, I think, on creating different types. I think they will either be broad beam or a narrow beam, or 2 or 1. You pinch the cap—you can’t see the light, it looks like a normal baseball cap, but it has light inside the brim—and when you pinch the brim, the light comes on. And that’s so convenient, because my clients can put that on—the one lady hangs one right next to the thermostat, because even though we have the large numbers in the rim around the old type of thermostat, she still couldn’t see it with the light on the dining room. But when she put the baseball cap on, she had no problem with the thermostat anymore.

GUY EAKIN: I can tell you it’s absolutely what you’re describing. It looks like a baseball cap, but there’s just a little hidden button in that brim that you touch and suddenly everything is lit up.

We are starting to get a few questions, and a couple have been submitted before the talk that relate to light. We have Betty from Alabama and Judith from Georgia asking two questions about light, one saying that sometimes brighter light leads to nausea if she uses it too long, and there was a question about where is a good place to start with lighting and how do you adjust it. Is there a general rule of thumb you can give people or is it all based on personal preference?

MARY JO MCGUIRE: Well, it is preference, and it’s the specific activity. So, this is where we don’t come in and say, “Here’s the light you need.” No, show me activity you’re trying to do, show me where you’re doing it and now let’s look at what light is needed. So we really put into the context of the environment where you are doing the activity. I want to just touch on the nausea because it sounds like—and I think it was Betty that was experiencing that—your nervous system can get overwhelmed with too intense stimulation. So—and the good news is that it can be desensitized to that too. So, if the light was enabling you to do something but it was making you nauseous, obviously you decrease the amount of time that you’re doing that activity, take a break and come back to it. Don’t press forward when your body starts giving you signals, the nausea or headache or whatever or eyes being really fatigued. Be your best friend and listen to your body and take the break. Slow down, but come back to it. If you press on, you can make yourself so sick that you’re like, “I don’t want to use that light, or do that activity,” and then we withdraw from participating in life. Be sensitive to those signals and just be smart and adjust your activity to them.

GUY EAKIN: Well, thank you. Mary Jo, we’ve talked a bit about light and maybe we can return to it, but amongst the key things you had listed, lighting, size, and contrast. So, what are the tools you keep in your toolbox to help people with size?

MARY JO MCGUIRE: The good news is, I don’t work alone. So, I work with a low vision optometrist in the area who has a wonderful clinic set up with all of the video magnifiers, portable magnifiers, and she’s been a great servant in our community. She even has boxes of things that people have tried and thought they were going to work, or families have donated them from the state—there’s a huge amount to try, and so when you talk about what’s in the toolbox, there are so many tools that it’s not “this works and that works.” Again, it comes to the person, the activity, and the environment. So, handheld magnifiers with light are very nice, but not if you have a little bit of tremor. The standing magnifiers—where it sits right on top of the paper and can put bright light and have different size magnifiers—and that’s very nice if you can be at a table. It just depends on the environment for the person. Truthfully, Guy, these video magnifiers and both the desktop and the portable ones are just an amazing improvement for reading and seeing all sorts of things.

GUY EAKIN: These would be electronic magnifiers that maybe differ from just something that you would have on a modern cellphone, these are specialty magnifiers.

MARY JO MCGUIRE: So, the technology started with what we call the CCTV—the closed caption television—and basically, that was a camera and a wonderful device for seeing things. And it’s moved from that to using the technology, and today with a video to be able to have much clearer images and very adjustable. They have greatly improved the science of these desktop magnifiers, but they also now have portable ones that you can take into a store or take with you to a party or wherever you’re going so that when you want to read something you can put it up there and increase the magnification so something—because there’s bright light, you may not need as large of a magnification, so whereas if you have a magnifying glass, it is only 4x or 8x or whatever it is. When you have a portable magnifier, you can adjust the magnification according to the need of the activity and the environment

GUY EAKIN: So, Mary Jo, there are a lot of companies, and you’re describing a lot of different types of products. One of the questions we would have—what are your recommendations for getting the most out of the training to use these new tools? Sometimes these things, especially electronics, are a little tough. So if someone is suggesting a new device for me, what should I be on the lookout for? What kinds of signs should I look for that will tell me I’m getting the service I deserve in terms of the instruction time or the demonstration that they are providing?

MARY JO MCGUIRE: That’s very good, and this is where there are different types of people who do different things and the optometrist—it’s typically optometrists who specialize in low vision—who will have the largest array of equipment or a low vision clinic where they will have a variety of equipment, different types for you to look at. They often will also have facilitators or instructors that come with the clinic who have good skills in showing exactly how to do it, but they may not be therapists in being able to really monitor whether you are encoding, what are you able to remember, how can I help you remember it.

So the ideal situation is to have a clinic or a place where you can see a variety of pieces of equipment and get your basic training in, but then to be able to take it home where you are using it and to have someone come in and give you the training you need until you’ve mastered it and you can do what you want to do. So it takes a team—and I’m an occupational therapist, and unfortunately there aren’t as many available occupational therapists across the country to do this type of work as is needed—but there are a lot out there who may not have been tapped. There may be listeners who have them in their area who have the equipment, but they are not using it or they say this doesn’t work. Well, it might be especially frustrating if you feel like it worked when the person showed it to you but then when you got home it doesn’t work. And that would be a flag that you need someone to come in to help you learn according to your own skillset and preferences.

GUY EAKIN: I think we’ve all had that experience of having something that looks so easy in the salesperson’s hand, and then when we got it home and we ask, how does this work? I want to remind everyone you can briefly leave the call and ask a question to Mary Jo, our speaker today, by pressing *3, and submit a question to your operator. And if you’re disconnected from the call, you can always call back in at 877-229-8493, and you’ll be asked to punch in an ID code, and that number is 112435.

I’d like to segue into the questions that are coming in from our audience. So, if you can imagine, we have a number of questions that have either been submitted earlier by people who registered for the call or they are coming in right now, and one of the first questions is simple. Maurice from Connecticut is asking what acuity qualifies someone for low vision. So, is there a threshold at which you would be able to go and see an occupational therapist, or is that up to some amount of discretion?

MARY JO MCGUIRE: Well, actually, I did get a chance to see that question, and I had a chance to pull up the definition of levels of vision impairment that were established by the American Medical Association used for coding by all doctors, by all optometrists, ophthalmologists, and everyone. So there really are levels. Here’s what Medicare and the American Medical Association say: there is a moderate level of vision impairment, a severe, a profound, near total, and total blindness. So the moderate is best corrected visual acuity, less than 20/60. So if your vision is better than 20/60, then that would be mild vision impairment. It would not mean you didn’t qualify for services, for occupational therapy services—there again, most of my clients don’t come with just one diagnosis, so there may be arthritis that a therapist may be able to deal with—but moderate is 20/60. Severe, which is considered legal blindness, is when the best corrected visual acuity is less than 20/160 or the visual field is 20 degrees or less. That is legally blind. And then profound or moderate blindness is 20/400 or worse, severe blindness is 20/1000, and no light perception is considered total blindness.

That was a lot of words that I guess the takeaway is that 20/60 and over is considered a moderate visual impairment that would qualify for services.

GUY EAKIN: Well thank you, and I hope that was helpful to Maurice. We have Ms. Middleton from New Jersey asking for people who have severe vision loss, and maybe are completely blind—are there any general tips that you suggest for someone coming in that might have lost a substantial amount of vision, and how would you treat them differently from someone who might be in the more moderate—although you know certainly problematic, but more moderate?

MARY JO MCGUIRE: Well, I guess that the real issue for me and working with someone is, was this just gradual loss or was this quick instantaneous loss? And when it’s a gradual loss, the brain adapts. It’s not easy, doesn’t really make it a whole lot easier, and in some ways it drags out a loss that can make it difficult for a person. But when somebody experiences a big drop in vision suddenly, they are probably at more risk of falls than someone who has been coming down hill and has been learning to cope on their own in a way.

Someone with a quick drop, I would be more concerned for their safety when looking at risk and helping them to be aware where things could be dangerous. Whether its total blindness or a moderate impairment from the OT point of view, you know, I want to sit down at your kitchen table and say, “Let’s talk about where does the rubber hit the rug, where is this causing you the most problems?” Maybe it is, “I can’t find the shampoo in the shower,” or “I can’t remember if I used shampoo, I keep washing my hair three times in the shower,” or whatever it is. So the degree of impairment doesn’t guide me quite as much, Guy, as does the person’s preference and how it’s impacting them.

GUY EAKIN: It looks like we have a question. We have a listener, Carmen from Florida, asking about the devices we were talking about earlier, and asking about the insurance coverage, whether or not they might be covered by insurance or Medicare. And of course, earlier in the interview we were talking about your service in terms of coverage, what about the devices themselves?

MARY JO MCGUIRE: Unfortunately, Medicare and most of the Medicaid programs, most of the Medicare Advantage programs, do not cover the cost of the equipment. That said, there is one for folks who are on waiver programs in the state—that would be somebody who is on Medicaid—anyone who is on Medicaid can contact their state agency and ask to have their…sort of like an entitlement counseling session. It’s like, what am I entitled to with these problems? It may be that with low vision you are entitled to a waiver program that has been set up by many of the states, and the waiver program will cover the costs. This is for Medicaid clients who qualify for waiver programs; the waiver programs will even cover the desktop monitors for the clients, the video monitors for clients. Of course, there is also—there are other agencies in the area, too, depending on your local community: the Lions Club and different churches may have different funds. We’ve had churches donate so that we can purchase these supplies because, unfortunately, the government can’t handle it.

GUY EAKIN: Well, thank you. So, let’s move on to a question from Charlene from California, who is 90 years old and depends on the Internet to stay connected to her family and to learn about current happenings in the world. Unfortunately, her eyesight is declining, and she’s asking about software devices that might help specifically with computer and Internet usage, and might add in—are your recommendations different for the Internet we access through tablets or phones, as well as desktop computers? How do you help people stay connected with the Internet world?

MARY JO MCGUIRE: Right, right and there are a couple of things I would love to say to that. The technology has been changing so rapidly from the CCTV to these wonderful video magnifiers, now we have the Internet and apps, applications, for the tablets and computers that are beginning to deal with low vision. So for Charlene, first congratulations on being 90 and enjoying the Internet, and I really hope that we will get somebody in your area to help you stay connected through that. There is a device too  called Chromecast that can enable folks on the Internet to connect their computer or tablet to a large screen TV, so that turns everything that’s on your computer into big screen where you can increase font size, increase the size of whatever you’re seeing. That would be one.

GUY EAKIN: That product name, I didn’t quite catch that.

MARY JO MCGUIRE: It’s Chromecast. It’s a device that you plug into the television, and if you have a computer that’s on Wi-Fi you connect the Wi-Fi to the television set. It connects through Chromecast, so it’s not the kind that will do whatever is on your screen; it has to be Internet connected. It sounds like that’s what Charlene wants, or it might be a device worth looking into. The other—and I really want to make sure I get this out for your listeners—there are two other things that are relatively new and someone else has asked about these. Spotlight Text. Are you familiar with that one Guy?

GUY EAKIN: No I’m not.

MARY JO MCGUIRE: Oh my, Charlene you will have to Google this, and everyone else on the line. Spotlight Text. That’s the name of the app. It’s only for Apple, so you would have to have an iPad or an Apple computer for this, but it is the first eBook reader specifically for individuals with vision loss. It’s amazing. They have over a quarter million books on something called Book Share, and this enables you to have an eBook reader where the text can be blown up to about any size you want. And again, this can be connected to the television and it can be as large as you want it. It has two interesting things. They have what they call “dynamic text presentation,” and so it has two modes on this, one is a teleprompter mode and one is the marquee mode, and you can change the speed. So in teleprompter mode, you keep your eyes in one spot to go across the page and the information moves up, so it will move up as quickly as you can read so that you don’t have to be moving and then losing track of where you are. It also has a marquee mode, where the entire text would just go across the screen in one line so that you keep your eyes on one spot on the screen and the information moves across in front of you and you can have it do that. Again, you can choose the size of the font and you can have it move as slowly or quickly as you want.

And I have not had anyone try this yet, but I’m very excited about someone who may have macular degeneration to the point that they are using their eccentric viewing or that PRL (preferred retinal area)—that if there is one area on your retina that you can kind of use, you can put the teleprompter in that spot and the information can go across in that spot, and honestly our brains are amazing, and it can learn to read.

GUY EAKIN: That’s a wonderful and hopeful message. Unfortunately, we have to end things, but you threw out a few words there, you threw out this Chromecast and Spotlight Text. We will make sure those get into the transcript so that anybody, if you missed it, give us a week or so to get the transcript together and we will make that available on our own website, and we will also make it available if anybody would like to call in.

But, Mary Jo, I think that’s about as much time as we have for today. I want to thank you so much for taking the time to speak to us and thank you to everybody who joined the call and those of you who asked questions. Give us a week and we will get that recording and the transcript of the call up on our website. We will also get the downloadable version, the iTunes and SoundCloud, and—of course you can always call us for anything—but you can call us at 1-800-437-2423 to order a print transcript, just give us a little bit of time to get that transcript transcribed.

So our next chat will be, “I Have AMD, Now What?” and we are going to encourage you to register and submit questions in advance, and we will be sending anyone who registered for today’s call, we’ll be sending you a reminder email. If you would like to register for that August chat right now, and also request free materials from BrightFocus such as a Macular Degeneration: Essential Facts brochure, you can stay on the line right after the call concludes and leave a message, or you can call BrightFocus at 1-800-437-2423. You can always find these free sources on our brand new website, which is brightfocus.org. So, Mary Jo McGuire, thank you again for sharing, you’ve covered so much—

MARY JO MCGUIRE: My pleasure.

GUY EAKIN: —there are a lot of people out there who are walking away with some of the answers they have been looking for. Thank you to everyone for calling in today. If you’d like to leave a comment after the call, just stay on the line, and thank you from all of us at BrightFocus.

MARY JO MCGUIRE: Thank you, Guy.

The information provided in this transcription is a public service of BrightFocus Foundation and is not intended to constitute medical advice. Please consult your physician for personalized medical, dietary, and/or exercise advice. Any medications or supplements should be taken only under medical supervision. BrightFocus Foundation does not endorse any medical products or therapies.

If you have difficulty locating any of the resources listed below, please call our Donor Services department at 1-800-437-2423.

• BrightFocus Foundation, 1-800-437-2423, or visit us at brightfocus.org
• Common Treatments for Macular Degeneration
• Macular Degeneration: Essential Facts
• Macular Degeneration Treatments Fact Sheet
• Macular Degeneration: Frequently Asked Questions
• BrightFocus Foundation: Alzheimer’s Resources
• Spotlight Text (only for Apple users)
• Chromecast
• Closed Captioned TV
• LED hat
• Pop-up LED lights to highlight common settings on appliances, such as washing machines