This easy-to-search resource can help you learn about new ways to address eye health issues and replicate eye health-related projects in your community. Visit the Healthy Vision Community Programs Database.
The National Eye Health Education Program is coordinated by the National Eye Institute, National Institutes of Health, U.S. Department of Health and Human Services. This administrative document may be reprinted without permission.
In This Issue:
As a term of the trade, “low vision” refers to visual impairment that is not corrected by standard eyeglasses, contact lenses, medication, or surgery. As one who believes that simple descriptive terminology facilitates communication in healthcare settings, I have no qualms about the term, “low vision.” As healthcare and community professionals, however, it is critical that we be cognizant of the effect that low vision can have on someone and the anguish that can come from difficulties with performing everyday activities such as reading, writing, and getting around independently.
While vision that is lost usually cannot be restored, eye care professionals can help people make the most of the vision they do have and continue to pursue activities that are important in their lives. Many people with low vision can benefit from devices and services that help them keep their independence. A story in this issue of Outlook highlights 90-year-old Ruth Lotz, an award-winning artist who was diagnosed eight years ago with age-related macular degeneration and continues to actively pursue her passion for painting. The story also illustrates how a combination of personal determination, innovative technology, and professional intervention can make a difference in people’s lives.
The NEHEP Low Vision Education Program is designed to promote awareness of vision rehabilitation services. The program website includes a variety of resources and several video testimonials about how devices and services have helped individuals with low vision continue to live independently.
The Low Vision Module of the NEHEP See Well for a Lifetime Toolkit is another resource that health and community professionals can use to educate the public about low vision, how it is diagnosed, and the options available to help people continue living their lives. The module includes a handout, Tips for Talking to Your Eye Care Professional, to help people make the most out of the time they spend with their eye care providers. I encourage you to take a look at all of the resources available from NEHEP. I hope they prove useful in your communities, and as always, we welcome your feedback on how to enhance the value of NEHEP materials.
I would also like to offer my sincere thanks to everyone who participated in efforts to support Healthy Vision Month in May. Some of the achievements of the 2011 observance of Healthy Vision Month are summarized in a companion article in this issue of Outlook. Of course, we all want the importance of eye health to be recognized year-round and all of us on the NEHEP Planning Committee will continue to look for opportunities to advance this goal. Please keep in touch with your ideas and news of successful efforts in your community.
Anne Louise Coleman, M.D., Ph.D.
Chair, National Eye Health Education Program Planning Committee
Frances and Ray Stark Professor of Ophthalmology
Jules Stein Eye Institute
David Geffen School of Medicine at UCLA
Professor of Epidemiology
UCLA School of Public Health
The National Eye Health Education Program (NEHEP) won four Plain Language/Clear Communication Awards on May 17 for producing clear and concise health education materials. These prestigious awards are given to recognize communication/health education products for the scientific community, patients, and the public that show exemplary use of plain language principles.
The awards, sponsored by the National Institutes of Health (NIH), are part of a larger, government-wide clear communication initiative. NIH hosts the awards ceremony each year to recognize outstanding efforts to produce easy-to-understand scientific fact sheets, newsletters, periodicals, radio and video features, web materials, graphic images, animations, and more.
The following NEHEP products won awards:
Information for Healthy Vision Website
This website provides the public with information about common vision problems and eye diseases and provides tips on keeping the eyes healthy.
A Comprehensive Dilated Eye Exam Vodcast
This video describes the importance of getting a comprehensive dilated eye exam to detect eye diseases and disorders.
Healthy Eyes Bulletin
This bulletin provides information on dilated eye exams and financial assistance available for eye care, and tips for keeping the eyes healthy and on how to find an eye care professional.
Tips for Working With Media To Promote Eye Health Programs and Events
This media guide helps community-based organizations work with print and broadcast professionals to promote their eye health education programs and events.
To learn more about plain language, visit http://www.plainlanguage.gov.
Social media is an important vehicle for sharing health information. Follow and “Like” the National Eye Health Education Program (NEHEP) on Twitter and Facebook to stay informed about eye health education activities and learn about resources that can help your efforts in promoting eye health. Share with us what you are doing, as well!
Watch and share new eye health education videos on YouTube. Dr. Rachel Bishop of the National Eye Institute discusses comprehensive dilated eye exams, age-related macular degeneration, cataract, diabetic eye disease, dry eye, and glaucoma. Consider linking to these videos from your website, share them through your social media outlets, or send links to these videos to family, friends, and colleagues.
Download the Healthy Eyes Widget on your website! Post this interactive widget to keep visitors up-to-date on relevant eye health information and resources. The widget includes a series of regularly updated questions and answers designed to raise awareness about the importance of healthy vision.
For more information about NEHEP and to find additional educational resources, visit http://www.nei.nih.gov/nehep.
For eight years, the National Eye Institute (NEI) Healthy Vision Community Awards (HVCA) Program has provided funding to more than 350 community-based programs nationwide. In lieu of accepting HVCA applications for 2012, NEI will be conducting an HVCA program-wide evaluation. This effort will assess aspects of the program, from the application process through final reporting after project implementation. NEI is especially interested in the pillars of the program—partnerships and sustainability. Answers to questions about the status of partnerships and program sustainability after the receipt of initial seed money will assist NEI staff with enhancing HVCA program effectiveness. The HVCA program will resume with a new funding cycle for 2013.
For more information on the program, visit the HVCA Website. To learn about HVCA recipient projects and other community-based eye health education activities, or to submit a project you have in your community, go to the Healthy Vision Community Programs Database.
If you’re in New York City walking around 42nd Street and 7th and 8th Avenues, take a look up at the CBS Super Screen and you’ll see a public service announcement (PSA) from the National Eye Institute (NEI). This 15-second spot, which runs once each hour, will be on display through the end of September. Viewed by more than 1.5 million people daily, this PSA reminds people that “Millions of Americans have undetected vision problems” and that it’s important to schedule an eye exam. The PSA directs viewers to the NEI Website for more information.
To view the PSA, visit http://www.nei.nih.gov/news/briefs/timessquare.asp.
The National Eye Health Education Program (NEHEP) gratefully acknowledges Partnership organizations that helped make Healthy Vision Month (HVM) 2011 a success. These organizations include the following:
Held each year since 2003, HVM was established to elevate vision as a health priority for the Nation. The purpose of the NEHEP Partnership is to establish ongoing, interactive, mutually beneficial relationships between the National Eye Institute (NEI) and other organizations to achieve healthy vision for everyone. Their efforts are a powerful force in giving HVM a national voice and are vital to educating communities nationwide, all year long about the importance of comprehensive dilated eye exams in detecting eye diseases and conditions and about eye safety as well. During HVM in May, NEHEP Partnership organizations collectively employed a variety of activities, listed below:
We encourage you to visit the Healthy Eyes Toolkit for a variety of free resources you can use to help raise awareness in your community all year long about the importance of comprehensive dilated eye exams. Resources include web badges and banners, drop-in articles, print public service announcements, fact sheets, downloadable stickers and bookmarks, electronic postcards, and more.
Eight years ago, Ruth Lotz was diagnosed with age-related macular degeneration. Currently age 90, she is an inspiring example of someone with low vision who makes the most of the vision she has. Ruth is an accomplished painter who considers low vision a part of her evolution as an artist. To this day, she continues to pursue her passion for expressing—and sharing—her vision on canvas. Her medium of choice is watercolor, although she has worked in oils and acrylics. Ruth uses a powerful hand magnifier to help her identify paint colors and makes use of a variety of other devices and systems that support her ability to live independently and engage in other activities of interest to her.
Ruth’s paintings have been featured in numerous exhibitions, including the Baltimore Watercolor Society 2010 Mid-Atlantic Regional Watercolor Exhibition, a highly competitive, juried show, where she received an award sponsored by the Art League, Inc., and The Terry-Fletcher Company. Ruth holds an art degree from the University of Oregon and is a member of a local Fine Arts Association and the Baltimore Watercolor Society.
From May 11 to July 8, the National Eye Institute (NEI), through its NEHEP Low Vision Education Program, sponsored an exhibit of Ruth’s work at the Clinical Center Galleries at the National Institutes of Health. This is the first in a series of work by artists with visual impairment that NEI plans to sponsor to help bring attention to how people with low vision are living life to the fullest.
The NEHEP Low Vision Education Program offers resources that can be used to provide people with information about vision rehabilitation and how they can live independently with low vision. The NEI Low Vision Website is another great resource where people can find information including frequently asked questions and how to help a loved one with low vision.
Students from the Student National Medical Association (SNMA) at Texas College of Osteopathic Medicine (TCOM), launched a new grassroots community initiative, “It Starts with Mom.” This new initiative promotes health consciousness among African American women about hypertension and the effects of untreated diabetes. The idea was conceived by Jessica Edwards, the current SNMA President, after seeing the CNN special, “Black in America,” which featured African American doctors in Chicago promoting health consciousness at local barbershops. After introducing the idea to the SNMA chapter president, the Director of Community Resources, and an Associate Dean of TCOM, the SNMA began conducting diabetes screenings in beauty shops in the area during the 2010-2011 school year. The students conducted screenings and counseled African Americans on the risks of hypertension and diabetes, including the complications associated with each.
Through its Vision Focus Initiative, the National Medical Association provided the student group with educational materials from the National Eye Health Education Program (NEHEP). These materials included the Diabetes and Healthy Eyes Toolkit and the Don’t Lose Sight of Diabetic Eye Disease brochure, which were effectively used by students when speaking to beauty shop patrons about the eye complications associated with diabetes. The SNMA students learned that most of the beauty shop patrons had no prior knowledge that uncontrolled diabetes could affect vision and lead to blindness.
The students continue to expand the screenings to additional locations and hope to make this effort a national initiative of medical students all over the United States. For more information about this project, contact Jessica Edwards at Jessica.Edwards@live.unthsc.edu.
The Centers for Disease Control and Prevention (CDC) invite you to visit Health Literacy: Accurate, Accessible and Actionable Health Information for All, the new CDC health literacy website. The site provides information and tools to improve health literacy and public health and make health information accurate, accessible, and actionable for all. The resources are for all organizations that interact and communicate with people about health, including public health departments, healthcare providers and facilities, health plans, government agencies, nonprofit, community and advocacy organizations, childcare centers and schools, the media, and health-related industries. The site features health literacy organizations by state and planning tools to implement the National Action Plan to Improve Health Literacy. The health literacy blog provides a forum for commentary and discussion of vital issues in health literacy improvement. Join CDC in implementing positive changes to improve health literacy.
If you have any questions or comments, contact Cynthia Baur at firstname.lastname@example.org or at 404–498–6411.
Lighthouse International now offers the Mult-E-Skills Vision Rehabilitation Training Program©. This new online course is designed to help healthcare professionals such as nurses, occupational therapists, physical therapists, and opticians work more effectively with adults who have low or no vision. Development of the program was made possible by a federal grant from The National Institute on Disability and Rehabilitation Research.
According to Mark G. Ackermann, President and CEO of Lighthouse International, “Building on our 35 years of experience in professional education for vision rehabilitation professionals, we are very pleased to offer this new web-based training program. Sixty one million Americans are at risk of significant vision loss.1 It is crucial that we prepare professionals to be able to deal with the profound implications vision loss will have in all aspects of our society.”
The program, which offers American Occupational Therapy Association continuing education unit credits, is made up of interactive lessons that cover the following:
The program is fully accessible to professionals who may be visually impaired, as well as those who are sighted. For more information, visit Lighthouse International at http://www.lighthouse.org/for-professionals/continuing-education.
Founded in 1905, Lighthouse International is a leading nonprofit organization dedicated to fighting vision loss through prevention, treatment, and empowerment. It achieves this through clinical and rehabilitation services, professional education, research, and advocacy. For more information about vision loss, contact Lighthouse International at 1–800–829–0500 or visit http://www.lighthouse.org.
Zhang X, MD, Saaddine JB, Lee PP, Grabowski DC, Kanjilal S, Duenas MR, Narayan KMV. Eye Care in the United States. Do We Deliver to High-Risk People Who Can Benefit Most From It? Archives of Ophthalmology. 2007;125(3):411-418.
Each year, the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO®) offers leading and innovative continuing education events for ophthalmic medical personnel. These programs provide valuable educational opportunities to ophthalmic professionals to strengthen the availability of quality patient care.
Two notable upcoming JCAHPO programs include the Technician’s Program held in conjunction with the 29th Annual Meeting of the American Society of Retina Specialists (ASRS) in Boston and the JCAHPO 39th Annual Continuing Education (ACE) Program in Orlando.
Courses at ASRS will highlight innovations in retina care and provide attendees with a chance to learn from some of the leading retina physicians and professionals. A full day of retina courses will be available on Saturday, August 20, with an additional half-day on Sunday, August 21.
The ACE Program in Orlando on October 21-24 will feature more than 200 courses and a variety of Sub-Specialty Sessions and Workshops where attendees may earn continuing education credits and receive hands-on training. The JCAHPO ACE Program, held concurrently with the Joint Meeting of the American Academy of Ophthalmology, is the largest continuing education program in the world, held exclusively for ophthalmic medical personnel. In addition to course opportunities, noted author and researcher, Mark Changizi, Ph.D., will serve as the 2011 Harold A. Stein Lecturer and discuss findings from his latest book, The Vision Revolution.
Visit http://www.jcahpo.org or http://www.asrs.org to learn more about registering and future continuing education opportunities. If you have questions or need additional information, contact Janice Prestwood at 651–731–2944 or Janice@jcahpo.org.
In response to an appeal from the U.S. Pharmacopeial Convention (USP) for comments from the public, the American Foundation for the Blind (AFB) invited constituents to share their personal experiences with medication labels. USP will use the input to guide the content, language, format, and appearance of prescription labels.
In support of the appeal, AFB gathered responses from nearly 200 respondents with vision loss from across the United States. Results show that people with vision loss find themselves unable to take prescription and over-the-counter medicines safely, effectively, and independently due to inaccessible printed drug labeling information. These findings mirror those of a similar survey AFB conducted in 2008.
The feedback provides support that the USP proposed model standards do not adequately account for the needs of people with vision loss. The respondents shared their inability to read prescription labels in the proposed standard of at least 12-point Times New Roman or 11-point Arial font. In addition, survey results showed that one solution alone cannot meet the myriad needs of people with vision loss. Rather, survey participants noted the need for both enhanced visual and nonvisual access to medication labels, depending on the individual’s personal situation.
With regard to print size, the majority of respondents requested at least 14-point font, with many requesting font sizes of 16 points or larger. Respondents also noted the need for high contrast and adequate spacing between lines of text. Many individuals, in particular those who identified themselves as having little or no usable vision, indicated the need for audio recordings with their prescription information.
The USP public comment period has now lapsed. However, AFB hopes that members of the Health Literacy and Prescription Container Labeling Advisory Panel will consider the needs of the 25 million Americans with vision loss and work to improve the accessibility and safety of prescription drug labels.
In the meantime, the AFB Senior Site has produced a number of resources to help individuals with vision loss take their prescription medicines safely and independently. A guide to medication management is available on Senior Site, as are tips on labeling medications and organizing glaucoma medication. AFB has also worked with the American Society of Consultant Pharmacists Foundation to develop guidelines for pharmacists regarding prescription drug labels.
AFB encourages everyone to advocate for changes in medication labeling to promote accessibility and safety for everyone. For additional information, contact Dr. Priscilla Rogers at email@example.com.
Macular Degeneration Partnership (MDP) clients are familiar with “the blue and the green book.” Everyone who contacts MDP receives a copy of the National Eye Institute (NEI) publications, What you should know about low vision and Age-Related Macular Degeneration: What you should know.
According to MDP Executive Director, Judi Delgado, “We have been using these excellent materials for years. In fact, they are so much a part of our program, we just refer to them by their cover colors.” To personalize the publications, MDP adds an adhesive label that contains the MDP logo and contact information.
MDP includes both What you should know publications in their own “AMD Toolkit”—a comprehensive packet of information provided to those who visit the MDP Website or call the MDP toll-free help line at 1–888–430–9898. MDP also distributes the books at health fairs, seminars, support groups, and community events. At the annual AARP Life@50+ meeting, hundreds of blue and green booklets are distributed from the “Vision Pavilion” to seniors at risk for eye disease. In addition, they are exhibited at optometry meetings and other professional gatherings, like the recent American Society on Aging conference.
“We value our relationship with NEI and the availability of these educational materials,” says Delgado. “They broaden the information we distribute and really extend the reach of our organization.”
For more information about MDP and how the organization is using NEI materials to support efforts to reach out to people about macular degeneration, contact Judith Delgado at 310–623–4466 or firstname.lastname@example.org.
NEI and the National Eye Health Education Program (NEHEP) offer a broad spectrum of eye health educational resources, in English and Spanish. Consider personalizing them with information that helps to promote your organization! Visit the NEI Publications Catalog and Healthy Eyes Toolkit to see what’s available to support your eye health efforts.
Many people don’t realize that smoking can lead to vision loss. Research links smoking to an increased risk of developing the following eye diseases and conditions:
Age-Related Macular Degeneration (AMD)1,2,3
Smokers are three to four times more likely to develop AMD. Nonsmokers living with smokers almost double their risk of developing AMD.
Heavy smokers (15 cigarettes/day or more) have up to three times the risk of cataract as nonsmokers.
Smoking is linked with high blood pressure and diabetes, both of which are risk factors for glaucoma.
Smoking and having diabetes increases the risk of diabetes complications such as diabetic retinopathy, heart disease, stroke, vascular disease, kidney disease, nerve damage, and foot problems.
Dry Eye Syndrome11
Dry eye syndrome is more than twice as likely to impact smokers as nonsmokers.
To increase awareness about the relationship between smoking and eye health, the Vision Health Integration and Preservation Program (VHIPP) and the New York State Department of Health (NYSDOH) Tobacco Control Program (TCP) adopted “Smoking Causes Blindness”—smoking cessation media from Australia —to launch an eight-week print campaign in Buffalo, New York.
The purpose of VHIPP, a collaboration of the NYSDOH and Prevent Blindness Tri-State, is to integrate vision and eye health within existing public health programs and organizations. VHIPP is funded by the Centers for Disease Control and Prevention through an award to Prevent Blindness America.
The “Smoking Causes Blindness” print campaign, consisting of billboards, bus sides, bus shelters, metro rail, airport, and store posters, followed a TCP statewide television, radio, and Internet campaign. Both campaigns urged consumers to call the New York State Quitline for help.
To test the effectiveness of the print campaign, “prompt to call” (PTC) data in the Quitline database for Buffalo residents aged 64 years or younger were analyzed for the three-month pre-campaign period (immediately prior), the eight-week campaign period (during), and the three-month post-campaign period (immediately following). Results revealed an association between the study period and calls to the Quitline from Buffalo indicating that the PTC was related to the print campaign. Further analysis showed that the proportion of calls attributable to one of these PTCs increased significantly from the pre-campaign to the campaign period (3.9% vs. 9.0%) and decreased significantly from the campaign to the post-campaign period (9.0% vs. 4.5%).
To spread this message beyond Buffalo, a fact sheet is now included in Quitline program mailings to all callers statewide. The NY experience demonstrates one method by which eye health can be successfully integrated into public health programs.
Thornton J, Edwards R, Mitchell P, Harrison RA, Buchan I, Kelly SP. Smoking and age-related macular degeneration: a review of association. Eye. 2005;19: 935-944.
Seddon JM, Willett WC, Speizer FE, Hankinson SE. A prospective study of cigarette smoking and age-related macular degeneration in women. JAMA. 1996;276(14):1141-1146.
Edwards R. ABC of smoking cessation: the problem of tobacco smoking. BMJ. 2004;328:217-219.
Cheng ACK, Pang CP, Leung ATS, Chua, JK, Fan DS, Lam DS. The association between cigarette smoking and ocular diseases. Hong Kong Med J. 2000;6:195-202.
Bonomi L, Marchini G, Marraffa M, Bernardi P, Morbio R, Varotto A. Vascular risk factors for primary open angle glaucoma: The Egna-Neumarkt Study. Ophthalmology. 2000;107(7):1287-1293.
Ding EL, Hu FB. Smoking and type 2 diabetes: underrecognized risks and disease burden. JAMA. 2007;298(22):2675-2676.
Sairenchi T, Iso H, Nishimura A, Hosoda T, Irie F, Saito Y, Murakami A, Fukutomi H. Cigarette smoking and risk of type 2 diabetes mellitus among middle-aged and elderly Japanese men and women. American Journal of Epidemiology. 2004;160:2.
Moss S, Klein R, Klein BEK. Prevalence of and risk factors for Dry Eye Syndrome. Archives of Ophthalmology. 2000;118(9):1264-1268.
The Bureau of Engraving and Printing has developed a free downloadable application (app) to assist people who are blind and visually impaired denominate US currency. The app is called EyeNote™. EyeNote™ is a mobile device app designed for Apple iPhone (3G, 3Gs, 4), and the 4th Generation iPod Touch and iPad2 platforms, and is available through the Apple iTunes App Store.
EyeNote™ uses image recognition technology to determine the denomination of a note. The camera on the mobile device requires 51 percent of the scanned image of a note, front or back, to process. In a matter of seconds, EyeNote™ can provide an audible or vibrating response, and can denominate all Federal Reserve notes issued since 1996. Free downloads will be available whenever new US currency designs are introduced. Research indicates that more than 100,000 people who are blind and visually impaired could currently own an Apple iPhone.
The EyeNoteTM app is one of a variety of measures the government is working to deploy to assist those in the community who are blind and visually impaired to denominate currency, as proposed in a recent Federal Register notice. These measures include implementing a Currency Reader Program whereby a United States resident, who is blind or visually impaired, may obtain a coupon that can be applied toward the purchase of a device to denominate United States currency; continuing to add large high-contrast numerals and different background colors to redesigned currency; and adding raised tactile features to redesigned currency, which would provide users with a means of identifying each denomination via touch.
More information can also be found at http://www.moneyfactory.gov/uscurrency/meaningfulaccess.html.
Studies have shown that balance can be affected by vision loss. As a result, older adults with visual impairments are at increased risk for falls. As a 2010 Healthy Vision Community Award recipient, the Arrowhead Area Agency on Aging (AAAA) focused efforts to address this problem. There are simple steps that individuals with and without visual impairments can take that have been proven to reduce the risk of falling. Many of these have been incorporated into A Matter of Balance (MOB), an evidence-based program derived from research conducted at Boston University. MOB uses trained coaches to assist older adults, typically in groups of 10-12 participants, to acquire practical strategies to reduce the fear and lessen the risk of falling.
MOB class materials include a participant workbook, flip charts, and handouts, among others. It is not easy, however, for those with visual impairment to make use of these resources. To remedy this situation, AAAA implemented efforts to perform the following activities:
Serving as the lead agency, AAAA worked in collaboration with the Duluth Lighthouse for the Blind and the Minnesota Falls Prevention Initiative to identify MOB materials modifications that would be necessary to allow individuals with visual impairment to fully participate in the MOB classes. Initially, AAAA intended to produce participant manuals in Braille. Staff from the Lighthouse for the Blind indicated, however, that this would not be effective for the target audience, as very few older adults in the region that AAAA serves have been trained to read Braille. In addition, most of these adults have enough vision to be able to read information printed in a large font or to use a reader to enlarge printed materials. Consequently, none of the MOB materials were produced in Braille.
Two new MOB coaches were trained specifically to work with participants with visual impairments using the new materials. Pilot testing was conducted in a class made up of six adults with visual impairments who were at risk of falls. The MOB materials were finalized based on the lessons learned.
All MOB coaches in northeastern Minnesota, the area served by AAAA, received the modified materials. Nine additional coaches were trained to implement the revised curriculum and materials. A statewide videoconference was conducted in October with 41 participants to teach all certified MOB coaches in Minnesota about how to use the new materials and adapt classes for participants with visual impairments. The MaineHealth Partnership for Healthy Aging, which holds the license/rights to MOB, has endorsed the modified materials and is disseminating them nationwide and incorporating the use of these materials for all future MOB licensees.
For more information about AAAA MOB efforts, contact Debra Laine at 218–529–7534 or DLaine@ardc.org.
To learn more about other community-based eye health education activities or to submit a project you have in your community, visit the Healthy Vision Community Programs Database.
NEI regularly attends and exhibits at national meetings across the country. Exhibits and presentations provide an opportunity to share information and publications, promote NEI messages and resources, and strengthen links with Partnership organizations. Locations for upcoming NEI presentations are listed below. If you plan to be there, please stop by and say “hello”!
National Council of La Raza
Marriott Wardman Park Hotel
July 23–26, 2011
NEHEP wants to know what you think about Outlook. Let us know what you find beneficial, ideas for content you would like to see in upcoming issues, or suggestions for improvement. We’re always interested in hearing about your eye health education efforts and especially how you have used NEI resources and materials.
Please contact us. We look forward to hearing from you!