DR. Bill FOUNDATION

We Specialize In Patient Care
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Heart Arrhythmias

We take care of the abnormal rhythms of your heart. If you think that you are having palpitations, you should visit your doctor to find out what is causing the irregular heartbeats. 

Arrhythmias are often associated with various other forms of heart diseases, and thus, it is quite essential for you to manage all the risk factors before you come across any major heart problems. 

Complete care on your schedule

Bringing life to your smile
Infectious Disease

We specialize in treating diseases caused by organisms such as bacteria, virus, fungi, and other parasites.

Coronary Artery Disease

Our doctors are specialized in treating impaired blood flow through the arteries.

Skin Cancer

We provide treatments for skin cancers including melanoma, squamous cell carcinoma, and basal cell carcinoma.

Modern Tech & Equipment

We use the latest technology and equipment, and our doctors are committed to providing you with the best treatment.

We love to see you smile
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National Cancer Institute

Our goal is to support various researches on cancer and help people live a healthier and longer life. We support cancer research scientists and help them provide improved solutions for cancer treatments.

Reviews from our happy patients

Creating vibrant smiles for healthy lifestyles!
Carol E. Buckner

If it hadn’t been for Dr. Bill Foundation, I would still be waiting for my diagnosis. The doctors told me what was happening to me and provided the right treatment at the right time. 

Steve D. Curd

Being a patient at Dr. Bill Foundation has given me confidence going forward that I have the right set of doctors for the right treatment. 

Our Blog

Vision And Learning

Vision plays an important role in learning. Studies have demonstrated that up to 80 percent of what students learn in school is through the visual system. Blurred sight, double vision, eyestrain, slow focusing, and poor visual processing skills can interfere with learning. Students may compensate by holding their reading materials close to their eyes to magnify the print, using their finger to help them maintain their place when reading, and by squinting or covering one eye. Others will avoid using their vision and ask their classmates for help, avoid doing their assignments, and use their verbal skills rather than to write their ideas on paper. These are the children who are often smart in everything but school.

The American Optometric Association recommends that children have their vision examined by the age of 2 years. This is very important because the first 3 years of life are critical in the normal development of vision. The early diagnosis and treatment of vision problems greatly improves the prognosis of correcting the vision problem. Unfortunately, many children have their first eye-screening test performed when they enter kindergarten and are asked to read letters from the Snellen eye chart. This screening test only measures how well students are able to read letters from 20 feet and it does not measure the visual skills used for learning.

There are many visual skills used in the process of reading, writing, and learning. Eye muscle control, peripheral vision, color vision, and visual processing are just a few that are not tested by the 20/20 Snellen eye chart. Children will benefit from having a comprehensive developmental vision assessment to make certain that they have the visual skills needed for learning before they are asked to perform reading and writing tasks in the classroom. There are three basic components of vision that should be evaluated. First, the tissues and structures of the eyes must be inspected to make sure that the eyes are healthy. Next, visual intake skills must be looked at to determine how efficiently the eyes are able to focus on words, letters, and images. Finally, visual perception skills should be assessed to determine how well the brain processes and interprets the information sent by the eyes to the brain.

The internal and external structures of the eyes must be examined thoroughly. This involves the use of eye drops to dilate the pupils of the eyes to allow doctors to inspect the internal structures of the eyes. Cataracts, glaucoma, retinopathy of prematurity, and other eye conditions can be detected and treated to maximize the development of vision. Children with blurred sight due to eye disease can benefit from low vision aids and specialized glasses. These children should be fit with such devices as soon as possible to allow the brain to interpret visual information with the low vision aid.

Visual intake testing involves a variety of tests to determine how well the eyes take in information and send it to the brain. Poor visual intake skills can cause blurred sight, double vision, headaches, eyestrain, and may cause words to appear to jump or move while reading. First, clarity of sight must be tested at distance and near to make certain that students are able to see words on the chalkboard clearly as well as their books and handouts. Near to far and far to near focusing skills must be examined to make sure that students are able to shift their eyes from the chalkboard to their paper and back to the board for extended periods of time. Students with poor near focusing skills may become tired after performing close work for ten to twenty minutes and their performance may worsen with time. Assessment of eye teaming skills, left to right tracking, eye alignment, and muscle coordination must be performed to make sure that students have the ability to point the eyes in a left to right reading pattern. Students with eye coordination problems frequently have difficulty keeping their place while reading or they may skip or omit words. They may compensate by using their finger to keep their place or they may cover one eye or tilt their head while reading and writing. ,. Other visual intake skills assessed include peripheral vision, color vision, contrast vision, glare sensitivity, and the need for glasses to correct farsightedness, nearsightedness, and astigmatism.

Vision perception testing is the third component of the developmental vision assessment and may be extremely helpful for students who are having academic difficulties. Vision perception is the brain’s ability to interpret or process information received by the eyes. There are many different visual perception skills such as visual discrimination, visual memory, visual spatial relations, and visual motor integration to name a few. Each of these skills are processed at different regions of the brain and play important roles in various aspects of learning. Visual discrimination is the ability to perceive similarities and differences between images that appear similar. Students with poor visual discrimination skills may have problems learning letters and they may confuse letters and numbers that appear similar. Visual memory is the ability to remember what has been seen and weaknesses in this area can cause students to have difficulty reading words that are not spelled phonetically and may force them to sound out each word that they read. Visual motor integration is the ability of the brain to control the hands when copying numbers, letters and images. Students with poor visual motor skills frequently have difficulty-writing notes, copying from the chalkboard, and they may write letters and numbers backwards. Students with visual spatial perception problems frequently have problems reading maps and diagrams as well as difficulties in subjects such as physics, chemistry, and geometry.

After the developmental vision assessment has been completed, the data will be interpreted and specific recommendations and accommodations will be made. Glasses, contact lenses, low vision aids, eye muscle surgery, medications, and vision therapy may be recommended to address the specific visual weakness. The doctors will also provide written reports to be distributed to teachers, parents, and therapists of students to help them to understand the best way of helping these students. Because vision is a learned and developed skill, many of the visual weaknesses will improve with treatment and these students may not require the special accommodations initially prescribed. In all cases, it is important to select the best teaching technique to match the learning style for each student. Students who are totally blind may not be able to perform up to their maximal potential until they develop the Braille skills to access print and write. Similarly, students with poor visual perception skills may perform much better in a classroom that has a stronger focus on verbal learning. Students should be reminded that each person learns best in a different manner. Some are visually; others are auditory or kinesthetic.

Interesting Facts About Vision and Learning

  • One of every five children has an undetected vision problem that may interfere with learning.
  • Most children are farsighted and will pass the Snellen eye chart test. This test only detects 18% of children who have vision problems.
  • Students with farsightedness must exert more effort and work harder to focus on their reading materials.
  • Boys are 8 to 10 times more likely to have color vision problems, which can interfere with learning that incorporates color-coding.
  • Holding books too close to the eyes and reading in the dark do not cause physical damage to the eyes. These behaviors force the eyes to work harder to focus and may cause eye fatigue.
  • Medications such as Ritalin, Cylert, and anti-seizure medications can affect the focusing ability of the eye and cause eye fatigue when reading.
  • Sitting too close to a television will not damage the eyes but can cause focusing problems. Keep a lamp on and sit at least 6 feet away.
  • Computer games do not improve eye hand coordination and can promote the development of nearsightedness.
  • The “darkness” of sunglasses has no relation with protection against ultraviolet radiation.
  • Racquet sports are the leading cause of sports related blindness.
  • Soft contact lenses can increase nearsightedness in children.
  • Law and medical students and those who perform lots or reading and close work tend to become more nearsighted. Gas permeable lenses and reading spectacles can reduce the progression of nearsightedness.

Aniridia

Aniridia also affects the development of other structures of the eye. The blurred sight that is associated with Aniridia is not due to the absence of the iris but is a result of the abnormal development of the macula, the centermost region of the retina that provides detailed sight, color vision, and daylight vision. As light enters the eye, it strikes the light-sensing cells of the retina and sends the information to the brain.

When the macula is not fully developed at birth, the brain is not able to perceive color, fine details, and images in the bright daylight. Consequently, many patients with Aniridia squint their eyes to reduce the glare and they tend to get closer to their reading materials to read. Their distance clarity of sight may range from 20/70 (able to read a 2-inch letter from 20 feet) to 20/200 (able to read a 4-inch letter from 20 feet).

In addition to the abnormal development to the macula, patients with Aniridia are at risk for developing other eye and medical problems. Cataracts (the cloudiness of the internal crystalline lens of the eye), glaucoma (increased intraocular pressure of the eye causing damage to the optic nerve), Wilm’s tumor (kidney tumor), abnormal blood sugar, reduced sense of smell, and dysnomia (difficulty naming familiar objects) are more common among children with Aniridia. Although these complications are associated with Aniridia, they are treatable when diagnosed early on.

Just like with most other health problems, it is crucial to recognize the problem as soon as possible and to start the appropriate and adequate treatment. If the therapy is incorporated in the early stage, the outcome of the disease will take a significantly optimistic look.

Nystagmus

Most patients with Aniridia have nystagmus, the uncontrollable shaking of the eyes. Nystagmus does not cause images to appear to shake from side to side. Patients with Aniridia may turn their head or eyes to reduce the nystagmus. Eye muscle surgery and exercises are sometimes recommended, but they do not eliminate nystagmus in all of the cases.

However, not all things are as negative as the symptoms and problems that we just listed here. Children and adults with Aniridia tend to have high levels of functional vision and respond extremely well to low vision aids. Specialized filters, high powered reading glasses, contact lenses, and bioptic telescopic spectacles can improve the clarity of sight, reduce problems with glare, and increase their functional vision to a level that allows visual reading and sometimes to the degree of vision allowing patients to take their drivers test. Assistive technology, computers, and software programs are extremely helpful for these patients.

By improving the quality of vision, the overall quality of life will also experience a significant boost, and it is entirely reasonable to try and enhance our lives with various tools and methods.

Recommendations

Children and adults with aniridia will benefit from a consultation by a low vision specialist and by using low vision aids. Patients should be evaluated for photochromic spectacles and tinted contact lenses to reduce glare and protect the eyes from the harmful rays of the sun.

Low vision aids such as contact lenses, biopic glasses, handheld telescopes, and video magnification systems can improve distance sight to 20/20 while specialized reading glasses, hand magnifiers, and closed circuit televisions can allow patients to read the small print.

Tinted paper with bold lines, bold felt pens, and thick pencils will help students to perform writing tasks at school. Students who are bothered by glare will also benefit from placing their paper on a dark blotter or dark piece of construction paper to help them to see the edges of their paper.

At home, the use of an incandescent light bulb hidden behind a dark torchiere floor lamp can provide excellent general lighting while reducing glare. A small desk lamp such as an OTT full spectrum lamp may provide a soft light for reading and writing. See Vision and Lighting.

Computer users will benefit from changing the background of the display to a black or blue background with white letters. Enlargement of the font size will also increase readability. For information on how to modify the computer screen, see “Solutions To Help You Use Your Computer.

Infants Recommendations

Infants should be examined by the age of 6 months or younger. Glasses should be prescribed based on the visual developmental level of the children. For example, four-month-old infants should have their glasses prescribed to focus at their arm’s length rather than 20 feet.

Infants will benefit from vision stimulation to maximally develop the visual cortex of the brain. For specific details, please see Developing Your Child’s Vision. Developing the visual cortex is an essential stage in lives of infants, and we should do anything in our power to facilitate this process.

Students Recommendations

Students will benefit from being positioned in the front portion of the class with their backs facing windows, doors, and glare sources. The use of a black chalkboard and bold architecture chalk are easier to see than dry-erase boards due to the glare created by the whiteboard. If a dry-erase board must be used, it is very helpful only to use bold black dry-erase markers rather than colored markers. Student and teachers should have an open discussion about the possibilities to handle this situation and to overcome the obstacles in the most efficient way possible.

Students may benefit from using specialized computer software and technology such as Zoom Text magnification software, scanning programs such as Open Book and Kurzweil, and Video Magnification systems. For more information, see Computer and Assistive Technology.

Students will benefit from having copies of material frequently written on the board or presented on overhead transparencies. If PowerPoint presentations are used, a dark background with white letters written in Arial or Tahoma will improve readability for students with low vision.

Students may have some difficulty seeing small objects such as a baseball while standing in the outfield. They may also have difficulty seeing in the direct sunlight and may prefer to wear their sunglasses and a hat. Students will benefit from additional time to adapt to the indoor lighting after entering the classroom from lunch or recess. Sports such as soccer, basketball, gymnastics, swimming, and golf may be easier to participate in rather than baseball or tennis.

 

Sun Dolphin Aruba 10: Something for Everyone/Sun Dolphin Aruba 10: A Time for Fun/Sun Dolphin Aruba

Whether you are an old hand at kayaks or just a beginner, the Sun Dolphin Aruba 10 could be just the thing to cement your love of the sport. It doesn’t matter if you want to explore lakes, rivers, or other bodies of water, the Aruba 10 has virtually everything you could possibly want in a kayak and more. From the moment you step in the cockpit, you will be surprised with how roomy the entry is. Go ahead and settle in, because once you do that you will be convinced that this is one of the best all-around kayaks available anywhere. Put your feet against the molded adjustable foot braces, and you will think that this one was made specifically for you.

Your intent could be recreational kayaking, boating, fishing, or anything else, the Aruba 10 is perfect for whatever your use might be. At 10 feet long and made of a sturdy UV-stabilized fortiflex high-density polyethylene, the Aruba 10 can take virtually anything that you put up against it and still be ready for more. Further, at less than 90 lbs., the Aruba 10 is easy to transport by whatever means you have and has the weight to keep sturdy against anything, no matter how rough things get, in the water and out.

If your purpose is just an easy day out on the water, you’re going to wonder how you could consider anything other than the Aruba 10 as your personal island. It has an adjustable padded seat with a high back support to keep your comfortable. There are also convenient gear storage ports on the deck, with shock cord rigging so you can attach virtually anything you want to take with you. There’s even a molded water bottle holder so you can keep your cool while you’re busy.

Colors the Aruba 10 are available in are lime, ocean, pink, and red. Why not get one for yourself and one of each color for the other members of your family or your friends. The Aruba 10 is just another word for fun when it comes to kayaking, whatever you happen to want to do with it. In fact, chances are good that you will discover something new to use your Aruba 10 with every time you take it out.

 

And when it’s time to call it a day, unload everything quickly and use the convenient carrying handles to bring it ashore. Don’t worry about where you will store it while you’re on the beach since it will give you such a good time while you’re on the water that everyone will probably want to take their chance with the ultimate self-propelled pleasure craft. In fact, it won’t be a matter of what you do with your Aruba 10, it will be a matter of what you do next. The Aruba 10 has proved itself for being so sturdy, stable, and fun to use that everyone will want to have their chance. There’s nothing like kayaking in the Aruba 10 to get your started on an entirely new adventure of a lifetime.

UK Maintains Stance on Marijuana, Chronic Pain Patients Suffer

UK on Medical MarijuanaPatients are unnecessarily suffering due to the stringent law around marijuana in the U.K. This is the argument of Britain’s leading experts on cannabis according on their latest report. They urged the British government to loosen up on the substance so that patients can benefit from its pain-reducing effects.

Risk of Heart Disease Can Be Lowered by Niacin

heart diseaseHeart disease is the leading cause of disease-associated death in America. Most patients at risk of heart disease are concerned with keeping cholesterol and lipids at lower levels. However, high-density lipoproteins, or HDL, are often known as “good” cholesterol has been shown to be associated with lower risk of cardiovascular disease.

Diet that Deals with Early Onset Ulcer

ulcer pain
An ulcer is a sore within the lining of your stomach, triggered by a bacterial infection that weakens the protective layer of the stomach. This results in its eventual corrosion from the potent stomach acid present. The most common symptom associated with ulcers is localized pain in the stomach, caused by the acid in the stomach consuming the lining of the tissue.

Advocating Patient Rights in Nursing Homes

nursing homes

As the baby boomers get older, so do their parents. Many of those parents are in nursing homes right now. It’s important for children of the elderly to know their parent’s legal rights when in this situation. Having an action plan will go a long way to reduce the burden of stress when it’s necessary to advocate for a parent in a nursing home.

Considering Cancer Therapy as an Option

cancer therapy

A number of factors determine what constitutes an effective cancer therapy. The type (benign and malignant) and organ involved are some of the determinant factors.

An ideal cancer therapy would involve killing or removing cancer cells while leaving normally growing cells intact. When the tumor is accessible, like in small superficial skin tumors, removal is possible. In less accessible cases, however, a combination of surgery, radiotherapy and chemotherapy may be necessary. New and experimental techniques also promise alternatives for safer and more effective cancer therapy. These are gene therapy, bone marrow and stem cell transplants, protease inhibitors and anti angiogenesis drugs. Telomerase inhibitors targeting cell division process and biological therapies enhancing immune system’s response are also being explored.

Getting Around the Flu Vaccine

Flu Vaccine Alternatives

Flu Vaccine AlternativesPrior to flu season, the media reports that millions of people will develop the flu causing an approximate death count of 36,000 people. But dying from the flu is rare.

According to the preliminary report from CDC website in 2002, the number of deaths from the flu was estimated to be around 753. The final total of deaths from the flu for the year 2001 was 257 not 36,000.

Enhanced Vision Merlin

The Enhanced Vision Merlin has been updated in 2008 with a more sleek and streamlined appearance. The Merlin continues to be one of the easiest video magnification systems to use with only three controls on the front panel, just below the monitor. The Merlin has an on-off button on the very right, a large circular dial to change the magnification, and a third button on the left side which changes the colors of the background and text. The Merlin continues to have a brightness control lever on the underside of the control panel. This lever allows users to alter the brightness of the image, a most helpful feature when reading faded print, handwriting written in pencil, or text printed on glossy paper.

In 2008, the Merlin is available in a 17-inch, 19-inch, and a 22-inch wide screen LCD flat panel monitors, priced at $2595, $2795, and $2995 respectively. The monitors of the Merlin adjust up and down, swivel from right to left, and tilt forward and backwards. The multiple adjustments of the monitor allow users to reduce reflected glare from overhead lights and windows. The LCD monitors display very sharp and clear images with excellent color and contrast. The auto-focus color camera focuses very accurately and quickly and also displays the widest field of view.

The Merlin has a very large X-Y table that will allow users to place large books or handouts under the camera. The table has a manual locking device that allows users to easily lock the table, preventing it from sliding from side to side when writing or working on projects under the Merlin. The X-Y table slides very smoothly in all directions, making reading rows and columns of text very smooth.

The Merlin comes with some features that are optional on other video magnifiers. First, it comes with color select, which allows users to alter the colors of the background and the text. Secondly, the Merlin comes standard with a computer connectivity package, allowing users to connect their computer to the Merlin. With the press of a foot pedal, users can switch from having their reading materials displayed on the screen or having their computer displayed on the screen. This feature is very helpful when reading and inputting data into the computer. The Merlin also has an optional feature that will allow users to see both the computer and the magnified reading material simultaneously with a split screen for $250.

We found the Merlin to be a very well built video magnifier with very easy to use controls. The Merlin produced very clear magnified images of all text, newspapers, and photographs we placed under the camera. The brightness control lever was extremely helpful and the wide field of view allowed us to see a larger region of text compared to other video magnifiers. We wish the Merlin had a friction control on the X-Y table to prevent the table from sliding too quickly when reading. We also wish the Merlin had a focus lock that would help students or craftsmen who perform a lot of reading or repair work under the Merlin. Overall, the Merlin is a very easy to use video magnifier and is an excellent value with its many standard features.

Freedom Scientific Topaz

The Topaz desktop video magnifier has been improved significantly since it was first introduced in 2005 and is now one of the most features packed video magnifiers available. The Topaz is available with a 17-inch, 19-inch, or 22-inch color monitor priced at $2695, $2995, and $3495 respectively. The monitor adjusts up and down and tilts forward and backwards to provide comfortable viewing for users without reflected glare from room lights or windows. The sharpness and color displayed on the Topaz are excellent. The auto-focus color camera of the Topaz focuses very quickly and accurately. The colors of the images on the Topaz are very vivid and the Topaz performs extremely well when reading print typed on glossy paper.

The controls of the Topaz are very easy to access and easy to manipulate. The Topaz has five controls. On the very right is the on-off button. Just to the left is a color mode button that changes the colors of the background and text. In the middle is a large dial that changes the magnification. On the left side of the control panel are a brightness control knob and a focus lock button that locks the camera, a very helpful feature for those who will use the Topaz to write, draw, or repair objects.

The X-Y table of the Topaz has a manual lock and adjustable friction controls. This is a very helpful feature when reading and writing. Very few video magnifiers have the friction control and subsequently a person may move the X-Y table too quickly, causing them to lose their place while reading. The Manual friction control allows users to customize how quickly they want the X-Y table to move when reading. The Topaz has many standard features that are optional on other video magnifiers. First, the Topaz has a focus lock that keeps the camera focused on the target of interest. This will prevent the camera from focusing on the pencil while writing on a piece of paper. Second, the Topaz has a locator light that shines a beam of light on the reading material to help users to know what will be displayed on the screen. Third, The Topaz comes standard with many color combinations that allow users to change the colors of the background and text. Fourth, The Topaz has a brightness control knob that is extremely helpful when reading faded text or documents written in pencil. The Topaz also has the ability to turn the lights off to reduce reflected glare when reading magazines and glossy textbooks. Another nice feature of the Topaz is that it is modular and other advanced options can be added at a later time. We found the Topaz to provide an excellent image at all magnification levels. It was especially impressive when we place glossy paper, medication bottles, and other shiny objects under the camera. The Topaz provided the widest field of view of any video magnifier we tested and it also has the largest working space between the camera and the X-Y table, a very important factor for people who will use the Topaz to write or to repair items. . We wish the Topaz came standard with the ability to connect to a computer to share the same monitor for both the computer and the Topaz. Freedom Scientific has an optional computer connectivity module that easily plugs into the Topaz to allow users to connect their computer to the Topaz for $300. In summary, the Topaz is a very versatile video magnifier that works very well for reading, writing, and repair-work.

Humanware My Reader 2

Humanware has made the My Reader 2 more affordable in 2008 by offering the innovative camera without the monitor to allow users to use their computer monitor. Starting at $3895, the My Reader is an excellent video magnifier that scans the text and reformats it on the screen, eliminating the need to move the reading material from left to right while reading. The My Reader 2 is very versatile. It has a mode that allows users to use the My Reader 2 the same way that one uses a conventional video magnifier. This mode allows users to write, draw, and repair items under the color auto-focus camera. The My Reader also has other modes that make reading very quick and easy. The teleprompter mode allows users to have the text scrolled up the screen while the row mode scrolls the text from left to right similar to a Wall Street ticker tape.

The My Reader 2 has the capability to scan and place 13 pages of text in memory. The My Reader 2 provides high levels of magnification with the ability to alter the colors of the background and text.

We found the My Reader 2 to be a very unique video magnifier that can be tremendously helpful for people who have blind spots in their field of view. The row view can allow those with macular degeneration, diabetic retinopathy, and retinitis pigmentosa to keep their eyes focused on one spot and the My Reader 2 will move the text right before their eyes. The My Reader 2 with an in-line monitor sells for $4995 but is easily folded into a package that can be transported from home to work. We were very impressed with the My Reader 2 and feel it has a very special place for people who have difficulty or become dizzy when reading with a conventional video magnifier.

In 2008, Optelec has a 17-inch, 19-inch, and a 22-inch flat panel LCD screen to the ClearView Plus priced at $2695, $2895, and $3095 respectively. For years, the Clearview Plus has been one of the most popular and successful video magnifiers. Analogous to the Apple I-Mac Computer, the Clearview Plus is sleek with high tech features with a �cool design.� The Clearview Plus produces very clear images with vivid colors at all levels of magnification.

Optelec Clearview Plus

The Clearview Plus is unique from other video magnifiers in that the controls are located on the X-Y table, making them very easy to access. This allows users to keep their hands on the table at all times while reading. The Clearview has a large ring on the front portion of the X-Y table that allows users to change the magnification. In the center of the ring is a button that controls the image mode, altering it from black and white, to color, or another customized background and text color. On the right side of the X-Y table is a window that can be slid open to alter the brightness and contrast. On the left side of the X-Y table are buttons that will change the colors of the background and text. In some models with the Advanced Feature Pack, the Clearview has buttons that will control the location of line markers to help users to maintain their places when reading. Another button on the left side of the X-Y table toggles from viewing the computer screen or the reading text.

The Clearview produces a vary sharp and clear image on the monitor. The auto-focus color camera focuses accurately and quickly. The X-Y table of the Clearview has an electronic lock feature that will lock the position of the table when writing. The Clearview also comes with a location finder, which shines a light on the reading material to allow users to know what region of the paper is being displayed on the monitor.

We were very pleased with the Optelec ClearView Plus. It produces a very sharp image and is arguably the most aesthetic video magnifier made today. We appreciated the location of the controls on the X-Y table for reading but found it to be a bit more difficult to draw and write on larger sheets of paper because of the reduced working area. We wish the ClearView had a brightness control knob or lever rather than the push button digital controls. We also wish the ClearView had a friction control to slow the speed that the X-Y table moved from left to right.

Coloboma

Vision plays an important role in learning. Studies have demonstrated that up to 80 percent of what students learn in school is through the visual system. Blurred sight, double vision, eyestrain, slow focusing, and poor visual processing skills can interfere with learning. Students may compensate by holding their reading materials close to their eyes to magnify the print, using their finger to help them maintain their place when reading, and by squinting or covering one eye. Others will avoid using their vision and ask their classmates for help, avoid doing their assignments, and use their verbal skills rather than to write their ideas on paper. These are the children who are often smart in everything but school.

The American Optometric Association recommends that children have their vision examined by the age of 2 years. This is very important because the first 3 years of life are critical in the normal development of vision. The early diagnosis and treatment of vision problems greatly improves the prognosis of correcting the vision problem. Unfortunately, many children have their first eye-screening test performed when they enter kindergarten and are asked to read letters from the Snellen eye chart. This screening test only measures how well students are able to read letters from 20 feet and it does not measure the visual skills used for learning.

Iris coloboma is when a section of the iris is not developed normally. Iris Colobomas generally involves the lower portion of the iris, resulting in a pupil that resembles a keyhole of an old-fashioned door lock or the pupil may appear oval rather than round. The iris regulates the amount of light that enters the eye and also gives the eyes their eye color. Colobomas of the iris generally do not cause blurred sight but they may cause mild sensitivity to glare and bright light. Cosmetic contact lenses can be fit to improve the cosmetic appearance of the iris.

Eyelid colobomas can cause visual and cosmetic problems for newborn children. The absence of part of the eyelid interferes with the manner in which tears wash and lubricate the eyes. As the front of the eye dries out, the cornea can become clouded or opaque. This hinders the manner that light enters the eye, causing blurred sight, glare, distorted vision, and sensitivity to glare. Contact lenses and artificial tears can keep the cornea moist until surgery can be performed to repair the eyelid.

Choroidal and retinal colobomas generally occur simultaneously and cause the loss of peripheral vision in the upper field and blurred sight. The choroid is a vascular tissue that supplies blood and oxygen to the light sensing tissue called the retina. When the choroid is not fully developed, the cells of the retina do not develop and that region of the eye is blind. Choroidal and retinal colobomas generally affect the lower retina, which provides us with our upper peripheral vision. Choroidal colobomas may also extend to the central retina and affect the macular region of the retina where detailed vision occurs. When the coloboma extends to the macular region, the visual acuity may be as poor as 20/400 (able to read a 7 inch letter from a distance of twenty feet). These patients often have difficulty reading street signs, small print, and they may bump into objects that are above their head. Patients with choroidal colobomas are at risk for developing retinal detachments and should be seen by a retinal specialist each year.

Colobomas may also involve the optic nerve and are called optic nerve colobomas. The lower portion of the optic nerve is typically the affected region and this can result in the loss of peripheral vision in the upper field as well as blurred sight, ranging from 20/100 to 20/400. Color vision may also be affected in cases of optic nerve coloboma. Their symptoms are similar to those of patients with choroidal/retinal colobomas. Fortunately, patients with colobomas to the retina, choroids, and optic nerve often respond very well to low vision aids.

Microphthalmia is the term used to describe the partial development of the entire eye. In contrast to a coloboma where only one section of the eye is not fully developed, microphthalmia affects the entire eye and the eye can be thought of as a miniature eye. Microphthalmia can affect one or both eyes and is often inherited. Vision may range from total blindness to the ability to perceive motion and high contrast. Unfortunately, there is no medical treatment for microphthalmia but some patients respond favorably to low vision aids and computer technology.

Anophthalmia is the condition where the eye does not develop during fetal development. In most cases, the eye did not develop at all and there are no eye structures present at birth. In other cases, the eye began to develop but stopped and there are no functional tissues of the eye to support vision. Children with anophthalmos are fit with prosthetic eyes to improve the cosmetic appearance of the eyes as well as to ensure the normal growth of the orbit (eye socket). Without the prosthetic eye, the bones that form the orbit will “sink inward,” affecting the structure of the face.

Patients with coloboma are at risk for other medical conditions. The incomplete development of the eye can also extend downward to other structures of the face, mouth, heart, and body. Many children with coloboma have cleft palates, incomplete closure to the septum of the heart, abnormalities to the fingers, and developmental delays. C.H.A.R.G.E. syndrome describes a congenital disorder that affects the eyes, heart, throat, genital urinary tract, and ears. The letters CHARGE are acronyms to describe Coloboma of the eye Heart defects, including abnormalities to the aorta, Atresia of the choane (abnormal connect from the back of the throat to the nasal cavity), Retardation of development and growth, Genital-urinary abnormalities (undescended testes in males and small genitalia, kidney and urinary problems), and Ear and hearing abnormalities that may cause severe hearing impairment. In as many as 80 percent of cases, children have severe hearing impairment and cardiac problems.

Recommendations

  • Adults and children with coloboma often respond very well to low vision aids. A consultation by a low vision specialist and low vision aids are recommended.
  • Infants will benefit from vision stimulation to maximally develop the visual cortex of the brain. For specific details, please see Developing Your Child’s Vision.
  • Patients with iris colobomas often benefit from wearing specialized filters to reduce problems with glare. Transitions photochromic lenses, Melanin filters, polarized filters, and tinted contact lenses are often very helpful.
  • Low vision aids such as bioptic glasses, hand held telescopes, and video magnification systems can improve distance sight to 20/20, while specialized reading glasses, hand magnifiers, and closed circuit televisions can allow patients to read small print, read medication labels, and see photographs. For more details, see Low Vision specialist and low vision aids.
  • Students will benefit from being positioned in the front portion of the class with their backs facing windows, doors, and glare sources. The use of a black chalkboard and bold architecture chalk are generally easier to see than dry erase boards due to the glare created by the white board. In the event that a dry erase board must be used, it is very helpful to only use bold black dry erase markers rather than colored markers.
  • Tinted paper with bold lines, bold felt pens, and thick pencils will help students to perform writing tasks at school. Students who are bothered by glare will also benefit from placing their paper on a dark blotter or dark piece of construction paper to help them to see the edges of their paper.
  • Students will benefit from having copies of material normally written on the board or presented on overhead transparencies. If PowerPoint presentations are used, a dark background with white letters written in Arial or Tahoma will improve readability for students with low vision.
  • Many children with coloboma will have difficulty seeing a baseball, tennis ball, or other flying objects while playing sports.
  • The use of incandescent light bulbs hidden behind a dark torchierre floor lamp can provide excellent general lighting while reducing glare. A small desk lamp such as an OTT full spectrum lamp may provide a soft light for reading and writing. See Lighting and Vision for more information.
  • Computer users will benefit from changing the background of the display to a black or blue background with white letters. Enlargement of the font size will also increase readability. For information on how to modify the computer screen, see “Solutions To Help You User Your Computer.
  • Students may benefit from using specialized computer software and technology such as Zoom Text magnification software, scanning programs such as Open Book and Kurzweil, and Video Magnification systems. For more information, see Computer and Assistive Technology.
  • Teenagers with coloboma who are interested in learning whether they have sufficient vision for driving should have a low vision examination by an optometrist who specializes in fitting bioptic-driving glasses.
  • Specific low vision aids that are often helpful to patients with coloboma include:
    • Cosmetic contact lenses for patients with iris coloboma
    • 3x to 6x bioptic spectacles
    • Micro spiral telescopes to improve distance sight
    • Aspheric high powered reading glasses
    • Prescription CPF, Transitions, Melanin, and NoIR filters.
    • 4x to 6x aspheric hand magnifiers for reading fine print
    • ZoomText software magnification software for those with coloboma and JAWS screen reading software for those with microphthalmia and anophthalmos.
  • For more information, please see Low Vision Rehabilitation

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