Sleek New Devices Help Low-Vision Patients See

With a stylish exterior of metallic blue and gray, the device looks like a personal digital assistant but slightly larger.

Julius Mendalis, 84, a lawyer for the company that makes Arizona Iced Tea, paid $795 for this gadget, and he loves it, though he is not a man of technology, rarely uses computers and does not surf the Web.

The Quicklook, an amalgamation of a tiny digital video camera and a four-inch liquid-crystal display screen, acts as an electronic magnifying glass, enlarging the text of a newspaper or a legal brief to an inch high. At that size, Mr. Mendalis, whose vision has deteriorated from macular degeneration, can see the letters clearly.

"This has been a world of good," he said. "It's brought back to me what I've been able to do all the time. It's been wonderful for me."

About 16 million Americans suffer from uncorrectable vision loss from glaucoma, cataracts, diabetes, macular degeneration and other diseases. Effective treatments exist for glaucoma, and cataracts can be removed by surgery. But for other eye diseases, no cures exist, only treatments that slow the loss. The National Eye Institute estimates the number of Americans who lose part of their vision to disease will double in 30 years as the population ages.

Macular degeneration, which usually strikes people over 60, destroys the central part of the retina, blurring the center of a patient's field of vision and making it hard to read or recognize faces. About 1.7 million Americans have lost part of their vision from the disease.

Diabetic retinopathy, a complication of diabetes, damages tiny blood vessels in the eye and causes severe vision loss or blindness if the vessels break.

Magnifying glasses, eyeglasses and more elaborate devices like wearable telescopes are the traditional vision aids. Closed-circuit television systems that look like library microfilm readers have been available for decades to enlarge text.

But the proliferation and miniaturization of consumer electronics in recent years have led to a new generation of more powerful and more portable gadgets for low-vision patients.

"They want to see at the baseball games," said Hal Reisiger, vice president for product development at Enhanced Vision of Huntington Beach, Calif., a maker of low-vision aids. "They want to see other than at a table with a large stationary device."

The computing power of electronics offers capabilities impossible for optical devices. With built-in illumination, they work even in dim lighting.

"Restaurants in the city are notorious for their poor lighting," said Dr. Bruce P. Rosenthal, chief of low-vision programs at Lighthouse International, a Manhattan-based nonprofit group that provides services to people with vision problems.

Electronics can also alter the image on the fly. Black text on a white background can be flipped to show white text on a black background; the greater contrast is easier for many people to read. Distracting color can be reduced to black and white.

"Eventually, a lot of the electronic devices will begin to replace some of the optical devices," Dr. Rosenthal said, adding that anyone who is thinking about buying a vision aid should first visit an eye specialist to diagnose the underlying problem. Lighthouse International runs a hot line to answer vision questions: (800) 829-0500.

The vision aids, experts say, may even improve mood. A Lighthouse study of 584 low-vision patients found that people who used optical aids, either traditional or electronic, suffered measurably less depression than those who did not have such help.

"Optical aids do contribute significantly to a decline in depression and a decline in disability in the first six months," said Dr. Amy Horowitz, senior vice president for research at Lighthouse.

By contrast, so-called adaptive aids like large-print books, talking clocks and Braille watches did not reduce depression.

"I think it's psychological," Dr. Horowitz said. With optical aids, "you're still doing things the way you used to."

The study could not tell whether the use of optical aids staves off depression or whether people who seek out optical aids are by nature more determined to continue their usual routines and less susceptible to depression, the Lighthouse researchers said.

An eye doctor diagnosed a mild form of macular degeneration for Mr. Mendalis two decades ago, but that did not slow him down. Then, a year and a half ago, while at a restaurant, the vision in his right eye suddenly went black. The blood vessels there had started leaking — the more severe, or "wet," form of macular degeneration.

A laser treatment, photodynamic therapy, helped stop the leaking. A few months later, blood vessels in the left eye started hemorrhaging. He underwent more laser surgery. Mr. Mendalis continued working, but "my entire work is document reading," he said.

Because he was unable to see clearly, his wife, Sylvia, read documents aloud. She said they got into many more arguments. "It's frustrating for him," she said.

Scarring in the retina has left the vision in his left eye irreparably blurry, but special glasses with a magnifying lens now allow Mr. Mendalis to read using his right eye, though he has to hold the paper a couple of inches from his face.

On a visit to the store at Lighthouse International, he spotted the Quicklook, made by Ash Technologies of Ireland, and bought one. His wife said that with the glasses and the Quicklook, "he's pretty much on his own now."

As the technology has changed, product design has become snazzier. Just a year ago, a device similar to the Quicklook had the size and aesthetics of a large brick, and it was $100 more expensive. Cost is important, because Medicare and most private insurance plans do not pay for visual aids. A federal study this year will look at the feasibility of Medicare coverage for vision rehabilitation services.

One product from Mr. Reisiger's company looks like the visor worn by the Geordi LaForge character, played by LeVar Burton, in "Star Trek: The Next Generation." In fact, the vision aid is called the Jordy and evolved partly from NASA technology. Images from a video camera are projected to the inside of the goggles.

Douglas Webber, a freshman at the University of Florida who has suffered vision problems since birth, started using an earlier version of the device, named LVES (and pronounced "Elvis") seven years ago. "It covered my whole head," he said. "It was two and a half pounds. It was basically like a helmet, a huge helmet on my head."

The Jordy, which costs $2,795, has many more features. It can show images in full color, even enhance the contrast artificially. Or it can mute the image to black and white or reverse black and white. The camera can also magnify images by a factor of 30. And it weighs a fifth of what the LVES did.

The Jordy has allowed Karoline Schmidt, 47, a seamstress in Canyonville, Ore., to continue sewing. Her vision has slowly deteriorated for the last two decades because of cysts growing on her corneas. She was about to shut down her business, the Sew-N-Sew Shop, when specialists from the Oregon Commission for the Blind brought her a slew of gadgets to try.

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Ruby Washington/The New York Times VISION GADGETS Dr. Bruce P. Rosenthal helps Maia Gregory with the Jordy, which projects video images to the inside of goggles. The Quicklook, above, enlarges text.

Thanks for posting this, as a suffer of very bad eye sight that is gradually getting worse I keep hoping they will come up with a product much like my glasses. I still must use a magnifier to work on my quilting even with glasses.

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