Who hasn’t been asked
"what’s it like to have” fill in the blank… When working with eyes, whether imaging
them or making prescription lenses, everyone assumes you know what it’s like to
be blind or to have certain diseases.
How can we describe to someone what it is in fact like to have a
degenerative disease that we have never experienced?
As imagers, we can
describe the physical characteristics, the part that the curious person
generally isn’t so curious about. Want
to know about ARMD? Sure, I can describe what it looks like from MY eyes when imaging
it. I can describe the process and
breakdown of the retina and how it affects Bruch’s membrane or the RPE; but
what it really looks like from the patient’s perspective? Luckily, I am at a
But now technology has a
way of keeping up with us! The Braille
Institute has come up with an app called VisionSim that allows you to "see”
with certain diseases. Using your camera
on your phone or other device, it simulates what the world would look like at
different stages of disease.
The app shows macular
degeneration, glaucoma, cataract, and diabetic retinopathy. So you know that kind old lady with macular
degeneration that drives herself in from out of town every six weeks for her
injections? Ever wonder what the road map looks like to her when she is on her
way to you? Well now you can see it for yourself… Over time that little blind spot becomes
invasive and all consuming.
How about that patient
who has a constant battle with their forever worsening glaucoma? They say it is like getting tunnel vision,
and while I feel confident I may have actually experienced "tunnel vision”
during a few of the more stressful moments in life, it has immediately
corrected itself. But what is it like for
those who are not so fortunate?
A simulation of cataract is another common
condition which is available to be observed.
As my grandfather described it to me- the world gets brighter and
everything has a glare. Sort of like a migraine maybe? I was always curious how it compared with
normal vision and always hoping to never find out. Well the app gods heard my thoughts because
here it is in all its glory. This one
seems to me to give a bit more realistic simulation than the glaucoma simulation
in its representation, but how can I really know for sure?!
finally, the diabetic retinopathy simulation.
I have often heard exclamations of "Oh my gosh, I can see my own veins!”
or "I can see the inside of my own eyes!” moments after shining obnoxiously
bright lights into the eyes of our poor unsuspecting patients. However, I’ve never had a patient tell me
that they can regularly see veins obstructing their vision. The simulated diabetic retinopathy presentation
shows the splotchy vision eventually having veins come into view? Whether or not this has any truth to it I do
not know as my encounter with patients does not often include specific
descriptions of their vision. Any of you out there know the truth of this??
So what is my favorite part of this
app? Well besides that fact that it can give you a sneak peek into the world of
some of your dear patients, and hopefully open all our hearts to a bit more compassionate
and empathetic… It’s free! I personally
have an Android phone so I hopped on to the Google Play Store to download it,
but I know it is also available (still for free) to all the Apple users out
there. I think the Braille Institute did
a good job with this, I just wish more people in ophthalmology knew about
Hillary Bernard, CRA has been at the University of
Michigan's Kellogg Eye Center for 5 years. She joined OPS in 2011 and is a
member of the Professional Development Committee. In her spare time, she
can be found out on her bike or racing her sailboat around the Great Lakes.