SEE BAD FEEL GOOD REMEMBER:

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1 SEE BAD FEEL GOOD REMEMBER: Even if you are old Even if you dont believe it is possible Even if life seems like a dead end Even if you have lost your dreams You can regain something to do, somone to love and a new project to look forward to

end Even if you have lost your dreams You can regain

2 Krister Inde, MA in spec ed Innovator of low vision rehabilitation in Sweden and in Jordan Low Vision Training 1975 See Bad Feel Good 2003 Eccentric Fixation and Use of Low Vision See More, 2005, Lund University Linneaus Uniersity- Indenova Inc. Leber s Disease with CFL since 1967 with 0,05

Eccentric Fixation and Use of Low Vision See More, 2005, Lund University

3 Come and visit us in Sweden

4 What is a low vision clinic Correct information Services offered to whom? Staff what professionals? Organisation where in the world? Core business what are the needs to be offered to whom and where and at what costs?

5 The Four LV Groups + 1 extra Central scotomas and VA <20/200 (<0.1) Abnormal nystagmus Peripheral restrictions Low visual acuity and reduced visual acuity 20/200 20/60 ( ) Visual field restrictions and perceptual problems due to Stroke

acuity and reduced visual acuity 20/200 20/60 (0.1-0.

6 All Methods to be used or not? Nova Vision to make dead parts come alive? Visio Coach train saccadic eye movements? To See is not Enough Gunvor Birkeland Wilhemsen. - Synanamnes is great! DynaVision trains neglect and attention in all directions NeuroVision Tech - trains sideways clinically and in real situations for better life Q? Treatments with Prisms by Boston research? Every other patient needs it? Danish Optomtric Behaviouism in addition?

7 Sweden 9,2 million inhabitants

8 Regional centers 34 Low Vision Centers in the 27 regions The largest one has more than Low Vision center employees 83 professionals Referrals by ophthalmologist VA 0.3 and lower Service is almost free!

center employees 83 professionals Referrals by

9 Low vision center in Jönköping Started 1976 Staff: 1 optometrist 4 low vision therapists 2 social workers Ophthalmologist consultant

10 Low vision center: Patients The province population about new referrals every year from ophthalmologists 3500 visits Always try with optical devises and training

11 Low Vision Therapy Started early 70th by Örjan Bäckman and Krister Inde 1975 the book Low Vision Training where published in English First LVC in 1973 role model from Copenhagen 1960 and New York 1953

Training where published in English 1979.

12 Special service Appr. 350 Home Instructors Seven Labor Market Offices Six places for Rehab Courses for LV Seniors Special Education Institute - service for low vision and blind children - education of teacher and parents

13 University of Kalmar Sweden Optometry School at Kalmar University From this year Linnaeus University Vision Enabling lab. Research with optometrists as doctoral students

University www.lnu.se Vision Enabling lab.

14 OPTOMETRIC REHABILITATION Since ,5 points Webbased for optometrists and low vision theraprists Low vision Optometry, Pshyckology, Team, Low Vision Training and Devices Pracitce, Interviews Three Meetings and web contacts

Optometry, Pshyckology, Team, Low Vision Training and

16 Finansiärer Ett projekt finansierat av: Synskadades riksförbund Norges Blindeförbund Dansk Blindesamfund Center for Syn og Kommunikation, CSK Ekhagastiftelsen (logga) Ett tiotal optik- och hjälpmedelsleverantörer med Multilens som huvudsponsor. Stort tack!

Kommunikation, CSK Ekhagastiftelsen (logga) Ett tiotal optik-

18 AMD - AGE TELATED MACUAR DEGENE-RATION It can be considered a pandemia 1 of 3 over 75! e

19 Help in different stages of AMD, particularly dry AMD FIRST STAGE Reduced vision skaffa bättre läsglasögon (högre addition) och en belysning som gör att du använder det bästa som linsen och näthinnan kan åstadkomma mitt i apoptos-problemen 0,7 0,4

addition) och en belysning som gör att du använder det bästa

20 Help in different stages of AMD SECOND STAGE Low vision öka förstoringen och kompensera den lägre tapptätheten i kombination med bra belysning 0,4 0,1

21 Help in different stages of dry AMD THIRD STAGE No macular vision central scotoma BRA - Best Retinal Area När merparten av Makula inte längre fungerar, då måste man hitta sin BNP, Bästa NäthinnePlatsen (på engelska BRA, Best Retina Area)

22 SEEnior a New Scandinavian Global AMD Rehab Program also in Israel? Krister Inde, Jörgen Gustafsson, Sweden, Gaute Mohn Jenssen, Arne Tömta, Norway, Kirsten Kobberö, Jytte Mejlvang, Kirsten Baggesen, Denmark Kalmar University, Sweden,

23 The Scandinavian SEEnior Team 7 professionals speaking three languages: 3 optometrists, 3 low vision therapists 1 ophthalmologist

24 Three Scandinavian and Five Nordic Countries Denmark, Norway, Sweden is Scandinavia + Iceland and Finland = the Nordic Countries Scandinavia - 20 million inhabitants with 69 low vision clinics and 600 professionals

26 The Poster of Scandinavian Low Vision 20 million Services Scandinavians whereof A Role 5% have Model? visual problems in everyday life, = 1 million that want your help, 2 of 3 over 65! 70 low vision clinics (82 employed in Stockholm, 51 in Copenhagen etc) 600 professionals (343 Sweden, 205 Denmark, 52 Norway) + Iceland (Eyes land) All devices free of charge on loan bases 1700 CCTVs at total amount of 6,5 million USD only in Sweden in Norway, 800 in Denmark!

27 Who do we see in SEEnior? AMD Patients, with emphasis on dry AMD from early stages of the disease to persons with CFL (central scotomas) AMD in three stages: 1. When reading starts to be a problem (+4 to +8) 2. When stronger magnification is needed in the macula (+8 to +24) 3. When PRL or BRS is needed (+24 to +56) and use of CCTV

28 Objectives: What can the world expect from SEEnior? We will develop a Professional Vision Enabling Program including Assessment and Training methods with materials for persons and professionals in AMD Rehab programs

29 Principles: AMD is an acronym for Altering Magnification Drastically The material starts at Reduced Vision and ends up at No Vision in the macula The material is designed Side by Side for Everyday Life with respect for Active and Passive Elderly Persons It involves optometrists and private eye doctors and ends up with low vision professionals Patients understand when they have

30 Inventory of materials used until now at 69 centers in Scandinavia What kind of materials do you use today for AMD persons? Have you made any materials of your own? What rehab programs are used? Preliminary results: No common programs, no standardized updated

31 wherever whenever What situations cause the biggest problems in AMD? 1. To learn to live with the problem (SEE BAD FEEL GOOD) 2. To learn to read at a closer distance in a natural way 3. To assess the right magnification size and method 4. To use and implement optical devices in everyday life, in the shop, in the golf course, in the garden, meeting friends in the street 5. To find the BRS, Best Retina Spot (PRL) 6. To learn not to drive 7. Not to feel embarrassed or ashamed of the poor visual function

32 BRA/PRL TEST FOR CFL PERSONS Where do I focus to see the objects better? BILD

33 MOVITEXT A new concept of reading a word document according to the earlier described training method of reading with PRL/CFL MOVITEXT IS A METHOD TO LEARN

34 User's Manual for SEEnior MANUAL - 40 pages for both professionals and very interested patients

35 Evaluation at 9 plus 2 centers during October/Nov ember 2008

36 Results: Production of reviced SEEnior materials in five languages Denmark 5,6 million Finland 5 million Iceland 0,3 million Norway 4,6 million Sweden 9,3 million Appr 25 million in the Nordic countries > 1,5 million with reduced vision, low vision or no vision.

37 Mina elever vet att jag inte ser så bra. Därför

38 SEEnior materials was published and implemented from March 2009 Interested? Yes, we would love to make it in more languages!

50 Mer texter att testa med

52 Synen blir sämre med du kommer klara dig bättre och bättre

53 Att läsa nära med optik

54 Eller med hjälp av elektronik

55 Läs och lyssna

56 Se på TV

57 Spela kort

58 Se och sy

59 Sticka och virka

60 Skyltar som visar vägen och tiden

61 Tolka suddiga bilder

62 Se en föreställning

63 Njut av en utställning

64 Ljus i tillvaron

65 Vem får köra bil?

66 Se nära på långt håll

67 Se upp med nacken

68 En bländande tillvaro

69 Gå och handla

70 Rätt gradtal på ugnen?

71 Storstilat tidur

72 Att finna rätt och laga god mat

73 En norsk, en dansk, en svensk och

74 Instrumenten att värdera med BNP = bästa näthinneplatsen - värderas med hjälp av BNP-test AVANTIMETER att värdera förstoringsbehov I förhållande till läsavstånd

78 BNP-test formelen Fikseringspunkt på aktuell leseavstand: Fokuseringpunkt (FP) x Arbeidsavstand m/hjm (AA) Testavstand (TA)

80 Avantimeter

81 Avantimeter

82 Avantimeter

83 LäsTV

87 Contact me and HiK, School of Optometry, Vision Enabling Lab De som hör av sig och skriver och klagar är mindre välkomna än de som hör av sig och vill förbättre och utveckla världen.

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