Perhaps more than any other sense, most of us fear losing vision the most. While we may know of people with hearing aids and walkers who lead near-normal lives, the thought of not being able to drive (or even walk) to the corner store leads to worries about the lack of independence such a condition engenders.
But even many serious eye problems can be treated, if not perfectly, then with an eye (no pun intended) toward maintaining the patient’s independence.
Dr. Laurie Chaikin of Wild Iris Optometry in Castro Valley is not only an optometrist, but also holds a Master’s degree in Occupational Therapy. This combination of skills has allowed her to focus on treating people with serious eye problems, in addition to performing routine vision screening.
Whether discussing the pros and cons of macular degeneration treatments, the independence of someone with Low Vision, or eye problems resulting from head injury or stroke, Chaikin focuses on what those mean for the patient’s daily life.
For instance, in a patient with Low Vision, which Chaikin defines as “a retinal specialist saying the person has 2200 or 2400 vision,” she pulls together a variety of optical aids and rehabilitative techniques to assist the person.
“We can still help them find portions of their retina and help them use magnifiers and other tools to help them be functional again. They can read, they can become independent, they can do crafts, painting, and read again.”
But Chaikin is also aware that the patient is not simply going to adapt to the new tools they must use and be deliriously happy. “Reading or using the computer won’t be as fast as it used to be. That’s why we train people and work with them. The process is a little slower.”
And along the way, the patient is likely to go through a grieving process of sorts, as they try to grapple with their new situation. “There’s a loss, the loss of their normal vision. Some people are not really ready to take action right away, either. They’re too upset and angered by the loss.”
In the case of macular degeneration, Chaikin says the difficulty comes with “the different decision points along the way,” as the patient must weigh the risks and benefits of various treatments. “For instance, if there’s bleeding in the macula, the patient has to decide: A laser can stop the bleeding, but make the vision worse. The laser can create a blind spot.”
That blind spot, however, is not necessarily disruptive, however. “The brain has an incredible ability to fill in where the vision is missing, and it helps keep us functioning normally,” she explains.
Chaikin also works with those experiencing vision problems as a result of a head injury or stroke. “For instance, in the case of a stroke, often people won’t dress half their body. Because of the stroke, they don’t recognize that half as being part of their body. The stroke destroyed that part of the brain that kept a ‘map’ of that half of the body.”
Chaikin works with the patient to overcome the problem, rebuilding the brain’s “map” that was lost due to the injury or stroke. “It’s an extremely slow process, redeveloping the lost piece of the map by reestablishing neurological connections,” she explains. “Progress is to greater or lesser degrees, but we don’t stop trying. We’ll also set up home-based programs, and include spouses or caretakers in the work as well,” she adds.
While Chaikin remains realistic about the most serious eye diseases, she also works hard to ensure her patients end up with the best quality of life possible. “Often, we can’t get the patient back to normal functioning, but we can improve things enough so the patient can be independent, or is at least OK to be left alone for long periods.”