Low Vision Resources in Tampa

Although medical and surgical treatments often help to restore vision or minimize loss of vision, many people lose vision permanently from various eye conditions. This information was compiled to inform you about what is available in the community to assist in overcoming some of the problems encountered with low vision. Keep in close contact with trusted friends and family members who can provide help. Remain as active as your health and vision with allow. Identify and treat depression with the help of your internist. You will not harm your eyes by trying to use them. You may sit close to the TV to see it better without risking damage to your eyes. When reading, good lighting is important (a gooseneck lamp may be helpful). To reduce glare when outdoors, consider wearing glasses tinted dark-yellow or amber.

TRANSPORTATION

CTI “Share-A-Van” transportation service………….272-7272

HARTline buses (discount for legal blindness)…….623-5835

Angel Wings/Red Cross (Free, Non-Medicaid).……251-0921

Evacuation Preparedness and Assistance………….272-6900

MAGNIFICATION

The Lighthouse for the Blind
1106 W. Platt Street
Tampa, FL 33606
(813) 251-2407
Harbor Freight

154 W Fletcher Ave

Tampa, FL 33612

(813) 930-0774

TELEPHONE DIRECTORY SERVICE

Free directory assistance over the phone from Verizon is available with a form filled out at our office.

HELP FOR VETERANS

VIS Program offers low-vision aids and training.

Call (813) 903-2441

TALKING BOOK LIBRARY

Applications for the free books on cassette tape are available from our office. Tapes are mailed to your home.

Hillsborough County Talking Book Library

3910 South Manhattan Avenue

Tampa, Florida 33611-1214

(813) 272-6024

U.S. National Library Service 1-800-424-8567

www.loc.gov/nls (books and magazines on tape)

Books and magazines on tape to keep (free):

American Printing House for the Blind 1-800-223-1839

Choice Magazines 1-888-724-6423

Large-print books (loan):

National Association for Visually Handicapped

1-212-889-3141 (www.navh.org)

SUPPORT GROUPS AND CLASSES

Eyes Only Support Group

Lighthouse for the Blind

1106 W. Platt Street

Tampa, Florida 33606

(813) 251-2407

REHABILITATION

Division of Blind Services

415 S Armenia Ave

Tampa, FL 33609

(813) 871-7190

Comprehensive Home Care

(813) 373-8438

 

LOW VISION CATALOG

Maxiaids Catalog (free catalog of helpful aids)

1-800-522-6294

LOW VISON SOFTWARE FOR COMPUTER

Freedom Scientific

http://www.freedomscientific.com/product-portal.asp)

1-800-444-4443

NEWSPAPER READING SERVICE

 USF Newspaper Reading Service broadcast by radio.

Applications are available in our office.

TAX RELIEF

 Tax deductions on property tax and income tax are available to persons who are legally blind. Your eye doctor can supply you with proper documentation of legal blindness.

ADDITIONAL INFORMATION ON LOW VISION:

National Eye Health Educational Program

National Institutes of Health (English and Spanish)

www.nei.nih.gov
Association for Macular Diseases (1-212-605-3719)

www.macula.org
Macular Degeneration Partnership (1-888-430-9898)

www.amd.org
MD Support (information and video: Learning to live with low vision)

www.mdsupport.org

Self-Help Books:

Making Life More Livable, M. Duffy, NY: American Foundation for the Blind, 2001; 1-800-232-3044

Macular Degeneration: The Complete Guide to Saving and Maximizing Your Sight, L. Mogk, MD & M. Mogk, PhD, NY: Ballantine 2003; available in bookstores and www.amazon.com

Overcoming Macular Degeneration: A Guide to Seeing Beyond the Clouds, S. Soloman, MD and J. Soloman, NY: Avon 2000; available in bookstores and www.amazon.com

This list was compiled to help provide information on available services for the visually impaired. It does not represent an endorsement of listed businesses or services. Please verify phone numbers and addresses as they may have changed since this publication was printed.

By Scott E. Pautler, MD

Copyright © 2017-2022 Designs Unlimited of Florida. All Rights Reserved.

Retinal Artery Occlusion

globe anatomy
anatomy of the eye (click on image to enlarge)

What is a retinal artery occlusion?

The retina in your eye is like the film inside a camera. The retina “takes the picture” of objects you look at and sends the message to the brain. The retina is a living tissue, which requires blood supplied by tiny vessels called arteries. If a retinal artery becomes blocked, it is called a retinal artery occlusion.

What causes a retinal artery occlusion?

Usually a blockage occurs from a piece of hardened artery in the neck (carotid artery) which breaks away and flows “down stream” to lodge in a small retinal artery. Hardening of the arteries is due to aging, obesity, high cholesterol, high blood pressure, diabetes, and tobacco use. Therefor, patients with retinal artery occlusion are at risk of other complications of hardening of the arteries (e.g. heart attack and stroke).

Abnormal tissue from a heart valve may also be the source of blockage. Rarely, an occlusion may result from blood disorders or inflammation such as giant cell arteritis. Fibromuscular dysplasia is suspected in young patients with retinal artery occlusion.  Trauma may cause retinal artery occlusion by dissection of the carotid artery, often associated with neck pain.

What are the symptoms of a retinal artery occlusion?

A sudden, painless loss of vision is common. There may be loss of only the central vision, the side vision, or there may be a dark bar or band above or below the center of vision. The loss of vision may be temporary or permanent.

What treatment is available?

If the blockage is mild, some or all of the vision may return with time. Sometimes it is necessary to help relieve the blockage with eye drops, pills, or an office procedure to lower the pressure in the eye. The blockage may be overcome and the blood flow may resume if the pressure in the eye is decreased quickly. This treatment may bring back some or all of the vision, but sometimes no treatment can bring back any vision. If an underlying medical problem is found, it must be treated.

Your doctor is going to order appropriate tests and recommend the best course of action to take at this time. The retinal artery occlusion will not be worsened by your daily activities or by using your eyes. If you have any questions, please feel free to ask.

What general health issues are there?

Retina artery occlusion usually indicates the need for an urgent general medical evaluation for increased risk of stroke. About 10% to 15% of people who experience retinal artery occlusion will suffer from a stroke within three months. Half of those individuals will have a stroke within 48 hours of having eye symptoms. Those people who survive this initial high-risk period must still be monitored because there is a 40% risk of stroke or heart attack within ten years from the time of retinal artery occlusion. This important health issues are why it is important to undergo regular general medical evaluations and work to minimize factors that worsen hardening of the arteries. Such factors include physical inactivity, overweight, tobacco use, high blood pressure, high cholesterol, and diabetes.

Where do I go for urgent care?

An urgent MRI brain scan (diffusion-weighted imaging) may be performed at a stroke center such as those available through the emergency room at Adventist Hospital, St. Joseph’s Hospital, or Tampa General Hospital. The brain scan can identify strokes that may be present without symptoms. Such strokes need to be treated in the hospital to prevent complications of paralysis and death.

Other important studies may also be performed to identify underlying treatable conditions. Blood tests may identify giant cell arteritis, a treatable inflammation of the arteries. A carotid sonogram studies the circulation of major arteries in the neck that lead to the brain and eyes. An ECHO cardiogram may identify an abnormal heart valve or a blood clot in the heart. These findings may be treatable to reduce the risk of future stroke.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Tampa Stroke Centers:

Adventist Hospital Emergency Department

3100 East Fletcher Avenue

Tampa, FL 33613

(813) 971-6000

St. Joseph’s Hospital Emergency Department

3001 W Dr Martin Luther King Jr Blvd

Tampa, FL 33607

(813) 870-4000

Tampa General Hospital Emergency Department

1 Tampa General Circle

Tampa, FL 33606

(813) 844-7000

Copyright  © 2014-2022 Designs Unlimited of Florida.  All Rights Reserved.

Retinal Detachment

globe anatomy
anatomy of the eye (click on image to enlarge)

What is the retina?

The retina is a “tissue-paper” thin layer of nerve tissue, which lines the inside of the eye like the film in a camera. In the eye, light is focused onto the retina, which “takes the picture” and sends the image to the brain.

What is retinal detachment?

When the retina detaches, it is no longer in proper position inside the eye. Instead, it is like film that has unrolled inside a camera. When this occurs, a camera cannot take a picture.  Similarly, when the retina detaches the eye loses vision.

Retinal break
Horseshoe-shaped retinal tear as seen in an eye with retinal detachment (Click on image for enlargement)

What causes retinal detachment?

Retinal breaks (holes and tears in the retina) cause retinal detachment. These retinal breaks are usually caused by a degeneration of the vitreous (the clear gel that fills the eye and normally helps to hold the retina in place). Vitreous degeneration is common in aging and near-sightedness, but may also follow a direct blow to the eye, hemorrhage, infection, or inflammation inside the eye. When the vitreous degenerates and condenses, it pulls on the retina and may cause retinal tears, which often lead to retinal detachment.

What are the symptoms of retinal detachment?

Prior to retinal detachment, most people notice warning signs such as new floating spots or “cobwebs” in the vision. Sometimes, brief lightning-like flashes of light are seen in the side vision. These are the symptoms of vitreous degeneration and retinal breaks. The retinal detachment that follows usually causes a dark “curtain” or “shadow” to form in the side-vision. The “shadow” often comes from below and on the side near the nose.  If it is not treated, the shadow gradually covers all of the vision resulting in blindness. There is generally no pain with retinal detachment.

How is retinal detachment treated?

The treatment of most retinal detachments requires surgery. Your doctor is skilled in a number of techniques to prevent blindness. Which type of surgery is recommended depends on the precise findings on examination. Surgery is not usually aimed at eliminating flashes and floaters. Flashes usually disappear in a few weeks or months. The floaters gradually fade over many months, but rarely disappear completely.  Some retinal detachments that do not cause symptoms may be observed without initial surgery.

Laser/Cryopexy demarcation:  Small areas of the retinal detachment (especially before any side vision has been lost) can sometimes be treated with laser or cryopexy to “seal down” the retinal along the edges of the detachment in an effort to prevent it from extending further.  This surgery is performed in the office. If it is not successful in stopping the detachment, more extensive surgery is required.

Pneumatic retinopexy:  Many retinal detachments can be repaired by this surgery performed in the office by anesthetizing the eye, sealing the break(s) with laser or a freezing probe (cryopexy), and pushing the retina into proper position with a gas bubble which is injected into the eye. Although this procedure is successful most of the time, it requires the strict cooperation of the patient to remain in proper head position for about five days. If this procedure fails, more extensive surgery in the hospital operating room is sometimes needed.

Scleral buckle surgery:  Some retinal detachments require the placement of a permanent plastic supporting belt around the eye to create a “ledge of support” for the retina. This is a major surgery in which a belt is placed around the eye in the hospital operating room. The eye is often rendered more near sighted by this procedure. Rarely, permanent side effects include double vision. If this surgery is not successful, vitrectomy surgery may be recommended. Scleral buckle surgery is preferred over other methods of surgery if the retinal breaks are located in the inferior (bottom portion) of the retina, where gas bubbles may not be effective in holding the retinal in position. Scleral buckle is also preferred over vitrectomy in eyes with a clear lens, because vitrectomy surgery usually results in cataract formation. Scleral buckle surgery is often used when other attempts at surgery have failed.

The video below demonstrates scleral buckle surgery. If you are uncomfortable watching surgery, please do not click on this video:

Vitrectomy surgery:  Performed in the hospital operating room as a major eye surgery, vitrectomy surgery involves making small incisions into the eye to remove floaters, dissect scar tissue, remove fluid from under the retina, apply laser, and place a gas bubble or silicone oil into the eye to hold the retina in place. Specific head positioning is sometimes needed. Sometimes a cataract or lens implant must be removed to adequately repair the retina. This surgery may be repeated if necessary to prevent blindness.

The video below demonstrates vitrectomy surgery. If you are uncomfortable watching surgery, please do not click on this video:

With one or more surgeries most retinal detachments can be repaired keeping useful vision. Vision may not return to normal, as there may be some permanent damage from the retinal detachment resulting in blurred or distorted vision. In some cases additional surgery is needed to removed scar tissue that forms after retinal reattachment surgery.  There are always risks to surgery including hemorrhage, infection, scarring, glaucoma, cataract, double vision, deformity, loss of vision/loss of the eye. Sometimes despite all efforts with surgery, all vision may be lost. Surgery is recommended for retinal detachments because blindness usually results if treatment is withheld. If you have questions, please do not hesitate to ask your doctor.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Copyright  © 2014-2023 Designs Unlimited of Florida.  All Rights Reserved.