WEBVTT 1 00:00:00.156 --> 00:00:03.156 (soft bright music) 2 00:00:04.110 --> 00:00:06.180 Welcome to "Hadley Presents." 3 00:00:06.180 --> 00:00:11.070 I'm your host, Ricky Enger, inviting you to sit back, relax, 4 00:00:11.070 --> 00:00:14.220 and enjoy a conversation with the experts. 5 00:00:14.220 --> 00:00:18.180 In this episode, Occupational Therapist, Fay Tripp, 6 00:00:18.180 --> 00:00:21.330 along with Hadley's Chief Program Officer Ed Haines 7 00:00:21.330 --> 00:00:23.760 join us to discuss bioptics. 8 00:00:23.760 --> 00:00:25.830 Welcome to the show, both of you. 9 00:00:25.830 --> 00:00:26.820 Thanks, Ricky. 10 00:00:26.820 --> 00:00:27.960 Good morning. 11 00:00:27.960 --> 00:00:29.940 So glad to have you here, Fay, 12 00:00:29.940 --> 00:00:32.160 and always good to have you, Ed. 13 00:00:32.160 --> 00:00:34.950 We're talking today about a subject 14 00:00:34.950 --> 00:00:36.990 that I know very little about. 15 00:00:36.990 --> 00:00:38.790 This is one thing I love about my job 16 00:00:38.790 --> 00:00:41.460 is that I get to learn something new every day, 17 00:00:41.460 --> 00:00:44.910 and we get to share that with our audience as well. 18 00:00:44.910 --> 00:00:48.720 So, before we get started talking about bioptics, 19 00:00:48.720 --> 00:00:50.460 what they are, and what they do, 20 00:00:50.460 --> 00:00:52.680 and who can use them, that kind of thing, 21 00:00:52.680 --> 00:00:55.710 let's just take a moment to get a little information 22 00:00:55.710 --> 00:00:57.570 about each of you. 23 00:00:57.570 --> 00:00:59.400 Ed, you've been on the show before, 24 00:00:59.400 --> 00:01:00.420 but we'll start with you. 25 00:01:00.420 --> 00:01:02.880 I, of course, you're Hadley's chief program officer, 26 00:01:02.880 --> 00:01:05.940 and I think you've also had some field experience 27 00:01:05.940 --> 00:01:06.960 as well, right? 28 00:01:06.960 --> 00:01:07.793 Yeah, thanks, Ricky, 29 00:01:07.793 --> 00:01:09.870 yeah, I'm the chief program officer at Hadley, 30 00:01:09.870 --> 00:01:12.180 but I've also worked as a voc rehab counselor, 31 00:01:12.180 --> 00:01:14.850 and a vision rehab therapist for many years, 32 00:01:14.850 --> 00:01:17.550 so, I am a little familiar with the use of bioptics. 33 00:01:17.550 --> 00:01:19.200 It's an important topic, so, I'm really glad 34 00:01:19.200 --> 00:01:20.310 we're talking about it today, 35 00:01:20.310 --> 00:01:23.340 and I'm grateful that Fay is willing to speak with us today. 36 00:01:23.340 --> 00:01:25.320 Yes, we so appreciate that. 37 00:01:25.320 --> 00:01:28.500 Fay, can you tell us a bit about yourself, as well? 38 00:01:28.500 --> 00:01:31.800 Good morning, and thanks so much for having me 39 00:01:31.800 --> 00:01:33.570 chat with you this morning. 40 00:01:33.570 --> 00:01:35.610 I am an occupational therapist. 41 00:01:35.610 --> 00:01:39.450 I've worked within the Duke system for about 33 years, 42 00:01:39.450 --> 00:01:42.420 and about 15 years, I've been involved 43 00:01:42.420 --> 00:01:44.970 with Duke Eye Center Vision Rehab group, 44 00:01:44.970 --> 00:01:48.420 and full-time for the last eight years. 45 00:01:48.420 --> 00:01:51.600 And within the realm of occupational therapy 46 00:01:51.600 --> 00:01:54.120 prior to the vision rehab part, 47 00:01:54.120 --> 00:01:58.110 I worked in general rehab setting, and then acute care, 48 00:01:58.110 --> 00:02:00.660 and I've worked in outpatient in a variety 49 00:02:00.660 --> 00:02:01.740 of different settings. 50 00:02:01.740 --> 00:02:04.320 So, with the background, I feel like it's brought 51 00:02:04.320 --> 00:02:06.870 a good foundation to the world of vision, 52 00:02:06.870 --> 00:02:09.450 because we don't just see the person 53 00:02:09.450 --> 00:02:11.160 with their vision limitation, 54 00:02:11.160 --> 00:02:13.470 we work with a person as a whole person. 55 00:02:13.470 --> 00:02:17.160 So, in our setting, especially with our population now 56 00:02:17.160 --> 00:02:18.840 of older adults, 57 00:02:18.840 --> 00:02:23.250 we typically don't have just the vision issue to address, 58 00:02:23.250 --> 00:02:25.080 it's other issues, too. 59 00:02:25.080 --> 00:02:28.080 So, I'm thankful for the background, 60 00:02:28.080 --> 00:02:31.890 and to be able to pull all of that into the world of vision, 61 00:02:31.890 --> 00:02:34.770 and I have had an opportunity to work with folks 62 00:02:34.770 --> 00:02:36.930 with bioptics over the last eight years, 63 00:02:36.930 --> 00:02:39.420 so, I hope that I can share some information today 64 00:02:39.420 --> 00:02:41.010 that will be helpful. 65 00:02:41.010 --> 00:02:43.001 Yeah, it really sounds like you're the ideal 66 00:02:43.001 --> 00:02:43.834 person 67 00:02:43.834 --> 00:02:45.120 to take this on, 68 00:02:45.120 --> 00:02:50.120 not only because you do have experience with bioptics, 69 00:02:50.400 --> 00:02:55.400 but also the fact that you are treating patients 70 00:02:55.800 --> 00:02:57.030 as whole people, 71 00:02:57.030 --> 00:03:00.750 not just sort of a vision problem to be solved 72 00:03:00.750 --> 00:03:04.380 is so important and doesn't always happen. 73 00:03:04.380 --> 00:03:07.500 So, yeah, really glad to have you here 74 00:03:07.500 --> 00:03:09.360 to talk about bioptics, 75 00:03:09.360 --> 00:03:13.050 and I'm looking forward to learning a bit more about them, 76 00:03:13.050 --> 00:03:15.990 and who might be able to use them. 77 00:03:15.990 --> 00:03:20.550 So, with that, I'm ready to sit back and take it all in, 78 00:03:20.550 --> 00:03:23.190 so, I'm gonna throw things over to you, Ed. 79 00:03:23.190 --> 00:03:24.840 I know you have a lot of great questions, 80 00:03:24.840 --> 00:03:26.940 so, let's get right into it. 81 00:03:26.940 --> 00:03:28.140 Oh, well, thanks, Ricky. 82 00:03:28.140 --> 00:03:30.240 Fay, let's just start with the basics. 83 00:03:30.240 --> 00:03:32.938 If you could just tell us, what are bioptics? 84 00:03:32.938 --> 00:03:35.190 What do they even physically look like, 85 00:03:35.190 --> 00:03:36.840 and how are they constructed? 86 00:03:36.840 --> 00:03:40.740 Sure, so, bioptics, it's two parts, 87 00:03:40.740 --> 00:03:44.340 for bi as two, and then optics is, like, the glasses part. 88 00:03:44.340 --> 00:03:48.240 So, bioptic telescope lens system glasses 89 00:03:48.240 --> 00:03:51.240 are essentially made up of the two parts 90 00:03:51.240 --> 00:03:53.910 of the regular glasses, as you think of glasses, 91 00:03:53.910 --> 00:03:55.380 with the prescription lens, 92 00:03:55.380 --> 00:03:58.980 and then the bioptic is either attached, as we would say, 93 00:03:58.980 --> 00:04:01.800 a frame mounted system, or a clip-on system. 94 00:04:01.800 --> 00:04:05.640 There are different versions of the bioptic glasses, 95 00:04:05.640 --> 00:04:08.460 and it really depends on what a person's needs are, 96 00:04:08.460 --> 00:04:11.970 and how they would be fit or prescribed the glasses. 97 00:04:11.970 --> 00:04:14.610 So, generally, it's a pair of glasses 98 00:04:14.610 --> 00:04:18.240 with the telescope mounted to it in a variety of ways 99 00:04:18.240 --> 00:04:22.410 so that it allows a person to use their regular lens 100 00:04:22.410 --> 00:04:24.210 just for distance, 101 00:04:24.210 --> 00:04:27.600 but then the telescope gives that ability 102 00:04:27.600 --> 00:04:29.280 to see much further, 103 00:04:29.280 --> 00:04:32.760 so, to expand the world to a much further space 104 00:04:32.760 --> 00:04:35.400 than what the regular glasses would. 105 00:04:35.400 --> 00:04:38.340 Well, that makes sense, and maybe you could explain 106 00:04:38.340 --> 00:04:41.280 a little about the experience of using bioptics? 107 00:04:41.280 --> 00:04:43.500 I know that folks who are new to vision loss, 108 00:04:43.500 --> 00:04:46.020 they're always looking for some kind of optical device 109 00:04:46.020 --> 00:04:48.930 that's gonna make them see the way they used to see, right? 110 00:04:48.930 --> 00:04:50.550 It's just a normal thing. 111 00:04:50.550 --> 00:04:52.860 So, do bioptics do that? 112 00:04:52.860 --> 00:04:54.360 Are they easy to use? 113 00:04:54.360 --> 00:04:56.400 And what do people say they like about them, 114 00:04:56.400 --> 00:04:57.480 and what are the kinds of things 115 00:04:57.480 --> 00:04:59.400 that people don't like about them? 116 00:04:59.400 --> 00:05:03.030 Sure, so, it's not gonna revert the vision back 117 00:05:03.030 --> 00:05:05.460 to the way it used to be. 118 00:05:05.460 --> 00:05:07.950 For example, before the vision loss 119 00:05:07.950 --> 00:05:09.240 or the vision impairment, 120 00:05:09.240 --> 00:05:12.840 it may not get the vision back to that point. 121 00:05:12.840 --> 00:05:16.890 What the telescope classes do is to magnify, 122 00:05:16.890 --> 00:05:19.200 so, if the person's limited in their vision 123 00:05:19.200 --> 00:05:21.990 in a way, like a visual field limitation, 124 00:05:21.990 --> 00:05:25.050 it's not gonna replace that visual field limitation. 125 00:05:25.050 --> 00:05:27.540 What it will do is magnify an image 126 00:05:27.540 --> 00:05:29.820 so that it's like bringing it up closer. 127 00:05:29.820 --> 00:05:32.640 So, to relate to the use of binoculars, 128 00:05:32.640 --> 00:05:35.400 so, when a person looks through binoculars, 129 00:05:35.400 --> 00:05:37.710 everything is up really close. 130 00:05:37.710 --> 00:05:42.060 It magnifies, it gets a bigger image on the retina 131 00:05:42.060 --> 00:05:44.460 or the back of the eye so that a person 132 00:05:44.460 --> 00:05:46.560 can take that information in more easily, 133 00:05:46.560 --> 00:05:49.050 and then, functionally, they see it better. 134 00:05:49.050 --> 00:05:52.530 So, the telescope glasses will not correct 135 00:05:52.530 --> 00:05:54.780 for any visual field limitation, 136 00:05:54.780 --> 00:05:57.990 or if there's distortion, or so forth, 137 00:05:57.990 --> 00:06:00.480 so, it's not gonna make it like it used to be, 138 00:06:00.480 --> 00:06:03.450 but what it does is magnifies the image 139 00:06:03.450 --> 00:06:07.380 so it's a bigger image on the retina on the back of the eye 140 00:06:07.380 --> 00:06:10.800 so that the whole visual system can take that information in 141 00:06:10.800 --> 00:06:12.750 and use it more efficiently. 142 00:06:12.750 --> 00:06:17.160 Whether it's easy to use or not, that's depends on the user. 143 00:06:17.160 --> 00:06:19.890 Some people catch on very, very quickly, 144 00:06:19.890 --> 00:06:22.740 and some people may have more trial time 145 00:06:22.740 --> 00:06:25.860 and more practice time to get really comfortable with it, 146 00:06:25.860 --> 00:06:28.560 and the practice time is really important. 147 00:06:28.560 --> 00:06:32.400 One of the factors that we would consider 148 00:06:32.400 --> 00:06:35.670 prior to the optometrist or ophthalmologist 149 00:06:35.670 --> 00:06:40.670 prescribing bioptics is to really encourage a real trial use 150 00:06:40.673 --> 00:06:42.810 so that a person would come into the clinic 151 00:06:42.810 --> 00:06:45.240 to see can they actually do it, 152 00:06:45.240 --> 00:06:47.940 and it's something that they really wanna pursue, 153 00:06:47.940 --> 00:06:49.980 because it can be a challenge. 154 00:06:49.980 --> 00:06:53.040 When a person is using one of the common types 155 00:06:53.040 --> 00:06:54.150 of telescopes, 156 00:06:54.150 --> 00:06:57.060 they may be looking through their regular lens glasses, 157 00:06:57.060 --> 00:07:00.120 but the telescope's mounted on the top of the frame, 158 00:07:00.120 --> 00:07:02.280 so, what they have to do is just transition, 159 00:07:02.280 --> 00:07:05.490 or finding a target with their eye vision, 160 00:07:05.490 --> 00:07:07.890 transitioning from the carrier frame lens, 161 00:07:07.890 --> 00:07:11.310 the regular lens down into the telescope, 162 00:07:11.310 --> 00:07:13.770 and to be able to spot their target 163 00:07:13.770 --> 00:07:15.720 as they look through the telescope. 164 00:07:15.720 --> 00:07:20.310 So, it does require a level of eye control, 165 00:07:20.310 --> 00:07:23.280 cognitive ability to learn new skills, 166 00:07:23.280 --> 00:07:27.900 and the ability to get comfortable with that movement sense. 167 00:07:27.900 --> 00:07:29.190 And that's really useful, Fay, 168 00:07:29.190 --> 00:07:31.440 'cause I know in the past, I've had folks 169 00:07:31.440 --> 00:07:33.157 who are new to vision loss tell me, 170 00:07:33.157 --> 00:07:35.550 "Oh, a friend of mine said you can get these great glasses, 171 00:07:35.550 --> 00:07:38.160 and they'll just fix everything, and it'll be super easy," 172 00:07:38.160 --> 00:07:39.540 and it sounds like this is something 173 00:07:39.540 --> 00:07:41.490 that does require practice, 174 00:07:41.490 --> 00:07:45.240 and a certain amount of cards to all be in the right order. 175 00:07:45.240 --> 00:07:48.630 So, are there certain types of patients 176 00:07:48.630 --> 00:07:50.310 that do better with bioptics? 177 00:07:50.310 --> 00:07:52.230 Or are there certain types of eye conditions 178 00:07:52.230 --> 00:07:54.030 that people have that are more prevalent 179 00:07:54.030 --> 00:07:56.190 among bioptic users? 180 00:07:56.190 --> 00:07:59.340 Yeah, so, again, we might look at the whole person 181 00:07:59.340 --> 00:08:02.610 and the whole visual functional status, 182 00:08:02.610 --> 00:08:04.890 although there are certain eye disease processes 183 00:08:04.890 --> 00:08:09.480 that would be more supportive of using the telescope. 184 00:08:09.480 --> 00:08:13.290 Ocular albinism is one of those, 185 00:08:13.290 --> 00:08:17.190 whereas the visual fields are usually full, 186 00:08:17.190 --> 00:08:19.320 but it's an acuity limitation, 187 00:08:19.320 --> 00:08:24.090 so, when a person uses the telescope, then it magnifies, 188 00:08:24.090 --> 00:08:27.690 so, it improves their visual acuity at a distance, 189 00:08:27.690 --> 00:08:29.850 and they're not hindered by any limitation 190 00:08:29.850 --> 00:08:31.770 in the visual field, potentially. 191 00:08:31.770 --> 00:08:34.290 Another common might be Stargardt's. 192 00:08:34.290 --> 00:08:37.620 Then again, that's a macular degeneration issue, 193 00:08:37.620 --> 00:08:40.920 usually an earlier onset limitation, 194 00:08:40.920 --> 00:08:42.840 but then again, it depends on the person, 195 00:08:42.840 --> 00:08:44.940 because if there's a central vision deficit, 196 00:08:44.940 --> 00:08:49.470 and there's a significant visual blind spot or scotoma there 197 00:08:49.470 --> 00:08:54.240 that may hinder the person from using a telescope, 198 00:08:54.240 --> 00:08:56.820 and because of the way it has to be mounted. 199 00:08:56.820 --> 00:08:59.849 Certainly, other eye issues, 200 00:08:59.849 --> 00:09:02.250 myopia, which would be nearsightedness, 201 00:09:02.250 --> 00:09:05.070 or when a person can see close up, 202 00:09:05.070 --> 00:09:09.480 but they can't see far away would be a strong indication 203 00:09:09.480 --> 00:09:12.570 for possibly benefiting from the telescope glasses, 204 00:09:12.570 --> 00:09:14.550 because they can see up close, 205 00:09:14.550 --> 00:09:17.310 but then the corrective lenses may not help them see 206 00:09:17.310 --> 00:09:19.050 as far away as they might need to 207 00:09:19.050 --> 00:09:20.730 for their functional goals, 208 00:09:20.730 --> 00:09:23.730 like for employment, or just in the community, 209 00:09:23.730 --> 00:09:25.860 and seeing those fast food restaurant menus, 210 00:09:25.860 --> 00:09:27.570 or the bathroom sign is. 211 00:09:27.570 --> 00:09:28.950 They don't, you know, wanna be able to see 212 00:09:28.950 --> 00:09:30.570 those kind of things from a distance, 213 00:09:30.570 --> 00:09:33.630 and expand their whole visual world 214 00:09:33.630 --> 00:09:36.780 so they have a little bit more accessibility 215 00:09:36.780 --> 00:09:39.150 to real things in life. 216 00:09:39.150 --> 00:09:42.900 One of the primary reasons a person may use a telescope 217 00:09:42.900 --> 00:09:44.430 that's mounted to their glasses 218 00:09:44.430 --> 00:09:47.040 and be hands free is for driving, 219 00:09:47.040 --> 00:09:49.800 or for use when they're in a moving situation, 220 00:09:49.800 --> 00:09:52.380 because you can't hold the telescope device 221 00:09:52.380 --> 00:09:55.320 when moving or doing other things. 222 00:09:55.320 --> 00:09:59.550 So, being able to expand the world for that is important, 223 00:09:59.550 --> 00:10:02.550 but not everyone might be able to use that, 224 00:10:02.550 --> 00:10:06.300 and again, it depends on their visual field, 225 00:10:06.300 --> 00:10:09.330 and if their visual field is intact 226 00:10:09.330 --> 00:10:12.090 to where the telescope would be mounted, 227 00:10:12.090 --> 00:10:16.170 and if their visual acuity is sufficient 228 00:10:16.170 --> 00:10:18.870 to allow them to look through the telescope 229 00:10:18.870 --> 00:10:20.463 and benefit from that. 230 00:10:21.420 --> 00:10:22.440 So, that's really interesting. 231 00:10:22.440 --> 00:10:25.830 It sounds like they're not for everyone, 232 00:10:25.830 --> 00:10:28.020 and you've mentioned some specific activities 233 00:10:28.020 --> 00:10:29.460 that people do use them for. 234 00:10:29.460 --> 00:10:30.870 You mentioned looking at menus. 235 00:10:30.870 --> 00:10:33.030 I like that idea, at a fast food restaurant, 236 00:10:33.030 --> 00:10:34.980 looking up at the menu. 237 00:10:34.980 --> 00:10:36.510 The million dollar question, of course, 238 00:10:36.510 --> 00:10:37.860 is using them for driving, 239 00:10:37.860 --> 00:10:40.890 but before we get there to talk about that, 240 00:10:40.890 --> 00:10:42.870 are there, just in your experience, 241 00:10:42.870 --> 00:10:44.280 are there some specific activities 242 00:10:44.280 --> 00:10:46.560 that people really tend to use bioptics for 243 00:10:46.560 --> 00:10:48.840 if they're not using them for driving? 244 00:10:48.840 --> 00:10:52.050 Yeah, so, there are, 245 00:10:52.050 --> 00:10:54.630 and in our clinic, many people do come in 246 00:10:54.630 --> 00:10:55.770 specifically for that, 247 00:10:55.770 --> 00:10:58.200 but my main message to them is that this 248 00:10:58.200 --> 00:11:00.780 is not just for that purpose. 249 00:11:00.780 --> 00:11:03.660 The bioptic telescope glasses are for all 250 00:11:03.660 --> 00:11:07.170 of your life activities that may require distance vision, 251 00:11:07.170 --> 00:11:08.730 and there are different options 252 00:11:08.730 --> 00:11:10.140 for the telescope glasses, too, 253 00:11:10.140 --> 00:11:13.260 that allow for near vision, for spot-checking. 254 00:11:13.260 --> 00:11:16.470 Not to read a book, but for spot-checking details. 255 00:11:16.470 --> 00:11:19.440 So, some of the main message is that get used 256 00:11:19.440 --> 00:11:22.200 to using the telescope glasses in your whole life 257 00:11:22.200 --> 00:11:23.190 when you go shopping, 258 00:11:23.190 --> 00:11:27.000 and seeing those overhead signs when you're traveling, 259 00:11:27.000 --> 00:11:31.260 and you need to see in an airport the flight numbers 260 00:11:31.260 --> 00:11:33.390 or the gate numbers. 261 00:11:33.390 --> 00:11:36.690 A common thing is when we're in the community, 262 00:11:36.690 --> 00:11:39.330 and we see someone at a distance, 263 00:11:39.330 --> 00:11:40.410 and it looks like they're waving, 264 00:11:40.410 --> 00:11:41.820 but are they waving at me, 265 00:11:41.820 --> 00:11:43.620 or are they waving at somebody else? 266 00:11:43.620 --> 00:11:45.510 Or who is that person? 267 00:11:45.510 --> 00:11:47.940 I always think of using the telescope 268 00:11:47.940 --> 00:11:51.420 to expand the world to see, you know, 269 00:11:51.420 --> 00:11:54.423 the detail that's necessary to make a good decision. 270 00:11:55.320 --> 00:11:58.590 So, in the community, just for real life function, 271 00:11:58.590 --> 00:12:02.820 shopping, social interactions, on the job, 272 00:12:02.820 --> 00:12:04.200 of course, what the job is, 273 00:12:04.200 --> 00:12:08.430 but for being able to interact more with customers 274 00:12:08.430 --> 00:12:13.430 or the presentation that's being presented on the board, 275 00:12:15.030 --> 00:12:17.310 in social situations, like at church, 276 00:12:17.310 --> 00:12:20.250 or other kinds of meetings where, you know, 277 00:12:20.250 --> 00:12:23.460 sitting may not allow to sit up close, 278 00:12:23.460 --> 00:12:26.550 but the telescope will allow that use of ability 279 00:12:26.550 --> 00:12:30.060 to see the pastor, or to see the speaker, 280 00:12:30.060 --> 00:12:32.040 or to see the choir members, 281 00:12:32.040 --> 00:12:35.310 or to see other signs and information 282 00:12:35.310 --> 00:12:40.310 that would be helpful in interacting with the community. 283 00:12:40.350 --> 00:12:42.570 Well, it sounds like for the right person, 284 00:12:42.570 --> 00:12:44.040 they could really be useful. 285 00:12:44.040 --> 00:12:48.810 So, if someone wants to get bioptics, 286 00:12:48.810 --> 00:12:51.840 are say, Medicare pay for them, insurance? 287 00:12:51.840 --> 00:12:53.343 How do you actually get them? 288 00:12:54.240 --> 00:12:57.000 So, it is a whole process to get 289 00:12:57.000 --> 00:12:58.620 the bioptic telescope glasses, 290 00:12:58.620 --> 00:13:01.170 and the individual would need to be seen 291 00:13:01.170 --> 00:13:02.940 by an eyecare professional, 292 00:13:02.940 --> 00:13:06.120 one that can prescribe glasses, 293 00:13:06.120 --> 00:13:08.310 because it is an optical device, 294 00:13:08.310 --> 00:13:11.130 so, it would be an optometrist or an ophthalmologist. 295 00:13:11.130 --> 00:13:14.250 Not every optometrist or ophthalmologist 296 00:13:14.250 --> 00:13:17.370 may be familiar with the bioptic telescope ordering 297 00:13:17.370 --> 00:13:18.660 or prescribing process, 298 00:13:18.660 --> 00:13:22.620 so, it would be helpful to ask those questions 299 00:13:22.620 --> 00:13:24.570 before scheduling an appointment. 300 00:13:24.570 --> 00:13:27.180 Typically, it would be someone that's identified 301 00:13:27.180 --> 00:13:31.020 as a low-vision specialist or low-vision care provider, 302 00:13:31.020 --> 00:13:34.440 and that person would be able to prescribe, 303 00:13:34.440 --> 00:13:37.260 just like the eye doctor prescribes glasses, 304 00:13:37.260 --> 00:13:38.430 there is prescription, 305 00:13:38.430 --> 00:13:43.200 and then the decision has to be made as to what type 306 00:13:43.200 --> 00:13:46.950 of telescope would meet the individual's needs, 307 00:13:46.950 --> 00:13:49.080 and how strong the telescope could be 308 00:13:49.080 --> 00:13:51.180 to meet the individual's needs. 309 00:13:51.180 --> 00:13:55.290 Some states, if the individual's visual acuity 310 00:13:55.290 --> 00:13:59.850 has an indication on how strong the telescope should be, 311 00:13:59.850 --> 00:14:03.420 and in some states, for example, for driving, 312 00:14:03.420 --> 00:14:07.740 the individual would need to have a certain visual acuity 313 00:14:07.740 --> 00:14:09.720 through the telescope. 314 00:14:09.720 --> 00:14:12.270 That's where the optometrist or ophthalmologist 315 00:14:12.270 --> 00:14:13.260 skill comes in, 316 00:14:13.260 --> 00:14:16.260 is that they need to prescribe the certain power 317 00:14:16.260 --> 00:14:19.050 of telescope to allow the individual 318 00:14:19.050 --> 00:14:22.170 to have that certain visual acuity 319 00:14:22.170 --> 00:14:24.540 when looking through the telescope. 320 00:14:24.540 --> 00:14:27.960 Elsewise, the person may get a telescope 321 00:14:27.960 --> 00:14:30.780 that does not meet the guidelines, so, they're limited, 322 00:14:30.780 --> 00:14:32.880 because they can't pursue their main goal. 323 00:14:32.880 --> 00:14:35.550 Once a person has been prescribed a pair 324 00:14:35.550 --> 00:14:37.890 of bioptic telescope glasses, 325 00:14:37.890 --> 00:14:40.500 and that order has been filled, 326 00:14:40.500 --> 00:14:42.090 the telescope user would come in 327 00:14:42.090 --> 00:14:44.100 and be fit for the telescope, 328 00:14:44.100 --> 00:14:47.040 have the telescope glasses dispensed, 329 00:14:47.040 --> 00:14:48.900 and then they would do training. 330 00:14:48.900 --> 00:14:52.620 The individual optical shops have different processes 331 00:14:52.620 --> 00:14:53.940 for training. 332 00:14:53.940 --> 00:14:56.250 I just highly suggest that you, 333 00:14:56.250 --> 00:14:57.960 whether it's through the optical shop 334 00:14:57.960 --> 00:15:01.590 or through another low-vision center or vision rehab center, 335 00:15:01.590 --> 00:15:05.430 make sure that there is training that's completed 336 00:15:05.430 --> 00:15:08.610 in how to use the telescope glasses, how to care for it, 337 00:15:08.610 --> 00:15:11.250 and how to use it functionally for safety. 338 00:15:11.250 --> 00:15:13.950 You ask about Medicare insurance, 339 00:15:13.950 --> 00:15:16.770 it's up to the individual provider 340 00:15:16.770 --> 00:15:20.820 what their guidelines are for insurance coverage, 341 00:15:20.820 --> 00:15:23.190 or if it's an out-of-pocket expense. 342 00:15:23.190 --> 00:15:25.230 I can tell you that Medicare itself 343 00:15:25.230 --> 00:15:27.990 does not cover bioptic telescope glasses. 344 00:15:27.990 --> 00:15:30.660 Most private insurances do not. 345 00:15:30.660 --> 00:15:33.060 There are some private vision insurances 346 00:15:33.060 --> 00:15:34.890 that can help cover, 347 00:15:34.890 --> 00:15:37.860 but that would be up to that individual insurance, 348 00:15:37.860 --> 00:15:41.370 and then the insurance subscribers should communicate 349 00:15:41.370 --> 00:15:44.640 very clearly about what the coverage options are 350 00:15:44.640 --> 00:15:47.400 prior to pursuing the telescope classes, 351 00:15:47.400 --> 00:15:49.470 because it would be very important to know 352 00:15:49.470 --> 00:15:53.190 what the options are ahead of time before committing. 353 00:15:53.190 --> 00:15:55.530 There are coverage options in some states 354 00:15:55.530 --> 00:15:59.940 for vocational rehab and independent living skill services 355 00:15:59.940 --> 00:16:03.420 where the device may be used, for example, 356 00:16:03.420 --> 00:16:06.000 on the job with vocational rehab, 357 00:16:06.000 --> 00:16:09.090 and some states can cover the telescope glasses 358 00:16:09.090 --> 00:16:11.070 for on-the-job performance. 359 00:16:11.070 --> 00:16:13.290 Many states will, from my understanding, 360 00:16:13.290 --> 00:16:15.810 will not cover it, though, for driving purposes, 361 00:16:15.810 --> 00:16:19.590 because they may not have an option for driver's training, 362 00:16:19.590 --> 00:16:22.470 and for the liability circumstances, 363 00:16:22.470 --> 00:16:25.560 they may not be able to pursue that. 364 00:16:25.560 --> 00:16:28.368 We've sort of touched on the topic of 365 00:16:28.368 --> 00:16:29.490 bioptic driving, 366 00:16:29.490 --> 00:16:32.580 and that's what a lot of folks are really interested in, 367 00:16:32.580 --> 00:16:35.430 so, obviously, it's not easy to get bioptics 368 00:16:35.430 --> 00:16:36.263 in the first place. 369 00:16:36.263 --> 00:16:37.980 There's a lot of tests and and training 370 00:16:37.980 --> 00:16:39.480 that needs to take place. 371 00:16:39.480 --> 00:16:41.850 What else has to happen if you're determined 372 00:16:41.850 --> 00:16:45.840 that bioptics are appropriate for driving for you, 373 00:16:45.840 --> 00:16:47.310 at least visually, 374 00:16:47.310 --> 00:16:50.370 then just, in short, what has to happen 375 00:16:50.370 --> 00:16:53.370 in addition to that to be able to actually obtain 376 00:16:53.370 --> 00:16:54.330 a bioptic license? 377 00:16:54.330 --> 00:16:56.760 And I know it's different in every state, so, we, (chuckles) 378 00:16:56.760 --> 00:16:58.410 but in just in general? 379 00:16:58.410 --> 00:17:01.710 So, the first step would be for the individual 380 00:17:01.710 --> 00:17:05.700 to pursue getting the bioptic telescope glasses, 381 00:17:05.700 --> 00:17:09.180 and that would be, again, through the optical provider, 382 00:17:09.180 --> 00:17:11.400 the optometrist or ophthalmologist. 383 00:17:11.400 --> 00:17:15.990 And then, generally, based on the state's guidelines, 384 00:17:15.990 --> 00:17:20.940 that eye care specialist should know what the guidelines are 385 00:17:20.940 --> 00:17:23.730 and be able to determine if that individual 386 00:17:23.730 --> 00:17:25.200 is actually a good candidate, 387 00:17:25.200 --> 00:17:27.960 and if they will meet the guidelines for driving. 388 00:17:27.960 --> 00:17:30.510 If the person does meet the guidelines for driving 389 00:17:30.510 --> 00:17:33.810 in the sense of visual acuity measures 390 00:17:33.810 --> 00:17:36.060 and visual field measurements, 391 00:17:36.060 --> 00:17:38.940 and the individual demonstrates that they actually 392 00:17:38.940 --> 00:17:42.240 can function with the telescope in the clinic 393 00:17:42.240 --> 00:17:43.860 and do a trial use, 394 00:17:43.860 --> 00:17:45.570 then they could go to the next step 395 00:17:45.570 --> 00:17:48.270 to pursue getting the telescope classes. 396 00:17:48.270 --> 00:17:52.110 Once the telescope glasses are obtained, 397 00:17:52.110 --> 00:17:54.210 each state will have their individual 398 00:17:54.210 --> 00:17:56.940 sort of guidelines and requirements. 399 00:17:56.940 --> 00:18:00.540 It may require specific in-the-clinic training 400 00:18:00.540 --> 00:18:04.530 to get used to how to use the telescope glasses safely. 401 00:18:04.530 --> 00:18:06.960 Typically, it requires on-the-road 402 00:18:06.960 --> 00:18:09.000 drivers training, as well. 403 00:18:09.000 --> 00:18:11.520 That is where the tricky part comes in, 404 00:18:11.520 --> 00:18:14.670 because a person may need to have a learner's permit 405 00:18:14.670 --> 00:18:17.433 or a driver's license prior to going on the road. 406 00:18:18.300 --> 00:18:21.330 So, this is a long process to go through. 407 00:18:21.330 --> 00:18:24.420 It's not an instant thing, where you walk into a store, 408 00:18:24.420 --> 00:18:27.570 and you buy a bioptic, and you're back on the road. 409 00:18:27.570 --> 00:18:29.880 We mentioned things are different in every state. 410 00:18:29.880 --> 00:18:32.370 I think there's different rules about driving 411 00:18:32.370 --> 00:18:33.750 with optics in every state, too. 412 00:18:33.750 --> 00:18:36.630 For instance, in some states, you can't drive at night, 413 00:18:36.630 --> 00:18:38.760 or maybe you're given a trial period. 414 00:18:38.760 --> 00:18:40.740 What advice would you give to someone 415 00:18:40.740 --> 00:18:43.087 who's, you know, heard this podcast, and just says, 416 00:18:43.087 --> 00:18:45.300 "You know, I'd like to try out bioptic driving," 417 00:18:45.300 --> 00:18:47.130 where should they just start? 418 00:18:47.130 --> 00:18:50.957 Yeah, I think a good start is to communicate 419 00:18:50.957 --> 00:18:54.990 with a vision rehab or low-vision care provider. 420 00:18:54.990 --> 00:18:58.248 A good starting point may be with the state services 421 00:18:58.248 --> 00:19:01.590 to find out a resource to go to. 422 00:19:01.590 --> 00:19:04.200 Although the state services for the blind 423 00:19:04.200 --> 00:19:06.180 or visual impairment may not have the answers, 424 00:19:06.180 --> 00:19:10.410 they may know someone to refer to to ask those questions. 425 00:19:10.410 --> 00:19:13.260 Another service would be, or an option 426 00:19:13.260 --> 00:19:17.310 would be to go to the state's DMV, 427 00:19:17.310 --> 00:19:20.790 or Department of Motor Vehicles website 428 00:19:20.790 --> 00:19:23.940 and search out information about the options 429 00:19:23.940 --> 00:19:25.680 for using a biopsy telescope, 430 00:19:25.680 --> 00:19:28.410 because, again, every state will have 431 00:19:28.410 --> 00:19:31.737 their own guidelines for using, 432 00:19:31.737 --> 00:19:33.997 and the questions to ask would be, 433 00:19:33.997 --> 00:19:38.010 "What is the required visual acuity with the carrier frame 434 00:19:38.010 --> 00:19:40.170 or best corrected vision? 435 00:19:40.170 --> 00:19:42.990 What is the requirement for visual acuity 436 00:19:42.990 --> 00:19:44.820 through the telescope?" 437 00:19:44.820 --> 00:19:47.940 And then, "What is a visual field requirement?" 438 00:19:47.940 --> 00:19:49.837 The next set of questions would be, 439 00:19:49.837 --> 00:19:52.740 "What's required for using the telescope?" 440 00:19:52.740 --> 00:19:55.620 For example, "What are the allowable 441 00:19:55.620 --> 00:19:56.700 strengths of telescopes?" 442 00:19:56.700 --> 00:19:59.250 Some states required 4x or less, 443 00:19:59.250 --> 00:20:03.990 others will allow up to 6x power telescope. 444 00:20:03.990 --> 00:20:08.520 So, know the specifics for options for the telescope use, 445 00:20:08.520 --> 00:20:11.190 and then the requirement for training, 446 00:20:11.190 --> 00:20:15.060 which may include the clinical and the behind the wheel, 447 00:20:15.060 --> 00:20:18.180 and then a length of time of having the telescope 448 00:20:18.180 --> 00:20:21.720 prior to pursuing getting a license. 449 00:20:21.720 --> 00:20:24.480 Another resource specifically for driving 450 00:20:24.480 --> 00:20:28.050 would be through the website, aded.com, 451 00:20:28.050 --> 00:20:32.460 is the Association of Driver Educators for Disabled, 452 00:20:32.460 --> 00:20:35.790 the host for the certified driver rehab specialists, 453 00:20:35.790 --> 00:20:39.600 and there are specific guidelines on that website 454 00:20:39.600 --> 00:20:42.450 for driving with a vision impairment, 455 00:20:42.450 --> 00:20:46.380 which includes bioptic telescope information. 456 00:20:46.380 --> 00:20:48.990 There's another website that's helpful 457 00:20:48.990 --> 00:20:52.170 to understand the function of the telescope, 458 00:20:52.170 --> 00:20:54.390 and guidelines for use. 459 00:20:54.390 --> 00:20:59.390 Bioptic Driving USA is a good website for an overview. 460 00:20:59.400 --> 00:21:02.460 There's also some very good information on the websites 461 00:21:02.460 --> 00:21:05.220 for the telescopes themselves, too. 462 00:21:05.220 --> 00:21:09.120 The main companies would be Ocutech, ocutech.com, 463 00:21:09.120 --> 00:21:13.500 and then the other is designsforvision.com. 464 00:21:13.500 --> 00:21:16.680 And, again, there are two different types of telescopes, 465 00:21:16.680 --> 00:21:21.450 and different telescope providers or optical services 466 00:21:21.450 --> 00:21:25.080 would cater toward one or the other, probably, 467 00:21:25.080 --> 00:21:28.740 but those websites can give you some really good guidance 468 00:21:28.740 --> 00:21:31.320 on just general information about, "Oh, 469 00:21:31.320 --> 00:21:34.410 what looks best for me," or "What might I wanna pursue," 470 00:21:34.410 --> 00:21:37.140 and then, "What is this local provider 471 00:21:37.140 --> 00:21:39.450 gonna be able to provide for me?" 472 00:21:39.450 --> 00:21:43.008 And we will have the links to all of those 473 00:21:43.008 --> 00:21:43.874 websites 474 00:21:43.874 --> 00:21:44.760 in our show notes, 475 00:21:44.760 --> 00:21:47.190 so, if you're listening and frantically trying 476 00:21:47.190 --> 00:21:48.900 to write those down, no worries, 477 00:21:48.900 --> 00:21:51.270 we'll have those in our resources. 478 00:21:51.270 --> 00:21:54.060 This has been really educational, 479 00:21:54.060 --> 00:21:59.060 and, as Ed said, not a quick thing that you're gonna do, 480 00:21:59.190 --> 00:22:01.290 just go in and grab one off the shelf, 481 00:22:01.290 --> 00:22:05.070 but it does sound like, for the right person, 482 00:22:05.070 --> 00:22:09.150 this could be sort of a life-changing device 483 00:22:09.150 --> 00:22:12.750 once you go through the acquisition of it, 484 00:22:12.750 --> 00:22:14.670 and then all of the training. 485 00:22:14.670 --> 00:22:19.670 You can do things that you weren't able to do previously, 486 00:22:20.040 --> 00:22:23.910 especially with distance vision, so, that's amazing. 487 00:22:23.910 --> 00:22:28.470 Fay and Ed, thank you both so much for stopping by 488 00:22:28.470 --> 00:22:33.470 and just letting us know about bioptics. 489 00:22:33.540 --> 00:22:36.450 Any final thoughts before we wrap up? 490 00:22:36.450 --> 00:22:38.190 [Fay]I'd just like to say I really appreciate 491 00:22:38.190 --> 00:22:41.130 the opportunity to chat this morning. 492 00:22:41.130 --> 00:22:44.460 I do totally agree with what you're saying, Ricky. 493 00:22:44.460 --> 00:22:48.690 It can be life-changing for whatever age of life, 494 00:22:48.690 --> 00:22:52.320 whether it's a teen or an older adult, 495 00:22:52.320 --> 00:22:56.100 and just to expand the visual world is so helpful, 496 00:22:56.100 --> 00:23:00.780 and enables people to do if they're a good candidate. 497 00:23:00.780 --> 00:23:04.050 Although it is a very, quite involved process, 498 00:23:04.050 --> 00:23:07.500 it can really maximize a person's function, 499 00:23:07.500 --> 00:23:10.680 and benefit them in all types of activities, 500 00:23:10.680 --> 00:23:12.330 so, it's a good thing to pursue. 501 00:23:12.330 --> 00:23:14.670 Again, it may not be for everyone, 502 00:23:14.670 --> 00:23:17.400 but it's a really good option. 503 00:23:17.400 --> 00:23:18.233 And thanks, Ricky. 504 00:23:18.233 --> 00:23:19.890 This was really an important topic, 505 00:23:19.890 --> 00:23:22.590 and many thanks to you, Fay, for sharing your expertise. 506 00:23:22.590 --> 00:23:23.850 We really appreciate it. 507 00:23:23.850 --> 00:23:25.080 Yes, we really do. 508 00:23:25.080 --> 00:23:27.450 Thank you so much for joining us. 509 00:23:27.450 --> 00:23:29.650 Oh, thanks for having me, I've enjoyed it. 510 00:23:30.510 --> 00:23:32.040 Got something to say? 511 00:23:32.040 --> 00:23:35.130 Share your thoughts about this episode of "Hadley Presents," 512 00:23:35.130 --> 00:23:37.710 or make suggestions for future episodes. 513 00:23:37.710 --> 00:23:39.330 We'd love to hear from you. 514 00:23:39.330 --> 00:23:43.620 Send us an email at podcast@hadley.edu. 515 00:23:43.620 --> 00:23:48.620 That's P-O-D-C-A-S-T@hadley.edu. 516 00:23:48.870 --> 00:23:53.870 Or leave us a message at 847-784-2870. 517 00:23:55.260 --> 00:23:56.793 Thanks for listening. 518 00:23:56.793 --> 00:23:59.793 (soft bright music)