Low Vision News

For low vision specialists and those who consult them

Category Archives: Conferences

Highlights of Vision 2011

I am now back from the 10th International Conference on Low Vision (Vision 2011) in Kuala Lumpur, Malaysia. I was very impressed.

The most interesting thing for me was that there are lots of Randomised Controlled Trials (RCTs) in progress in low vision research. Well designed RCTs are a powerful tool to investigate the effect of an intervention (such as a training programme) and are essential for us to really understand the benefits of different types of low vision rehabilitation. They are also increasingly necessary for us to continue receiving funding for low vision services (whether that funding is from the state or from an insurer).

Research highlights for me included Else Havik’s work on navigation of shared spaces (streets with no kerbs, signs or road markings, where drivers are encouraged to drive considerately); Kez Latham’s work on likelihood of success with low vision aids (if your near vision is poorer then N22 with a +2.50DS spectacle add and your contrast sensitivity is worse then 1.05 log units you’re unlikely to read newsprint with a magnifier); and Carlos Aguilar’s work on gaze-contingent magnification in macular disease.

I didn’t like everything about the meeting: as is often the case, there were many clashes on the programme and sometimes I had to choose to miss something which looked interesting. I didn’t like the keynote speaker being interrupted as the junior government minister attending the opening ceremony wanted to leave (and we had to stand as a sign of respect, although the speaker was far more deserving of that respect); and the weather was far too hot for me! Having said that, I’m looking forward to the 11th International meeting: Vision 2014, Melbourne.

Envision 2010 – Research overview

Here is the first of my reports from Envision 2010, concentrating on the research sessions.

Envision has really increased the profile of its research sessions recently and this is reflected in the number of people who were presenting new findings at this meeting. Although the organisers hope that there will be overlap between clinical and research sessions at the meeting, in my experience most of my academic colleagues spent 90% of the conference in the research stream with only occasional forays into the more clinical sessions.

The session I most enjoyed was the discussion on cortical reorganisation in macular degeneration. This session, moderated by Gordon Legge, included people with very different views on the extent to which the primary visual cortex changes in macular disease. Chris Baker from NIH (and formerly the Kanwisher lab in Boston) opened proceedings by presenting functional MRI data showing that the lesion projection zone in primary visual cortex did show activation in people with advanced macular disease. Another speaker, Tony Morland from the University of York (UK), showed that this did not occur in the cohort of people he studied, and presented some possible explanations for the cortical activity measured by other groups. The remaining speakers maintained the high level of the presentations and debate was lively throughout the session.

Other research sessions I particularly liked were the discussion on perceptual filling-in chaired by Walter Wittich from Montreal; the reading session moderated by Don Fletcher; and the Quality of Life session chaired by Bob Massof.

The most interesting new data I saw were those presented by Ava Bittner who looked at variability in quality of life experienced by people with retinitis pigmentosa. I also enjoyed the data which Don Fletcher presented on the perception of scotomas by people with macular disease: he showed that only 1 of 108 people perceived their scotoma as a black portion in the centre of their vision (and this one person only noticed it when first waking up before moving her eyes). It really is time people stopped using the NIH picture of AMD as an example of this condition.

Envision 2010 preview

There seem to be a large number of low vision conferences coming up in the next few months, including Vision 2011 in Kuala Lumpur next February (the largest low vision conference in the world, held every three years). However, I’m still looking forward to Envision this week.

Regular readers of the blog will know I enjoyed Envision last year (see my report here). For me as a someone who divides my time between clinical and scientific work it’s a nice mix of these two disciplines. Whilst the scientific sessions aren’t as likely to present breaking research news on gene therapy trials as a conference like ARVO, the scientific programme has certainly improved in the last few years and is now fairly strong.

I am particularly looking forward to the scientific session on Filling-In (I am speaking in this session, but am looking forward to hearing the other speakers – I’m not being egocentric!). Other scientific sessions which catch my eye are the session on Cortical Reorganisation in Macular Disease chaired by Gordon Legge; and the session on Retinitis Pigmentosa chaired by Olga Overbury, which discusses sleep disorders and emotional aspects of RP.

The clinical sessions which stand out for me include a session on Vision Rehabilitation in Glaucoma led by Mary-Lou Jackson, as I think glaucoma is an often overlooked disease in low vision clinics. The “Clinical dilemmas in visual impairment” event on Friday morning also sounds very interesting.

I’m looking forward to finally seeing the “Going Blind” movie as well.

Envision is a very ‘connected’ meeting – you can follow it on Twitter @envisionconf and you can of course read my report here next week. I hope to see some of you in San Antonio!

Conference report…from 1949

I was browsing in a second hand bookshop recently and found the proceedings of the ‘International Conference of Workers for the Blind’ held in Oxford, England in 1949. It’s fascinating.

First, the welcome addresses included greetings from Harry Truman, Clement Atlee and Helen Keller, and the united nations had considerable representation. Welfare of ‘the blind’ was of course a very political issue at this time as so many people were visually impaired as a consequence of the second world war.

One of the major resolutions of this conference was the standardisation of blind registration around the world, to recommend that every country has ‘a definition of blindness, to include both the totally blind and all other persons suffering from such defect of vision that they also require special education or special assistance to save them from destitution, and to enable them to share in the economic and cultural life of the nation’ and that a register of blind people is kept. It was also suggested that an international definition of blindness should be established, which has still not been adopted (although most countries have very similar criteria).

I was interested to see that there was considerable debate over whether registration should be compulsory, with a majority of delegates favouring this. I am not aware of any countries which have compulsory registration today as the idea of labelling people without their consent is not liked. Of course, many benefits are only conferred on those who are registered.

Not every resolution was successful: the suggestion that ‘the neutral auxilliary language of Esperanto be used internationally in work relating to the blind’ does not seem to have been widely adopted (perhaps unfortunately!).

Whilst conferences today would not make so many references to ‘the blind’ as these minutes do, many of the themes and discussions are just as relevant today as they were 61 years ago. And the report that a river cruise was ‘unfortunately marred by heavy rain’ isn’t unusual for a meeting held in August in the UK…

Low vision session at the world ophthalmology congress

I have spent this afternoon at the International Society of Low Vision Rehabilitation Research symposium at the World Ophthalmology Congress in Berlin. The WOC is a huge clinical ophthalmology meeting with the biggest drug company marketing area I have ever seen!

Ruth van Nispen from Holland opened the session speaking on which medical conditions (including those causing visual impairment) impact on quality of life over time. She found that quality of life was most likely to decline in stroke, asthma, chronic obstructive pulmonary disease, or visual acuity loss.

The next speaker, Dr Burggraff (also from the Netherlands) examined whether training improves reading performance with CCTV magnifiers. She used a randomised trial model where subjects either received training in the CCTV use or just the delivery instructions. She found an improvement in Reading performance in both the trained and control groups, although the improvement was no better in those who had training.

Ger van Rens spoke further on the same study, examining changes on quality of life after CCTV training. He reported that 35% of the participants in the study had clinical depression (twice that in the non-visually impaired population of the same age). He found an improvement in the reading scale of a quality of life questionnaire for all of those with a CCTV, but again no benefit of the extra training group.

Next, Gary Rubin from London gave an overview of low vision work in the uk. He pointed out this was an impossible task in ten minutes! He classified the research done into five categories: basic research (such as functional magnetic resonance imaging of the visual cortex); prevalence and economic burden of eye disease; low vision devices; development of new tools for assessing low vision outcomes; and the effectiveness of low vision services. It is clear there is a large volume of high quality work in low vision research in Britain.

Following this, I presented some of my own research on the development and use of the preferred retinal locus in macular disease, much of which was performed with Gary Rubin.

The last speaker presented results of a dutch translated version of the Massof Activity Inventory. The British stereotype of Dutch people is that they speak perfect English in any case, but of course it is important for instruments like this to be usable in every language.

Aside from this session, there is not much low vision at this meeting, so I only attended for one day. It’s not really my meeting– I’m not an ophthalmologist– and despite all the sponsorship attendance costs €250/day: one of the most expensive meetings I’ve ever been to. The conference bag is quite nice though.

ARVO 2010 review

As promised, here is my summary of this year’s ARVO conference. I’m writing this somewhere over Spain on my flight home (journey 2 hours longer than usual due to volcanic ash).

The meeting was well attended by the low vision community, although the scheduling was not kind to us: the bulk of the poster presentations were condensed into two sessions, and there were few relevant talk sessions. Presentations which stood out for me included: Calabrese and colleagues, who showed that people with wet AMD read more quickly than those with dry AMD (a very surprising result); some interesting work on peer pressure and low vision device use in children by Manastersky; and some interesting work on sleep problems in people with retinitis pigmentosa by Overbury and colleagues.

However the most important news from the conference was that Investigative Ophthalmology and Vision Science (one of the leading vision research journals, and an official journal of ARVO) will start having a low vision section. This is excellent news and shows the importance with which low vision research is being viewed. It will be great to have a high quality journal which will, I imagine, become the natural home of rigorous low vision research publications.

ARVO 2010 preview

Sorry for this being a brief post: I have been busy making preparations for next week’s ARVO meeting (the annual meeting of the Association for Research in Vision and Ophthalmology), which is being held in Fort Lauderdale, Florida.

ARVO is by far the biggest vision conference, with around 9,000 presentations and 12,000 delegates. It encompasses all types of research: from genetics and cell biology through to clinical trials. The programme seems to have a fair number of good low vision presentations: I will report back on my personal highlights next week.

For those of you who use Twitter, you can also read my updates at @lowvisionnews and other tweets from the meeting using the hashtag #ARVO. Apologies to those of you who found the last sentence to make no sense.

European Congress on Visual Impairment

I am looking forward to the European meeting on vision impairment to be held in Valladolid, Spain, this October.

Apart from Spain being a nice place to visit, there are many good speakers at the conference, from a variety of backgrounds. They include vision scientists (Aries Arditi from New York; Bob Massof from Baltimore); rehabilitation professionals (Krister Inde from Sweden, Duane Geruschat from Johns Hopkins); clinicians (Bruce Rosenthal from New York); and people who mix clinical work and practice (Eli Peli from Boston, Mary-Lou Jackson from Boston).

One thing which slightly concerns me as a European is that for a European conference only a small proportion of the invited speakers (5 of 14) are European: two working in Sweden and three in England. Whilst there is good low vision research going on in Europe (and Australia, Hong Kong, Canada and elsewhere), most of the ‘big names’ in this field still work in the USA. Is this because research funding is more generous in the States, or because they are better known from speaking at more conferences, or because American research centres are better than those in the ‘Old World’?

I think that the meeting should be interesting and will be a good showcase for the research being performed in this area in Europe. And I’m sure the Rioja and Tapas will beat the food and drink at most American conferences too!

[Disclaimer: I am on the scientific board of this meeting. However I will not profit from people going to the conference and have no financial interest in whether you attend or not.]

2010 conference previews

At the start of the year, I like to plan which events and conferences I intend to visit in the coming year. Although we’ll have to wait until 2011 for the once-every-three-year International Conference on Low Vision, there are several interesting meetings coming up.

In May, the Association for Research in Vision and Ophthalmology (ARVO) annual meeting will take place in Fort Lauderdale, Florida. This is by far the biggest vision meeting of the year – typically there are 8,000 presentations and 12,000 delegates. This conference covers all areas of clinical vision research but tends to have three or four low vision poster and paper sessions. It is also an excellent conference for networking and for finding out about the latest research trials of treatment of eye disease: for example, in 2008 the results of the gene therapy trials for Leber’s amaurosis were both first presented there.

I have been invited to speak at the Canadian Ophthalmology Society in Quebec City in late June. This is a conference which I have not visited before (being neither Canadian nor an Ophthalmologist) but is sounds as if this meeting will also have a substantial low vision content.

As frequent readers will know, I very much enjoyed the Envision conference in 2009. This year’s Envision meeting will be in San Antonio, Texas, from September 22nd-25th. Envision has a mix of clinical teaching and research seminars, and although it’s a relatively small meeting there are parallel sessions so the programme is very busy. More information on this meeting can be found at www.envisionconference.org.

I am very excited by a new European low vision meeting which is taking place for the first time in Valladodid, Spain, this October. Although there are not many details on their website yet, I think this could be an excellent meeting. (Note their website defaults to Spanish: the English button is towards the top right of the screen; and see disclaimer below).

More locally, I think it’s about time I made another visit to Sight Village in July (link) – the largest British trade fair of low vision aids and electronic devices – in order to check out new developments in this field.

Looking ahead to 2011, I’m slightly concerned that the organisers of the Vision 2011 meeting haven’t yet prepared their website or sent a call for abstracts yet, but I’m sure that will follow soon…

As always, I’ll update my blog with news from each of these meetings. Who knows, in between going to conferences (and collecting thousands of air miles, by the look of things) I may even get some work done!


Disclaimer: I am on the scientific committee for the European low vision meeting, but have no commercial connection with it.

Aaopt review 2/2: Nyctalopia

As I mentioned in my previous post, one of the highlights of the low vision programme at the American Academy of Optometry meeting last week was a special evening session on Nyctalopia.

The first speaker was Dr John Musick who spoke entertainingly on the identification and management of people with night vision problems.

He emphasised the difficulty of identifying poor night vision as people often assume everyone can’t see in the dark. He suggested asking ‘have you ever seen the stars?’ as a screening question. He also stressed the need for referral to an ophthalmologist who specialises in hereditary retinal disease rather than a general ophthalmologist given the rare nature of some of these conditions. He mentioned the importance of referral to orientation and mobility experts, and to ensure that people had a ‘caring community’ for support: be it family, friends or colleagues. He touched briefly on the need for occupational counselling, given the typical age of presentation of people with nyctalopia (age 10-20).

Next, Dr Roanne Flom gave an excellent overview of low vision rehabilitation for people with poor night vision. This ranged from the importance of arranging a workplace evaluation (she cited warehouses in particular as being dim environments to work in); to ensuring good task lighting (she demonstrated various head mounted led systems which can be used when walking). She also discussed the use of dark adaptometry, glare testing and night vision camcorders in people with nyctalopia. My favourite clinical pearl from this talk was ‘you can spot people with poor night vision as they come in with a torch and dark glasses, as the range of optimal illumination is so critical.

The final speaker was Dr Byron Lam from Bascom Palmer in Miami. He gave an overview of gene therapy, stem cell therapy, retinal implantation and dietary supplements in retinal disease. His talk was good, but not as impressive as Alan Bird’s award lecture on similar topics at this year’s ARVO. A salient point made by Dr Lam was the importance of counselling people appropriately before they enter a clinical trial, as that could well be their only chance of entering a study: participation in a previous treatment trial is often an exclusion criterion for entering future clinical trials.

In all, it was an excellent and interesting symposium on a frequently ignored topic.