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UC Berkeley optometrists expand services to low vision outreach clinic at California School for the Blind
24 June 2002

By Sarah Yang, Media Relations

Dr. A. Mika Moy, assistant clinical professor of optometry
Dr. A. Mika Moy, assistant clinical professor of optometry, meets with Liam McIntire, 5, of Fremont. Liam was diagnosed with cortical vision impairment when he was 2, and often tilts his head to help orient himself. Peg Skorpinski photo
Berkeley - Marcie McIntire noticed that her 5-year-old son, Liam, would often close one of his eyes and tilt his head when talking with her. It wasn't until optometrists from the University of California, Berkeley, examined Liam's eyes at school that she understood his vision problems.

"They saw that he was sensitive to light, and that he does that head tilt because it helps him orient himself," said McIntire, who lives in Fremont. Liam was diagnosed at age 2 with cortical vision impairment, a condition characterized by the brain's inability to consistently understand input from the eyes. "They also corrected the astigmatism on his glasses, which was way off by 180 degrees," she said.

The School of Optometry has been operating one of the few low vision clinics in the state at the UC Berkeley campus for more than 40 years, but last May, the school expanded its services to an outreach clinic at the California School for the Blind in Fremont. One year after the program began, UC Berkeley optometrists have conducted comprehensive eye exams for more than 80 students at the school.

"Unfortunately, it can be hard for some families who live far away to make it to our clinic in Berkeley. We saw an opportunity to bring this care to the patients," said Dr. Edward Revelli, associate dean of clinical affairs at the School of Optometry. Revelli worked with administrators at the school for the blind to launch the program.

Every other Wednesday during the academic school year, low vision specialists Dr. A. Mika Moy, assistant clinical professor of optometry, and Dr. Robert Greer, associate clinical professor of optometry, visit the school. Exams for each patient typically last 90 minutes. The students are examined by the two clinicians and a resident optometrist from UC Berkeley.

"Many of the students here have multiple disabilities that are associated with their visual impairment, and many doctors have not had experience with these children," said June Waugh, low vision services coordinator at the school for the blind. "What Robert and Mika have been able to give us is practical understanding of how the children see. They've been wonderful answering our questions and sharing our concerns."

While watching the optometrists conduct the eye exams, it becomes clear that they are able to relate to their young patients. Both the students and parents have noticed.

"I was feeling kind of weird having my eyes out, and my good friend Robert (Greer) helped me get over that fear," said Justin Kennedy, 17, who was treated in February for an eye infection that required removal of his prosthetic eyes.

Greer explained the secret. "We could see that Justin had an infection, so to persuade him to take the eyes out, we asked him to show us how to remove and insert prosthetic eyes," said Greer.

That extra motivation helped convince Justin to remove the eyes and allow the doctors to diagnose and treat the infection. After Greer smoothed out the scratches in the prosthetic eye that had been the source of irritation, he told Justin his eyes now looked shiny just in time for that night's Valentine's Day dance.

Dr. Shital Chatwani
Dr. Shital Chatwani, a resident at UC Berkeley's School of Optometry, gives Anthony "AJ" Machado, 16, his first comprehensive eye exam with Dr. Robert Greer, associate clinical professor of optometry, helping in the background. UC Berkeley optometrists have been conducting exams for students on site at the California School for the Blind in Fremont since May 2001. Peg Skorpinski photo

Justin's reaction? "It was a great success," said Justin. "I took my girlfriend with me to the dance, and even kissed her on the dance floor."

McIntire, Liam's mother, said the optometrists took extra time to explain her son's condition to her. "At this clinic, they really gave me a lot of information about Liam's impairment and how he functions, which has been really helpful because no one has ever really done that before," she said.

There are few eye care professionals available who have the expertise and experience to thoroughly examine low vision patients, defined by the National Eye Institute as those whose visual impairment cannot be corrected by standard glasses, contact lenses, medicine or surgery, and interferes with a person's ability to perform everyday activities.

Experts say it is difficult to support a private clinical practice specializing in low vision care because the condition is considered a low-incidence disability. According to figures from the California Department of Education, approximately 651,000 people up to age 22 in the state receive special education. Of those, approximately 4,500 are blind or visually impaired.

The California Blindness Advisory Task Force released a report last month outlining recommendations for educating visually impaired students. The task force, established last year by Delaine Eastin, California's superintendent of public instruction, highlighted the importance of having professionals assess the needs of visually impaired students from birth to age 22.

"It's very clear that this clinic has been a wonderful asset for the children at this school," said Eastin during a site visit to the clinic at the California School for the Blind. "We did not have the capacity to provide this service on our own. UC Berkeley has given us a fabulous gift."

Stuart Wittenstein, superintendent at the school for the blind, pointed out that improving a child's eye health impacts the child's classroom experience. "Some of the things a child learns from the low vision clinic are that a certain type of lighting works for them in the classroom, or a certain type of font works for them on a computer screen," he said. "We want to try to facilitate medical interventions for the students that will help us as educators do a better job."

Moy, who specializes in pediatric optometry, said observing the patients outside the exam room is invaluable. "It helps that we can evaluate these students in an environment that's familiar to them," she said. "We can follow them around campus, and we have access to their teachers, who interact with them on a daily basis."

In addition to the personnel, UC Berkeley provided $60,000 worth of specialized equipment for the clinic, while the school for the blind paid for the clinic's visual aids and set aside space on school grounds for the exam room. Maryann McBee, president of Parents and Friends, the school's parents association, said the clinic has been so popular with the parents that they are raising funds from private donations to help pay its ongoing operating expenses.

UC Berkeley's partnership with the California School for the Blind has been mutually beneficial, said Revelli. He pointed out that the school exposes UC Berkeley faculty and optometry residents to a relatively large pool of patients, some with rare conditions they might otherwise never encounter. "This may change the future of a lot of our graduates who come out of the low vision program," he said.

The program currently serves students at the school for the blind, but Superintendent Wittenstein said the school expects to also open the clinic to children who are not enrolled at the school.