On a cold spring morning this year, the Braille Institute in San Diego opened its doors to curious visitors standing in line for registration, anxious to hear about the latest discoveries in technology for the visually impaired and people with low vision.

Precisely at 10 a.m., Jay R Hatfield, executive director of the institute, was opening the 18th Annual Low Vision Seminar and Technology Fair. He started by welcoming the visitors, followed by a brief explanation about the benefits of the seminar, as well as a verbal tour of the Institute.
“For those of you who’ve come for the first time” he said. “I would like to clarify that The Braille Institute is not only a place where people can learn to read and write in the Braille system, there are a variety of classes and services provided here, and all of them are free of charge thanks to the generosity or different philanthropists who make this possible. We have a diversity of classes such as computers, music, technology, dance, art, etc. We also provide transportation. Our busses have different routes each day of the week; our students can be picked up at the most convenient location according to the area they live in. On weekends we also have youth and children classes and activities. Our services are not exclusive for the people who are blind, any person who can’t read a newspaper is welcome here and also eligible to receive a reader machine and borrow the books from different genres in our library.”

Hatfield also talked about the magnification and lighting devices as well as other state of the art equipment being exhibited in the Technology Fair.

Great expectations among the audience were floating in the air. Hearts pounding in the hope of finding new procedures, new devices and new medications that could reverse or at least slow the process of ending up in the darkness.

The Braille Institute was honored to present the keynote speaker Nikolas London, who joined Retina Consultants San Diego in 2012 after graduating from one of the most prestigious surgical training programs in the country at the Wills Eye Institute in Philadelphia.

London was born in the Bay Area, but grew up in Columbus, Ohio. After finishing high school, he went to UCLA for college and completed a Master’s degree looking at spinal cord injury and the ability of animals to walk on a treadmill after spinal cord transection. He also met his wife at UCLA and they later moved to Cleveland, Ohio for medical school. There, he obtained a second master’s degree and graduated with honors. He then went to San Francisco for his Ophthalmology residency, during which time he had the amazing opportunity to work with Doctors without Borders in Myanmar, working with very sick patients with AIDS. The last leg of his training was a two-year surgical retina fellowship at Wills Eye Hospital in Philadelphia. He has also authored dozens of peer-reviewed ophthalmology journal articles and book chapters. He has worked with multiple international organizations, and won countless awards during his training, one of them being the Ron G. Michaels Foundation award for The Most Outstanding Surgical Fellow in the Country in 2011. He has been in practice in San Diego for the past six years.

A young enthusiastic London, filled with experience and love for his profession, took the microphone to start with an extremely interesting talk focused on macular degeneration and diabetic retinopathy.

London started by explaining that Age-related Macular Degeneration (AMD) is a degenerative process of the central part of the retina, called the macula, which collects light and sends it to the brain and allows a person to see.

There are two forms of AMD, wet and dry, the latter which affects 90 percent of patients.
Dry AMD is a result of the buildup of drusen, a deposit of lipid underneath the retina. There is an advanced process of Dry AMD called Geographic Atrophy, which in time can cause loss of central vision. Patients with advanced AMD end up with blurry vision or distortions, however they don’t become completely blind as only the peripheral vision is not affected.

The second part of London’s talk referred to Diabetic Retinopathy (DR), which is the main cause of blindness among adults in the United States. This is a result of complications from diabetes, for that reason it is crucial to maintain a healthy diet and to have eye exams at least once per year. 30 percent of diabetics end up with DR and unfortunately in this case there are no early symptoms.

London also talked about the newest treatments mentioning some of the best eye injections and the implantable telescope. He even mentioned some clinics in Beverly Hills practicing the injections of mother stem cells, which people should be very cautious about and carefully check the credentials of doctors performing these types of practices.

During a small recess for lunch, a group of “volunteers” were scattered throughout the Institute guiding the visitors and offering their shoulders or their arms, helping them to feel the security of moving around in a place where most of them, were not familiar with.

The time for the second presenter came and Duane Tsutsui talked about the Argus II Retinal Prosthesis System, provided by a company called Second Sight based in California. This procedure provides electrical stimulation of the retina to induce visual perception in the blind people.

The Argus II consists of implanted and external components. When the system is being used, a miniature video camera on the glasses captures images in real time. The glasses send these images to a video processing (VPU). The VPU converts these video images into electrical signals and sends them back to the glasses (which is a part of the external component). The coil on the glasses sends the signals wirelessly to the implant. The implant then sends out small pulses of electricity to the retina, and the resulting signals travel along the optic nerve to the brain, where they are perceived as patterns of light. Over time, users learn how to interpret these visual patterns as objects and shapes.

With no doubt there was hope among the attendants, who asked all kinds of questions; one by one were patiently answered by London and Tsutsui at the end of each presentation.

This seminar was only one of the countless activities that the Braille Institute offers with the objective of helping the blind people and visually impaired to eliminate barriers in their everyday lives. The generous philanthropists, staff and volunteers are constantly on a mission to help in any way they can to make a change in somebody’s life.