R Venkataramanan

R Venkataramanan

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R Venkat's Blog
"To be an Inspiring Teacher,one should be a Disciplined Student throughout Life" - Venkataramanan Ramasethu

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SNK

Sunday, August 30, 2009

Optometry career Course Information

A writer once remarked that eyes are the gretest gifts of God to man. For what would the beautiful world be if one could not see it. All the wonders of the world and all the surprises of nature would come to a nought if there was no one to admire its beauty. Every third blind person in the world is an Indian and millions of others suffer from defective vision. There are people amongst us who want that everyone in the world should appreciate the creations of God on earth. The career of optometry is right for anyone who wants to serve people in this direction by helping them regain good eyesight. The career offers a fairly regulated work life and also makes one, an integral part of the profession of healthcare. And with our country severely in shortage of optometrists, this career offers a lot of scope in terms of work and monetary benefits

Optometry is the practice or profession of testing the eyes for defects of vision in order to prescribe corrective glasses. An optometrist is a person who is skilled in optometry. The job profile of an optometrist includes the recognition of ocular and visual signs of eye diseses, the understanding of the wide range of problems afflicting the eye and also the reference of patients to appropriate specialists. Thus, an optometrist diagnoses, treats and prevents the problems relating to the eye.

An optometrist fabricates lenses according to prescribed specifications and fits these to suit individual requirements. An optometrist also hardens and polishes lenses by the use of hi-tech machines. The role of the ophthalmologist, on the other hand is necessary when the patients needs secondary level or tertiary level of treatments. It is only when the patient needs eye surgery or medication that an optometrist refers him to an ophthalmologist. However, in countries like Australia and New Zealand, an optpmetrist also does a few surgeries but in India, an optpmetrist is not allowed to do so.

In India, there has been an increase in the population of the aged in recent years. Diabetic retinopathy and macular degeneration have become common diseases in the aged population. The signs of these diseases can be detected by optometrists. Hence, the need for trained optometrists is increasingly being felt in the country. Again, optometry as a profession is high on demand because of rise in the need for spectacles, contact lenses and low- vision aids by people afflicted with eye disorders.

Eligibility for Optometry career Course Information:

One should have completed 10+2 in science stream with at least 80% marks in Physics, Chemistry, Biology and English taken together in order to do a bachelor’s degree in clinical optometry. The candidates who apply for this course are short- listed and then called for a written entrance examination and an interview.

Those who have completed a diploma course in clinical optometry are eligible to get direct admission in to the third year of the degree course in optometry.

Aptitude

Any work in the healthcare profession requires a service mentality. So one should be willing to serve people. The job of an optometrist involves working with lenses, which requires high level of accurancy and precision. So one should be able to do tasks wih clockwork precision. One should be a hard working person. Since the job of an optometrist requires that one has to work in a team with opthalmologists and other technicians, team spirit is of utmost importance. One should have a scientific bent of mind.

Course:

Four- year degree courses in optometry are offered by various schools across the country. A student who takes admission in to a four year degree course studies theories including the Anatomy and Physiology of the eye, Mechanical optics, Orthoptics, Ocular, Motility etc, for the first three years. The last year of the four year degree course is devoted to practical training.

Prospects

As an Optometrist, one can take up jobs in hospitals or clinics where one would be working with an Ophthalmologist. One can practise at independent optical establishments or can also set up an independent practice of one’s own.

One can go to the US for a Ph.D, degree after the completion of the master’s degree in India. Teaching and research jobs can be taken up in the US and the canadian universities after the completion of the Ph.D degree. Many Indian optometrists have also set up successful practises in the US.

Optometry is an emerging career choice in India since statistics show that there are only one thousand professionals in India whereas the requirement of optometrists in the country is more than two lakhs. Due to the efforts of professionals, there are now distint attempt to standardise the optometry programme in India. Optometry, as a career, will soar to the new heights when a regulatory body of optometry comes in to being in India.

Remuneration:

A professional optometrist gets a starting salary as high as Rs, 12,000 per month. This amount may go still high depending upon his capabalities and the institution from which he has done the course. In addition, several incentives are also provided. With the establishment of a regulatory body and the recognition of all optometric programmes by the ministry of health, the salary graph of an optometrist is bound to take a steep upward rise. Again, the awareness about the role of an optometrist in correcting the faults of the eye is still to be developed among people. This awareness would make the remuneration of an optometrist, even more high.

The profession of optometry is in a growing stage in India. As already mentioned there is a severe shortage of optometrists in India. In the incipient stage of this career, any student who gets employed as an optometrist now, will find oneself in a very good position when the career gets its proper foothold in India. The future of the profession is very bright.



Where to study

Elite School Of Optometry
Medical Research Foundation,
18 College Road,
Chennai-600006, Tamilnadu
E-Mail: Information@Sankarnethralaya.Org


All India Institute of Medical Sciences
New Delhi-110029

Bharati vidyapeeth’s medical college
Katraj, dhanakawadi,
Pune-411043, Maharastre

Lotus College Of Optometry,
Lotus Eye Hospital,
13th NS Road,
Vithalnagar Society, Vile Parle
Mumbai-400049, Maharastra
Website: Www.Optomeyeinstitute.Com.

Aditya Jyot Institute Of Optometry,
168-D, Ashirwad, Vikas Wadi,
Dadar TT, Mumbai-400014,
Maharastra.

SNDT Women’s University,

1 Nathibai Thackersey Road,
Mumbai-400020, Maharastra.

Nagar School Of Optometry
Shshri C.H Nagari Municipal Eye Hospital
Ellis Bridge,
Ahmedabad-380006, Gujarat.

Lotus Institute Of Optometry
Lotus Eye Hospital,
Coimbatore, Tamilnadu

Bausch & Lomb School Of Optometry
Post Box No.1, Kismarpur P.O,
Rajendranagar B.O,
Hyderabad-500030,
Andrapradesh.

Christian Medical College
Thorapudi P.O,
Velore-632002, Tamilnadu
E-Mail: Eye@Cmcvellore.Ac.In

NTR University Of Health Sciences
Vijayawada P.O
Vijayawada-530002
Andra Pradesh.
Mahatma Gandhi University
Gandhi Nagar P.O
Kottayam-686008, Kerala

Pt. Jawaharlal Nehru Memorial Medical College
Raipur P.O, Raipur
Chhattisgarh

Academy Of Optometry
118/D, A.J. Ch. Bose Road
Kolkata-700019, West Bengal
School Of Optometry

Gandhi Eye Hospital, Aligarh,
Uttar Pradesh
Janakalyan Eye Hospital,

Education And Research Institude
A-1040, IndiraNagar,
Lucknow, Uttar Pradesh.

Manipal College Of Allied Health Sciences
Manipal University,
Manipal, Karnadaka
E-Mail: Rems@Yahoo.Co.Uk

Bangalore West Lions Eye Hospital & Cornea Grafts Centre
Bangalore-560002, Karnadaka.

Tuesday, August 4, 2009

Cancer Update from Johns Hopkins

AFTER YEARS OF TELLING PEOPLE CHEMOTHERAPY IS THE ONLY WAY TO TRY AND ELIMINATE CANCER, JOHNS HOPKINS IS FINALLY STARTING TO TELL YOU THERE IS AN ALTERNATIVE WAY.

1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a few
billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.

2. Cancer cells occur between 6 to more than 10 times in a person's lifetime.

3. When the person's immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumours.

4. When a person has cancer it indicates the person has multiple nutritional deficiencies. These could be due to genetic, environmental, food and lifestyle factors.

5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.

6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinal tract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc.

7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.

8. Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.

9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.

10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.

11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply.


WHAT CANCER CELLS FEED ON:

a.. Sugar is a cancer-feeder. By cutting off sugar it cuts off one important food supply to the cancer cells. Sugar substitutes like NutraSweet, Equal,Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses
but only in very small amounts. Table salt has a chemical added to make it white in colour. Better alternative is Bragg's aminos or sea salt.

b. Milk causes the body to produce mucus, especially in the gastro-intestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soy milk, cancer cells are being starved.

c.. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little chicken rather than beef or pork.. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.

d. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment. About 20% can be from cooked food including beans. Fresh vegetable juices provide live enzymes that are easily absorbed and reach
down to cellular levels within 15 minutes to nourish and enhance growth of healthy cells. To obtain live enzymes for building healthy cells try
and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees c).

e. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties. Water-best to drink purified water, or filtered, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it.


12. Meat protein is difficult to digest and requires a lot of digestive enzymes.
Undigested meat remaining in the intestines become putrified and leads to more toxic buildup.

13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of
cancer cells and allows the body's killer cells to destroy the cancer cells.

14. Some supplements build up the immune system (IP6, Flor-ssence, Essiac, anti-oxidants, vitamins, minerals, EFAs etc.) to enable the
body's own killer cells to destroy cancer cells. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body's normal method of disposing of damaged, unwanted, or unneeded cells.

15. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor. Anger,unforgiveness and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life.

16. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level.. Oxygen therapy is another means employed to destroy cancer cells.

Saturday, August 1, 2009

VISUAL REHABILITATION: A METHOD OF WORKING FOR THE EDUCATION OF PUPILS WITH DIMINISHED VISION - By AUTHOR: Mª Angeles Matey García

INTRODUCTION

The Diminished Vision or Visual Rehabilitation Services are usually a place where families and professionals alike seek answers and solutions to the complex problem of the child with residual vision. Up until relatively recent times, it was extremely difficult to find an acceptable level of resources and guidance concerning the use of vision under the best possible conditions, and so expectations are usually very high.

The work performed by specialists in diminished vision should not occupy an isolated place in the area of education or in any other set of circumstances surrounding the child, but can a specialist service satisfy all the demands which are often made of it? Can we, from within our sphere of activity, provide all professionals with useful information and, above all, anticipate the future visual functioning of the child? What characteristics must the child have in order to be a good user of optical aids? Do these instruments resolve all the needs these pupils will have throughout their schooling? What difficulties do they encounter at school?

In short, does Visual Rehabilitation respond to the expectations of the child, the family and the teachers?

This paper aims to analyse the performance of the diminished vision specialist service, and to suggest criteria for the shaping of coherent lines of action.

1. AREAS TOUCHED ON BY THE DIMINISHED VISION SPECIALIST SERVICE

Basically speaking, our field of activity can be divided into two areas: diagnosis and assessment of the visual function, and the prescribing of optical aids. We shall now analyse these.

1.1. Diagnosis and assessment of the visual function

This type of assessment aims at a careful evaluation of the residual vision of the child and the way in which he makes use of it. Such subjects present a characteristically wide range of diminished vision: there are no two people with the same degree of residual vision, the same pathology, who are affected to an identical degree and share a similar evolution, and who function in the same way. This explains why the examination includes both clinical and functional assessment. As is usual in formal assessments, the examination has many limitations which can be described as follows:

- The degree of co-operation between subject and assessor as regards the collecting of information is not always the best possible, as the subject being assessed is a child.

- Teachers often have many doubts and worries concerning the visual functioning of the pupil and expect an answer which will dispel these and give them greater assurance in their ability to perform their job. With this type of assessment, we cannot claim to offer a recipe which allows the teacher to solve all the problems surrounding the child.

In order to perform a satisfactory assessment, the following are essential:

- The availability of information the teacher has been able to provide on the basis of observing the environment which is closest to the child: the school situation. There is much to be learned from the way the child acts when using the vision he has available. The response to academic work is a deciding factor: uncertainty when performing manual tasks which require eye-hand precision, the size of the letters used when writing, the pupil tires easily, irregular pattern in the use of vision, etc.

- The pupil also needs encouragement to explain the way he sees, and the things he can and cannot do.

This is the only way in which we can start out at an advantage: by combining this information with the results obtained through clinical examination of the degree of disability. The assessment is never regarded as final, since the process is always initiated on the basis of the information obtained, and requires:

- Influencing the visual functioning of the child by encouraging him to overcome the difficulties he encounters in his use of vision.

- Informing the family.

- Transferring all recommendations to the school so that the specific characteristics of daily performance by the child may be fully understood.

Assessment must be performed periodically in order to confirm results and analyse progress made in the visual functioning of the pupil.

When the child has associated disabilities, assessment becomes much more complex, because it is very difficult to determine the underlying cause of his failure to interpret objects and pictures, why he has not developed exploration and search strategies, and why he is unable to extract valid information from what he observes. The fact that he has a sight problem is frequently used - often incorrectly - to explain this.

The functional assessment of residual vision is not at all easy; levels of co-operation are minimal, the child can only concentrate for very short periods, fatigue sets in early, and the assessment has to be performed over several sessions. The results are also affected when assessment is performed outside the usual environment of the pupil.

In this respect, the conclusions reached by the teacher and the specialist through daily observation provide specific, realistic information on the functioning and visual possibilities of the child, although the fact that it is not possible to quantify them with concrete figures is a drawback. Similarly, the parents are able to observe on a daily basis the way the child functions within the different situations which occur in the home.

1.2. The Visual Rehabilitation Programme: prescription of optical and non optical aids for children

The purpose of the Visual Rehabilitation programme is to prescribe optical and non optical aids which will maximize the use of residual vision. The prescription of optical aids for children involves taking into account a series of specific factors, and does not allow for pinpointing the chronological age which acts as an exact reference for initiating the child into their use.

However, there is a series of considerations which must be taken into account when planning the programme:

- It will never be a job complete in itself. The establishing of goals to be reached by a child is very complex, as on the one hand the level of requirements is wide-ranging, and on the other, the programme must be developed gradually since it undergoes changes as the child makes his way through the education system. It should commence with the use of simple materials which permit him to perform the job in hand, and the prescriptions should be adapted in accordance with the degree of progress made.

- Teachers should assist in the defining of pupil requirements.

- The opinion of the pupil is extremely important.

Before prescribing optical aids for the child, we should:

- Examine his level of visual perception with care. It is essential for the child to have been visually stimulated and for appropriate levels to be applied, because the aids magnify the size of the object under observation and prove useless if the child is unable to interpret what he sees, and his residual vision does not act as a path of perception in the recognition and discrimination of the image being received. - The most appropriate moment appears to be when the child has learned to read and write, as he can then use these instruments for a specific and motivating purpose. However, it must be pointed out that the learning of reading and writing skills is not possible with optical aids, since these only serve to make more difficult what is already a challenging task.

- The use of optical aids requires a series of skills which are related to reduction of the field under study, such as exploring, searching, following the text, changing from one line to the next, etc.

- The introduction of these instruments into the classroom is visible proof of the existence of a hitherto "concealed" problem. This is an aspect which should be watched over: the child must be aware of and accept the differences which his handicap produces in real terms.

- The child must feel the need for assistance because if he does not, it is unlikely that he will use it.

In addition, we must raise the question of whether optical aids which are more suitable for children are available. In our opinion:

- These must be simple and easy to handle.

- It is important for them to be functional: the child should find them practical to use.

- Non optical aids should be introduced in the early stages of schooling. Folding leaf tables and bookrests are convenient to use because they allow for short-distance work to be performed with the correct positioning. Correct lighting which avoids shadows and glare is also essential.

- Any optical aid can be used with children on the condition that they enjoy its use and adapt well to it.

The environmental information which fails to be perceived when sight difficulties exist is far greater over long distances than over short ones, which is why the telescope should be one of the first aids to be applied. In addition, the blackboard and visual material (maps, colour slides, video, etc.) are used a great deal in mainstream schools, and so the monocular telescope can prove to be a great help during these activities, although we must not be led to believe that the problem will be completely solved through the use of this instrument.

- The child must be fully conversant with the optical aid he is given, know what it can and cannot be used for, and also the correct way to use it.

It is of the utmost importance for the child to use the optical aids within the classroom context. There are ways of guaranteeing that this is done satisfactorily.

- Classmates should be aware of the child's problem and know what the special equipment is to be used for.

- Teachers should assist in and encourage the use of optical aids.

- We would reiterate that the pupil must be totally persuaded as to the usefulness of the aid which has been prescribed.

The different classroom tasks which require the use of optical instruments should never be carried out under the same conditions as for a pupil with normal sight. Perhaps this comment appears to be an obvious one, but it is frequently obvious to professionals treating diminished vision but not to others in the environment, and leads to faulty information being received because it is thought that the visual aids will improve vision and normalize the functions performed by the child. The use of optical devices makes it easier to perform certain tasks, but the child must become accustomed to shorter distances, smaller fields, fixed distance, etc.

An intervention model which may be considered more suitable is shown in chart 1.

2. THE ROLE OF PARENTS AND TEACHERS

The attitude of the family and its degree of participation will affect the visual functioning of the child in one way or another.

In principle, it should be borne in mind that the family is usually very anxious and raises many questions that must be solved by the specialist service with the help of the visiting teacher. There has to be an answer to questions such as: Why doesn't the child wear glasses? Is it bad to get too close? Won't the effort of using his sight only make it worse?

Once these doubts have been dispelled, the family usually plays a prime role in encouraging the child to develop his favourite pastimes and games using the residual vision that he does possess. This aspect of the problem is highly important and can, in many instances, be resolved with optical prescriptions.

In addition, all the professionals involved should participate in the assessment and visual rehabilitation processes, as they are a key element at all times for the achievement of the goals which are set. They should make the widest possible analysis of a whole series of aspects which can modify the visual functioning of the pupil in one way or another, namely:

- Motivation. The child should have an interest in using his sight. This is a basic requirement if the child is to complete the Visual Rehabilitation programme which has been developed for him.

- The level of ability and skill necessary for using optical aids. The teacher should fix specific, flexible goals in both these areas with a view to guaranteeing successful use of the aids later on. - To incorporate optical aids into the real situation of the educational framework. It is essential for the teacher to insist on the incorporation and use of the equipment and to intervene when problems of unwillingness and negative attitudes, etc. occur.

- To help to keep the needs of the child in perspective. In this respect, it is essential to avoid subjectivity and capture with exactitude the real needs of the student.

- Another basic element is the assessment of environmental questions and the situation of the child in class.

3. CONCLUSIONS AND DISCUSSION

The Diminished Vision Specialist Services should always be available for the education of the visually impaired child, with all that this involves. They should be utilized according to the needs of the pupil, and define specific requirements which can be met by the professionals on a daily basis and by the family who is aware of the routine difficulties experienced by the child.

From a technical point of view, therefore, we consider that this type of work can provide a satisfactory response, both regarding diagnosis and assessment and the prescribing of optical aids, always on the condition that it is regarded as a resource and that the service is not a place to seek definitive answers and solutions to the complex problem of the child with diminished vision. As stated earlier, the demand for services should be the product of reflection upon the existing need for this type of intervention.

On the other hand, we consider the information we can provide to be very useful, both from the point of view of confirming the visual functioning characteristics of the child and of anticipating future functioning.

Each case should be analyzed on an individual basis when considering the use of optical aids by children and, most importantly, parents and professionals should be persuaded that the use of these instruments alone will not solve all the needs the child will experience during his school lifetime. The only way to guarantee that the child will not feel a failure and will be able to perform school tasks in the most comfortable way possible, is to allow for flexibility and to ensure the use of these instruments in the school context.

Our specific proposals for achieving the above are as follows:

- To work in close coordination and to perform joint monitoring of the process being followed by the pupil.

- To use other, parallel types of resources whenever these are required.

In short, it is essential for the child with diminished vision to use his sight to the maximum of its possibilities, for him to have access to the resources he requires for this, and for him to be in full control of his life at school and in the future as an adult, which is why we should all be aware that our actions and participation will be a conditioning factor throughout the whole process.

MODEL FOR INTERVENTION


VISUAL STIMULATION

ASSESSMENT AND DIAGNOSIS FUNCTIONAL
PROBLEMS WHEN
PERFORMING TASKS

AWARENESS

SOLUTION TO THE
PROBLEM

. Optical aids
. Non optical aids
. Strategies
. Mobility
. Etc.

EDUCATIONAL
INTERVENTION

. Aid inclusion
. Acceptance
. Environmental modification

Better Vision, With a Telescope Inside the Eye




A TINY glass telescope, the size of a pea, has been successfully implanted in the eyes of people with severely damaged retinas, helping them to read, watch television and better see familiar faces.

The new device is for people with an irreversible, advanced form ofmacular degeneration in which a blind spot develops in the central vision of both eyes.

In a brief, outpatient procedure, a corneal specialist implants the mini-telescope in one eye in place of its natural lens. The telescope magnifies images on the retina, extending them so they fall on healthy cells outside the damaged macula, said Allen W. Hill, chief executive of VisionCare Ophthalmic Technologies in Saratoga, Calif., the implant’s maker.

In March, an advisory panel to the Food and Drug Administration unanimously recommended approval of the device. VisionCare says it expects the F.D.A. to give its O.K. later this year. The device has already been approved for use in Europe.

The implanted telescope holds much promise for patients, typically elderly, who suffer from end-stage, age-related macular degeneration, or A.M.D., said Janet P. Szlyk, a member of the advisory panel. Dr. Szlyk is executive director of the Chicago Lighthousefor People Who Are Blind or Visually Impaired, a social services agency.

The device does not cure the disease, but it does improve visual acuity, she said. For example, a person who might usually see a blur when looking at a friend’s face might, with the help of the magnified image, see a blur only in the area of the person’s nose or mouth.

“People can use it to recognize faces in a social setting,” she said. ‘That’s a huge advance.”

The telescope is implanted in one eye for jobs like reading and facial recognition. The other eye, unaltered, is used for peripheral vision during other activities like walking. After implantation, extensive therapy is crucial, she said, to learn to deal with the different abilities of the eyes.

Ruth A. Boocks, 86, of Alpharetta, Ga., who received an implant of the device in March 2003 during clinical trials, said her brain learned to adapt quickly. Mrs. Boocks uses her new visual abilities in various ways — for instance, to read e-mail and the messages that scroll across the bottom of the screen when she’s watching television. “My goal was to read to the bottom of the eye charts,” she said. “But I didn’t quite make it.” (She has gotten to the third line from the bottom.)

“I feel like a young woman,” she added. “It’s opened a lot of opportunities for me.”

Henry L. Hudson, a retina specialist in Tucson, Ariz., and lead author of two papers on the telescope published in peer-reviewed journals, said the device was not for everyone with A.M.D. “Maybe only 20 out of every 100 candidates will get the telescope,” he said. “They may not be eligible because of the shape of their eyes,” or they may have another problem, like maintaining balance, that precludes their selection, he added.

After F.D.A. approval, VisionCare will apply to Medicare to cover the device, Mr. Hill said. “We anticipate that it will be seen as a covered benefit for the improvement of visual acuity,” he said.

The price of the device has not been set. Current tools for ameliorating low-vision problems, like glasses fitted with telescopes or reading machines, are typically not covered by insurance.

Dr. Bruce P. Rosenthal is chief of low-vision programs at Lighthouse International in New York City, where telescopes mounted on eyeglass frames, for instance, might be prescribed for people with A.M.D. to help them watch a sports event. He said that patients might be as well served by these glasses as by the new implants, and that he hoped long-term studies would compare the benefits of the two approaches.

“Even though studies on the implants have reported minimal complications, there can be complications when you are inserting anything in the eye,” he said. “Even routine cataract surgery can lead to loss of vision.”

Dr. Rosenthal said the implanted telescope might be beneficial for some patients, “especially if they don’t want other people to know they are visually impaired.” Telescopes mounted on eyeglasses bulge outward, often extending an inch or so beyond the frames.

But he is concerned that people using implants might have trouble with balance. “There is a potential for falling when a person has a big image from one eye and a normal-sized image from the other,” he said.

DURING trials of the device, there was no increase in the incidence of falls among participants, Dr. Hudson said. More than 200 patients received implants in the study, and the effects have been tracked in the group for the past five years.

“The vast majority of the patients have been able to adapt to the new state,” using one eye for ambulating and the other for reading, facial recognition and similar chores, he said. “The average patient goes from legally blind to being able to read large-print books.”