Biting into Assistive Technology

This Jaws does not bite. Unlike the infamous sharks in Spielberg's blockbuster, Jaws the screen-reader software offers visually-impaired people the opportunity to work independently and traverse the wondrous world wide web with ease.

Dr Wong Meng Ee, president of the Retinitis Pigmentosa (RP) Society and who is visually impaired, showed today the workings of software Jaws, demonstrating its benefits and user-friendliness.

He typed in Microsoft Word and with each letter, Jaws echoed it back to him. And to audible gasps from the crowd of 60, he even set up a table in Word and effortlessly keyed in words into the individual cells of the table.

"Jaws is very useful for office work, since many of us use Word and Excel almost every day," said Meng Ee, who is also an assistant professor at the Nanyang Technological University. "It has allowed me to work in a mainstream environment, using things which are used by my colleagues. So I can read all documents, papers and e-mails sent to me."

He was speaking at a talk on Assistive Technology, organised by the Macular Degeneration Society, the RP Society and Glaucoma Patients Association. This is the second joint effort by the three organisations this year.

Getting the news, now

Besides using Jaws on Word and Excel, Meng Ee also used it to surf the Internet, searching for information through Google.

But while a sighted person can very quickly get to the information he wants on the website, going through Jaws takes a little longer because the software reads out all the text on screen. Still, with a little practice and some familiarity of certain websites, it gets faster and easier.

More importantly, Jaws allows a visually-impaired person to go online and "read" the news he wants, connecting to the world instantly and on his own demand. "In the past, we have to wait for someone to convert newspapers to braille and that takes time," he said. "By the time it is ready, it is old news. These days, we want news instantly."

Scanning documents

Since Jaws can only read out text that is already in the computer, that means that printed documents would be out of its reach. But he refers the audience to a product known as OpenBook, which scans printed documents and converts it into text format in computers, allowing Jaws to then do its magic.

"You can scan it, go for a cup of tea, come back and it is done. You can even save it into MP3 format," he shared.

Money no enough

But there is a downside to these products - cost. Jaws cost about S$2,500 and OpenBook is about S$1,500. The American company selling these products does not deliver to Singapore and so those who are interested would have to order through the Singapore Associated for the Visually Handicapped (Tel: 6251-4331).

For those who are unable to afford it, he suggests approaching the National Council of Social Service, which has an Assistive Technology Fund. It subsidises up to 90 per cent of the costs of the products. (AT Fund secretariat can be reached at 6210-2677 and ncss_rad@ncss.gov.sg)

He urged people to embrace assistive technology and invest in it, noting that an American colleague had remarked that while Singaporeans go for the biggest TVs and the latest mobile phones, we stint on the technology which can really change lives.

Increasing font sizes and magnifiers

Besides Meng Ee, MDS secretary Sharon Siddique and Exco member Steven Lo also offered tips on how to make technology work for the visually handicapped. After years experimenting with his computer settings, Steven showed how users can enlarge all the font sizes on screen, from the desktop icons to text on websites. This is to make it easier for MD sufferers who are no longer able to read small fonts.

Sharon, on the other hand, showed new magnifiers which are not only user-friendly, but portable and robust. She said: "Many of us here today do not need these equipment yet. But it is good to know that down the road, there are these innovations which can help with our lives. It gives me comfort."

* What is your view on assistive technology? Have you used any before? Share with other MDS members your experience. Click on the Comments tab.

Prof Leong: Prevent the preventable, delay the inevitable

By Sharon Siddique

MDS Secretary

About 45 of us gathered on Saturday afternoon to hear a lecture by Dr Leong Seng Kee on “Nutritional Supplements and AMD”. Before his retirement from the National University of Singapore, Dr Leong was Professor and Head of the Department of Anatomy.

One of his special research interests is the human nervous system, including the projection of the eye to the brain. This gives him a unique perspective on macular degeneration – its causes, its treatment, and its prevention.

According to Prof Leong, the causes of macular degeneration are multi-factoral, and can be divided into two categories – non-modifiable and modifiable. Non-modifiable factors include age, family history, genetic makeup. Amongst the most important modifiable factors are quitting smoking, including green leafy vegetables and fish in the diet and avoiding transfat, and controlling hypertension and other chronic conditions.

Reducing modifiable risk factors cannot cure macular degeneration, but there are studies to show that an antioxidant-rich diet, including nutritional supplements, can retard the rate of deterioration.

Taking a combination of antioxidants, including Vitamin C, Vitamin E, Vitamin A (betacarotine), zinc and copper, can stop the progress of macular degeneration at the mild stage in 28% of those on such supplements. Thus in terms of modifiable factors, good nutrition is critical, and nutritional supplements appear to help to prevent, or slow, the process of macular degeneration.

Dr Leong, however, also pointed out that there have been counter-studies, which have actually linked an intake of Vitamin A and E to an increase in mortality. Other studies find no relationship between high antioxidant intake and a slowing of macular degeneration. According to him, these studies are based on meta-analysis. No new research is undertaken, rather many existing studies are “trawled” for results. Such studies must be interpreted carefully because they are very selective in the cases they chose for comparative analysis.

He concluded his talk with several things to remember. First, nutrients work in synergy; they can’t be assessed in isolation; they must be taken in combination. Second, the power of nutrients is in prevention, not in cure. Third, quality control in supplements is very important. For example, always choose natural vitamin E, and not the synthetic vitamin E.

Dr Leong recommends the use of supplements, and he uses them himself. He sees nutritional supplements as having the ability to “prevent the preventable, and delay the inevitable”. An inspiring thought for all of us to take home and ponder.

Talk on Nutritional Supplements

TOPIC: Nutritional Supplements and Age-related Macular Degeneration

SPEAKER: Dr Leong Seng Kee

VENUE: All For Eyes

Tanglin Shopping Centre #05-23

19 Tanglin Road

Singapore 247909

DATE: Saturday, 21 June, 2008
TIME: 2:30pm to 4pm

As we have LIMITED SPACE, please ring Anne (62387387) to confirm your attendance, or send Sharon an email at alleyes@singnet.com.sg

All For Eyes is honoured to have Dr Leong Seng Kee to speak to us on the topic of nutritional supplements and AMD. Those of us with macular degeneration have certainly read many reports on the pros and con of vitamin and herbal supplements. Which ones, what dosages, and how often, are questions which we have all faced after our diagnosis.

We are all concerned with getting a clearer picture of current thinking on nutritional supplements, particularly from a more holistic perspective. We are therefore very grateful that Dr Leong has agreed to share his lifetime of insights with us.

Before his retirement from the National University of Singapore, Dr. Leong was Professor and Head of the Department of Anatomy. His special research interest is the human nervous system, including the projection of the eye to the brain. He has published more than 100 research papers in internationally refereed journals.

For many years Dr Leong has also maintained an interest in the area of nutritional supplements and general health. His friend of 40 years, Victor Wong (senior legal practitioner) said of him: "When Dr. Leong tells you something he means what he says and you will not regret taking him seriously".

Oily fish prevents MD

Australian scientists have found that eating foods rich in omega-3, such as oily fish, can help to prevent vision loss due to macular degeneration.

Oily fish are those fish which have oils throughout the fillet and in the belly cavity around the gut, rather than only in the liver like white fish. It does not refer to fish which are cooked in a lot of oil!

Omega-3 could cut down on the risk of people developing age-related macular degeneration (AMD) by as much as a third.

The researchers said that eating oily fish twice a week could help cut down on the chances of getting AMD as the body gets older.

Fish oil is oil derived from oily fish.

Watch your chicken rice

Eating too many plates of chicken rice and mee goreng may not be good for macular degeneration patients. While delicious, foods like that are "bad" carbohydrates that can significantly increase the risk MD, according to a study in the United States.

Low glycemic or "good" carbohydrates are found in foods containing whole grain, whereas high glycemic or "bad" carbohydrates are found in processed foods such as white rice.

Researchers say evidence is building that "bad" carbs rating high on a glycemic index

can cause spikes in blood sugar that are unhealthy for eyes, whereas "good" carbs help stabilise blood sugar.

Dietary glycemic index is a scale used to determine how quickly carbohydrates are broken down into blood sugar, or glucose. Refined carbs like white bread and rice have high glycemic indices. Whole wheat rice, pasta and bread have low glycemic indices.

The study found that men and women older then 55 who consumed diets with higher-than-average dietary glycemic index foods appeared to have an increased risk for both early and later stages of AMD.

"No one has been able to identify an effective noninvasive intervention that will slow the progress of AMD," said Dr Allen Taylor, a director of the research team.

"We feel we have identified a risk factor that could postpone the debilitating loss of vision with very little economic or personal hardship. Based on our data, limited refined carbohydrates intake, such as by limiting sweetened drinks or exchanging white bread for whole wheat, in at-risk elderly could reduce the number of advanced AMD cases by 8 percent in five years. This can equate to saving the sight of approximately 100,000 people."