vision problems? Try yellow glasses......

[Lulu54]

Sometimes I read research briefs and think - 'well, duh! I could have told you that." - and such was the case this morning when I was reading about a presentation at the CMSC conference last week that reported people with MS vision related problems stumble more often in low-light situations  than people without MS related vision problems.  I was busy shaking my head at that one, and am glad I went back and read further because there really was useful news in this one.  

Here is the link and the text - it might be very useful for many of you with vision difficulties -

http://www.medpagetoday.com/MeetingCoverage/CMSC-ACTRIMS/33096

"SAN DIEGO -- Vision loss, especially in low light, may contribute to problems with walking in multiple sclerosis (MS) patients, a researcher said here.

Lower visual acuity in low-contrast situations among MS patients was significantly associated with poorer performance on a gait test in a controlled trial, said Rachel Tripoli, a medical student at Florida State University in Tallahassee, Fla.

Moreover, many of the MS patients showed improvements when they wore contrast-enhancing yellow lenses, she said -- a simple and practical solution to a problem that diminishes quality of life and can cause physical injury.

Tripoli reported the findings at the joint meeting of the Consortium of Multiple Sclerosis Centers and the Americas Committee for Treatment and Research in Multiple Sclerosis.

Previous studies had indicated that reduced vision in low light was common in MS with or without overt optical neuropathy, Tripoli said.

She and colleagues recruited 22 MS patients and 22 age-matched healthy controls for their study, in which participants underwent visual and gait testing under a variety of lighting conditions.

The vision testing involved low-contrast Sloan charts, which display letters that appear increasingly faded as one reads down.

Participants also underwent optic coherence tomography scans to evaluate optic nerve morphology.

Finally, walking ability was measured on a "gait pad," a 22-foot carpet embedded with sensors that capture footfall pressure and duration, as well as gait speed and total time to traverse the pad. The data were used to calculate a functional ambulation performance (FAP) score.

Walking was evaluated under low light (less than 4 candelas) and four brightly lit (more than 80 candelas) conditions. Participants were tested four times under each lighting condition -- with and without obstacles (cones placed on the pad) and with and without contrast-enhancing yellow lenses.

The optic coherence tomography testing showed that, as expected, the MS patients had significantly decreased optic nerve thickness relative to controls, Tripoli said.

Sloan chart scores also were lower in the MS patients than in controls, she reported.

Under three different contrast conditions, MS patients were able to read about five fewer letters than controls.

On the gait tests, MS patients' FAP scores were negatively associated with EDSS disability scores, indicating that increased disability was correlated with poorer walking performance.

Differences in gait measurements in MS patients versus controls were apparent only under low light. In bright light, no significant deficiency for patients was apparent, Tripoli said.

With obstacles, the mean FAP score for patients was about 75, compared with more than 90 in controls. The difference in the obstacle-free test was smaller, about 10 points, but still significant, Tripoli said.

Use of yellow lenses improved FAP scores in patients to the point that they no longer differed significantly from controls, both with and without obstacles.

She said it was reasonable to conclude that the lenses "increase obstacle discrimination" and could be useful for injury prevention."

[debgen]

Thanks for sharing this with us Lulu and Mary for you insightful comments. I am amazed that I never thought about this, but it makes so much sense. I taught special education for many years and always tested my students reading ability using different color transparent overlays. Different colors worked best for different students. Once the right color was found for the child, their reading truly improved! Not ALL students improved but students who were visually effected, it helped a great deal.

I certainly will look into this for myself because my gait needs all the help it can get!

Thanks,
Deb

[Sidesteps]

Lulu, I have been wearing light gold tinted glasses for about two years now. I bought them because I have light sensitivity. As you know, I live in the PNW so it's frequently cloudy here but I STILL have trouble, this was a solution my sister (who worked in optometry for years) gave me.

I quickly felt it helped and began to wear them more when my MS symptoms hit me. I was even sometimes wearing them at work when they are more like super light sunglasses. (I can wear them at night when car lights bother me as well.)  Now that i think about it, I wear them less after my IVSM treatment from February. I just haven't needed them as much. Very very interesting!

PS My sister said that amber tonesdo not impact contrast whereas grey tones do. You can see better overall.

[maxthecat43]

I am going to see if this helps my husband.  He has vision problems due to diabetes.  

[doublevision1]

Thank you for this, Lu, and Mary once again for your helpful analysis!

[supermum_ms]

Years ago before i lost my up etc, light sensitivity was becoming a problem, funny coincidence but on testing its when they first discovered paling of the optic nerve (thought to possibly be early glaucoma with normal pressure) but at the time i still had 20/20 vision so what to do about the light sensitivity felt a bit strange to me. I was adviced to try coloured lenses, though she said i was probably going to need blues. Now if she thought i was going to need different shades of blue and if memory serves, yellow is the opposite on the colour chart, could it be because with blue it mutes the light and with yellow is enhanses?

hmmmm interesting, though i wonder if its similar to 'rose' tints to aide dyslexia, when they work they work but for the majority it makes no difference at all. I haven't got yellow, blue and rose so i cant play with this one but i'd love to try it. lol bright light doesn't affect my balance, just eyeball pain and squinting but take away light and i'm stumbling and wobbling all over the place, lol i'll even fall over by the momentum when i freeze frame and i seem to always forget lol maybe i need a combo, and i need to go green :D

cheers...........JJ

[twopack]

Thanks for sharing this Lu.  I think the point I take away from it is that the problems we face will sometimes have solutions we (and our health care providers) either forget to consider or don't believe are fixable.

Having gait problems?  Falling?
*Your doc's neuro exam probably won't reveal low light/contrast vision loss.  You'll get a cane or walker for stability rather than yellow tint glasses.
*Your PT might look at balance or strength - but never consider vision issues as a contributor.
*You go for regular vision checks but the testing doesn't differentiate how well you see in various lighting (at least mine never have) unless you mention it's a problem - then you are told it's an 'aging thing' you have to live with.... no solutions offered.
*Vision sometimes deteriorates slowly enough that we don't even recognize the problem ourselves.
*Or maybe the best solution for your problem involves treating two issues - except as soon as your provider chooses one course to pursue, all investigation into additional contributing factors shuts down.

Suggestions for care practices can be excellent but their value and the ability to disperse such info can be limited.  Suggestions only get a punch of authority when they can be raised to the level of a recommendation.  Research studies are necessary to confirm ideas and turn suggestions into recommendations that have the power to be heard.  

I agree many studies sound like useless grab-the-grant-money schemes devised by doctoral students wanting an easy to process research project.  But they actually do serve a purpose when they manage to verify useful information that can then be made accessible to a much broader audience.

This one doesn’t address a problem I have presently but I’m going to try to hold onto the info for future reference.  Thanks again Lulu.

Mary

[saucygrl]

I am going to show this to my family!  They like to watch television with the lights off and I told them I feel less coordinated moving around the room with no light.  They all thought I was nutso!  HA!

Chris

[kwarendorf]

I just read the same story, and had the same reaction. My reaction didn't soften though :-) Does that fact that we, the MS afflicted, walk better when we can see where we are going make us that different from anyone else? :-)