UC Berkeley optometrists in visionary partnership

By Sarah Yang, Public Affairs

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.

"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.

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.

Stuart Wittenstein, superintendent at the School for the Blind, pointed out that improving a child's eye health has an impact on 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."

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 also to open the clinic to children who are not enrolled at the school.

Dr. A Mika Moy, assistant clinical professor of optometry, meets with Lian McIntire, 5, of Fremont. Liam was diagnosed with cortical vision impairment when he was 2, and often tilts his head to help orient himself

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