Three Aspects of Retinitis Pigmentosa that Impact the Orientation & Mobility Adult Travelers Rae Loui Hunter Colle

1. Three Aspects of Retinitis Pigmentosa that Impact the Orientation & Mobility Adult TravelersRae LouiHunter CollegeOctober 2008

2. Retinitis Pigmentosa (RP) is an eye disease affecting the retina; which progresses over time. • RP can impact a person’s vision at night, peripheral vision, and ability to adapt to light.

3. Use of a Cane with Night Vision Devices(Zebehazy, etal 2005) • A participant using a cane with a night vision device in either a high-light or low-light area were similar. In both situations there was a reduction of cane contacts with the use of a night vision device. • Another participant with a restricted peripheral field of 7-degrees in daylight conditions had a 50% reduction in cane contacts even though the time to travel the course was the same as without the device. • The research suggests that although there are only two participants in this study of cane use with a Night Vision Device, Zebehazy, Zimmerman, Bowers, Luo and Peli in 2005 found the study did provide information on improved mobility when both mobility tools were used at the same time.

4. Use of Mobility Devices, according to research completed by Geruschat &Turano in 2002which summarizes vision science discoveries, information from psychophysical research along with their insights and impressions of functional problems and management strategies. • A client’s functional visual abilities and preferences must be considered when receiving O&M instructions. • Night vision technology is useful during travels at night. It provides good visual acuity in darkness. Use as a spotting device to identify an area. It offers increased independence and ease of travel. • The client that would be successful with a Fresnel prism would be someone who has reported bumping into people and things while traveling independently with good visual acuity and with a small visual field. Successful use of a Fresnel prism must include instruction and placement of the prism. • The use of the WAML during night mobility found significantly fewer errors with bumping, stumbling, and veering. Eighty-one percent of participants that used the WAML on average four to five times per week were satisfied with the product. Advantages: high intensity and width of the beam. Disadvantages: weight, size, battery life, and cost.

5. Mobility Tools to Enhance Safe Travel - Long Cane - Guide Dog - Optical Devices - Light Devices • There are several mobility tools that can be used at the same time to allow people with RP to travel safely and efficiently. For instance, studies show an improvement with mobility when using a long cane with a night vision device.

6. Techniques and Strategies to Enhance Safe Travels • Relationship between Visual Scanning and Walking Speed - What are you specifically looking for? Are you looking for a place to sit, the refreshment stand, or a particular office? - If information is coming too quickly, slow down your pace, or move to the side to gather information of your location.

7. Tips for Enhancing Night VisionUse of handheld light devices, such as - flashlights - handheld video camera lights. - Wide Angle Mobility Light (WAML)Innovative Rehabilitation Technology, Inc.Telephone: 800-322-4784 http://www.irti.net

8. Tips for Enhancing Peripheral Vision • Use of Optical Devices prescribed by a low vision specialist or ophthalmologist. - Reverse Telescopes - Night Scopes - Fresnel Prisms Available at The Fresnel Prism & Lens Company, www.fresnelprism.com

9. Tips for working with light adaptation O&M Specialists provide lessons and suggestions with • Analysis of the sun-shade pattern between buildings or walkways. • Use of mobility tools and devices. • Use of wrap around sunglasses of varied lenses from light to dark • Hats and visors with wide brims • Glasses that changes to sunglasses when exposed by light

10. Conclusion The three aspects of RP that impact the Orientation & Mobility Adult Travelers must be addressed by an Orientation and Mobility Specialist on an individualized basis. O&M Specialists that meet each client’s individual needs will provide optimum service to enable independence in safe and efficient travel in different types of environment and setting which include the use of mobility tools. The use of mobility devices may include a long cane with an optical or light device for the client with RP to experience improved mobility.

11. References • Gerushat, D., & Turano, K. (2002). Connecting Research on Retinitis Pigmentosa to the Practice of Orientation and Mobility. Journal of Visual Impairment & Blindness, 96. 69-85. • Zebehazy, K., Zimmerman, G., Bowers, A., Luo, G., & Peli, E. Establishing Mobility Measures to Assess the Effectiveness of Night Vision Devices: Results of a Pilot Study. Journal of Visual Impairment & Blindness, 99 (10).