Eye Strain

My eyes are constantly fatigued of late. The left eye has almost become some kind of screen saver. It goes in all possible directions to focus at the same object. In no time, I will morph into a wobbly-eyed toon.  

I need to check with a doctor. Either there has been a huge drop in the left eye vision or simply eye strain. I have been spending extra hours at work. 

Two months ago I changed my laptop. Even though I adjusted brightness to blend with the ambiance lighting, I felt constantly strained. Turns out that my previous laptop LED had a lower dot pitch and more pixels. My stuff is still with the movers and packers company as I've not found an apartment in the city I moved to. Once I get my stuff I can use my iMac and throw this junk laptop out of the window.

At work, the new seat is next to a window. I would need to either change my seat or make sure that i can close the blinds. 

I found a very comprehensive article online on reducing computer eye strain. A lot of things we already know but some were still new to me.  Here is the link: Computer Eye Strain: 10 steps for relief

Teaching again

After several days of hesitation, I've finally started conducting French language classes at work. Teaching was one of the first things that I ticked off my list when I started to lose my eyesight. It seemed impossible to conduct sessions when I myself cannot read what anyone will write. Eye contact is out of question.

First day of class and I couldn't help getting overwhelmed with the positive feedback I got from everyone from my batch. I used presentation slides and a notepad instead of traditional whiteboard. Used PPT pen to highlight, underline, draw (all those useless hours spent drawing in paint finally came to some good). Took a lot of time in creating slides out of the lesson plans, scanning worksheets etc., but it ensured that everything is one place and in order.

Have delivered six successful sessions. Very pleased that teaching still remains possible and as interesting as ever.  Are you also a visually impaired teacher? What methods of teaching do you use to conduct your classes?

Lazy eye

For past two weeks , my left  eye seems to have a mind of its own. I am trying to force it to focus but it doesn't seem to obey. Does anyone else has this problem? I've not been to my retina specialist in months. Time for eye check-up, maybe I can use glasses. I cannot read anything from my left eye anymore.

Prove You're a Human!

Alright, this drives me really crazy. You are a visually impaired blogger but you put a captcha on your blog to filter spam comment. Next I know, I will have to decipher a captcha even for viewing some posts. Please stop using challenge-response systems for comments. No one likes spam. But you can moderate your comments instead of putting a captcha. And if you didn't know they have figured out how to bypass captcha.

There is no dearth of CAPTCHA on the web. I've a plethora  of those squished, squiggly, irksome letters to deal with for payment gateways. And of course, every time I forget a password of my nth account, I am sent straight to the captcha gallows. (breach of some electronic code of conduct?). And if entering correct password wasn't enough, I'm given a 10 minute captcha treatment for even changing system. What is next? Browsing habit? Say if I login at 4 am to Facebook on a weekday!?!

Sometimes I wonder if the new technology is rather creating more accessibility issues.




June 25, 2012, Update - I guess I was just high on irk quotient that day. Even simple navigation is quite a challenge if you have low vision, so troubleshooting is obviously tedious. Lot of my low vision friends may not know that captchas can be disabled! We get so used to seeing them everywhere anyway.

 To disable word verification for blogger comments, go to your blog settings > Posts and comments and disable "show word verification" option. You can still avoid spam by selecting comment moderation.

Bewilderment

I read 3 books in one week, roughly some 1000 pages (after work, in transit, waiting for friends in cafes, on roadside because I didn't want to go home). I've not read as much in such short period after university days. I'm surprised.

Advances in Stem Cell Therapies

More advances in stem cell therapies with every passing day. Stroke patients show signs of improvement in earlyy phase clinical trials in Scotland. A ten year old girl gets vein growth from her own stem cells. ReNeuron to present the pre-clinical data related to its ReN009 therapy for critical limb ischaemia, a chronic and debilitating disease that restricts blood flow in the limbs at a major stem cell a conference in Japan this week.

Optimal way of growing embryonic stem cells

A team of European researchers discovered that embryonic stem cell properties are impacted by the laboratory conditions used to grow them. The study, supported by four EU projects - HEROIC, PLURISYS, EUROSYSTEM and ATLAS - evaluated the gene expansion (transcriptome) and chromatin modifications (epigenome). The results show differences between pure stem cells and embryonic stem cells grown in laboratory conditions. Stem cells being both unstable and primed to differentiate, the researchers now know the key information on what is the optimal way of growing them. The transcriptome analysis allows scientists to identify which genes are turned on or off inside the cells. The gene's level of activity is also calculated through this method. The epigenome analysis provides researchers insight into how genes are controlled.


Human embryonic stem cells may be totipotent


Another study led at Salk Institute uncovered that a small number of human embryonic stem cells believed to be pluripotent may be totipotent. Totipotent stem cells have the potential to develop into any cell found in the human body, including placental cells. Whereas Pluripotent stem cells cannot produce "extraembryonic" cells such as those in the placenta. More information on this study here.


Funding problems: Scientists urge EU parliament to not cut funding

Leading researchers, institutions and patient groups urged EU parliament not to cut funding for embryonic stem cell research in Horizon 2020. With Europe and UK being world leaders in embryonic stem cell research, any cuts will seriously jeopardize the future of stem cell research. 

"It will be years before there are treatments made from stem cells on the shelves."

I'm out of town. Just a quick post with a link to quite an informative article on stem cell clinical trials development.  Here is the link to the main article : Stem cell scientists take hope from first human trials but see long road ahead

Even though the stem cell research has come a long way from the first discovery of embryonic cells in 1989 to clinical trials today, we might need to wait several more years before we can find on-the-shelf treatment for a lot of currently untreatable diseases like Parkinson's disease, Type 1 diabetes, Chronic liver disease and heart diseases and ofcourse Stargardt's disease.

A lot still depends on the outcome of the  world's first human trial using RPE (retinal pigment epithelium) cells from stem cells derived from humon embryos. In phase one trial earlier this year, some Stargardt's and Age-related macular degeneration patients were injected with a tiny amount of RPE cells (50,000). Patients have reported small improvement that have nonetheless significantly changed their lives.  The chief scientific officer at Advanced Cell Technology Inc., Dr Robert Lanza thinks that "It is very hopeful if we are seeing this with a small number of cells at the very advanced stage, imagine what we could do with those young children who are going blind at the age of six to 10, sometimes."

Although the patients treated with the stem cell trial are taking precautionary drugs, they might not need to take immuno-suppressant drugs for lifelong unlike most transplant patients. Eyes are "immune privilleged" and "can better tolerate a graft of human tissue without the immune system mounting an all-out attack and causing rejection" says Prof Pete Coffey, of the Institute of Ophthalmology at University College London,

Ethical Problem and Funding issues

From the start, there has been strong political opposition on the use of embryonic stem cells. The destruction of an embryo is viewed as tantamount to murder of an early staged human life .And it violates the belief system that life begins when a sperm cell fertilizes an egg cell to form a single cell.  The opposition in Europe led to European court's ban on stem-cell patents in Europe in October last year. This means that any future clinical trials or research in stem cell therapy would not be protected in Europe. As a result, the biotech companies supporting stem cell research are facing serious funding challenges from investors. There is still strong views from political parties to stop European funding.

  

IPS cells vs Embryo cells

Despite the more recent advance regarding induced pluripotent stem cells (IPS), which are cells from skin or other parts of the patient's own body, IPS cells still remain an unworkable, enormously expensive and unrealistic solution in comparison to embryonic stem cells as of today.

"The embryonic cells are affordable and "you can treat many people with one batch of cells. That makes it somehow conceivable that it could be economically viable for the healthcare system.". ACT's Lanza says they have enough RPE to treat everybody on the planet.""

Embryonic/IPS cells vs Mice cells

Scientists believe that a great deal of research is still required because both embryonic and IPS cells are not the same as the true embroyinc cells from the mice.

"Mice embryonic stem cells, which have been used in so much early stage research, appear to be slower than human embryonic cells to divide and differentiate. Basically, the human cells taken from a blastocyst (a five- or six-day embryo) have already moved on to the next stage, where equivalent mouse cells have not. That makes it hard to produce standardised cells that will all, for instance, make exactly the same nerve cells. There have been some partial successes but, says Smith, "we don't have a human cell either from an embryo or re-programmed that is held at this ground state." Taking cells at an earlier moment in the blastocyst development won't work, he says. "It is not the starting point that is important. The biology is subtly different between rodents and primates.""

Outcome of First safety trials in human

There is a lot of hope in the scientific community on the current stem cell clinical trials to cure Stargardt's Disease. Positive outcome will also mean that human embryonic stem cell trials for other diseases like Parkinson's and diabetes could also begin in next 4-5 years.No damage has been so far reported by Advanced Cell Technology for those who were treated with RPE cells.

Alkeus to start clincal trials for SD later this year or start of 2013

Another pharmaceutical company dedicated to finding a cure for Stargardt's Disease will start their clinical trials later this year or in 2013. Alkeus research is more focused on a preventive treatment, with an aim of developing compounds to  prevent formation of toxic A2E and lipofuscin pigments, and thus to slow down macular degeneration. Currently, they are finding patients for their clinical trials. You can add yourself to their registry to get future updates on trials.

http://www.alkeus.com/starstudy2.html

Excerpt of a comprehensive article from their website:

"An imperfect recycling system

The retina is the thin membrane located at the back of the eye. It contains millions of photoreceptors used for vision, and plays a similar role as the light sensitive film at the back of a camera. These specialized receptors cover the retina and are responsible for black and white (rods) and for colored vision (cones). Vitamin A, which can be found on the tip of the photoreceptors, is the key molecule to vision. Its exact role was explicited by George Wald and resulted in a Nobel Prize of 1967. In other words, vitamin A is the fuel of vision.

Vitamin A and its derivatives (such as beta-carotene), originate from certain types of food: for example, eggs, milk and other dairy products all contain vitamin A while vegetables, fruits, carrots, etc. contain beta-carotene. After vitamin A is transported into the retina, it is struck by light forcing it to change its molecular shape, and acting like an electrical switch which enables the delivery of an electric signal to the brain. This signals the presence of light to the brain.

After vitamin A has changed its shape, it becomes insensitive to light and needs to be reactivated by specialized cells, the retinal pigmented epithelium (RPE). The geometric switch of vitamin A as well as its recycling by the RPE is called the "visual cycle".

While we would wish vitamin A to be a clean burning fuel, unfortunately, the visual cycle is imperfect and some vitamin A molecules are able to escape the recycling system: these vitamin A can then bind to other vitamin A molecules and create toxic aggregates of vitamin A called vitamin A dimers (or A2E). A2E is then absorbed and stored in the RPE cells where they are considered to be responsible for the formation of other toxic granules named lipofuscin.

With age, accumulation of lipofuscin reduces the proper function of the RPE cells and is thought to be partly responsible for inducing macular degeneration.

Stargardt disease patients present a defective gene which prevents proper transport of vitamin A back into the RPE, which results in even faster formation and accumulation of A2E and lipofuscin. This is why Stargardt disease is also called "juvenile macular degeneration" as the clinical presentations may be somehow similar.

Visual cycle imperfections lead to A2E formation and to macular degeneration. Alkeus Pharmaceuticals is developing compounds that can help perfect this cycle, prevent the formation of toxic A2E and lipofuscin pigments and potentially slow down vision loss in dry-AMD and Stargardt disease."

Increasing subtitle font size to watch foreign films

Stargardt's disease has limited my access to all possible forms of visual arts. With more loss in central vision, my depth and colour perception has further decreased. I no longer visit art galleries and museums. I hesitate to take out my camera for street photography. Cinema and theatre are still accessible from the front row, but only in the languages I know. Few weeks back, an Afghan troupe performed Shakespeare at Rangashankara, a local theatre. I was in dilemma for a week whether to buy tickets or not.  (Will I be able to read subtitles? or even see subtitle panels? :P)

I don't have problems with subtitles while watching movies at home. There is a feature in VLC media player which allows to enlarge the subtitle font size:

1. Go to Menu Tools > Preferences

2. Select Subtitles & OSD

3. In Subtitle effects, set font size to large or larger and Save.

At larger font size, the screen appears like this. You can download VLC media player from this link

Moving to a new city

Sometimes disability is imposed. Like, there are accessible cities and there are inaccessible cities. Experience is relative still. 

Ever since I arrived in this city 4 years back, I've been uncomfortable. Running in circles and always finding myself back at the starting line. Several change of jobs and relationships. Permanence is perhaps a utopia.

I feel no connection with this culturally inaccessible city. It limits me. It disturbs me. It took me sometime to understand that I need to move to a new place. More than 2 years. And then when I thought I need to move, I found someone. It didn't last long. I live my life from one minute to another (Either it is SD or just me, difficult to disassociate) and this person came with a schedule where I had to fit in or where I couldn't fit in. I'm the kind of person who will skip the world to be with someone for even 10 minutes and he was the kind of person who was too entangled in several worlds. Yet there was an inexplicable connection between us and now we are unrelated. 

I'm free to move to a different city. A city that expands my possibilities. It did take me a while to work things out and finally I got relocation approved from my employer. 

Being visually impaired, I like being in big cities, where people may not be monitoring your every move. I can get lost without looking stupid. I can look up and someone will guide me home. (And not be embarassed to ask 20 people for directions, within just a mile!. With more than 20,000 people per square kilometer to ask for help, I do not need a map). I can walk in crowded streets incognito. Be led by the pace of the city and find several things to do. And when I get tired of the world, find a pretty spot to renew my morale and spirit. I can depend on the city. 

Even though it will take a month or two to actually move, I'm already excited and feel less disabled :o)