Glaucoma:The Latest Diagnostic Tools

		Issue: September 2001 Glaucoma:The Latest Diagnostic Tools Today's technologies are faster, more accurate and able to detect glaucoma much earlier.Here's an overview of what's available. By Mireille P. Hamparian, M.D., Encino, Calif., and Alan L. Robin, M.D., Baltimore, Md. Recent advances in technology have done a great deal to enhance our ability to detect and treat glaucoma in its earliest stages. And increasing numbers of eyecare professionals are taking advantage of the new technologies. For example, hundreds of disc imaging systems have been sold during the past decade. More have been sold at the Academy and ASCRS meetings in the past 2 years than in the previous 8 years combined. Not only are the instruments and software better, but reimbursement for related procedures has become much more reasonable. A major step forward Previous technologies, which primarily monitored changes in intraocular pressure (IOP), loss of visual function and grossly visible structural changes in the disc, made diagnosing and monitoring glaucoma difficult at best: The sensitivity and specificity of disc changes and IOP as evidence of glaucoma are less than 50%. (Many patients who present with IOPs greater than 21 mm Hg or large cupping and cup-to-disc asymmetry don't have glaucoma.) As an indicator of glaucoma, the nerve fiber layer is much more sensitive and specific. However, it's hard to see in vivo, and until recently we've had to rely on qualitative assessments -- sketches and photos of the optic nerve -- to monitor glaucomatous structural damage and progression. In addition, nerve fiber layer photos are difficult to read when the patient is elderly or African-American, and these are the patients most likely to have glaucoma. In contrast, the new modalities can more reliably measure change in disc size and shape, as well as focal thinning in the nerve fiber layer. This allows us to intervene at an earlier stage of glaucoma progression and monitor those patients who present with elevated IOPs or large cup-to-disc ratios but still have normal perimetry. Perhaps the most compelling reason to use the new imaging technology is that clinically detectable structural changes in the nerve fiber layer and optic disc can occur years before functional measurements of the optic nerve (such as standard automated perimetry) are able to detect a problem. In fact, a patient may lose half of his optic nerve head axons before perimetric defects become obvious. (Also, visual fields have inter-test variability; you need at least two or three of them to confirm a defect.) Each of the new technologies has its strong and weak points. For example, some of the new modalities are primarily designed to screen for potential glaucoma, although they can also be used to follow progression of the disease. (Our ability to use these modalities effectively for the latter purpose will increase as we gain more experience with them.) This article will help you choose which instrument or modality makes the most sense for your practice by reviewing some of the most relevant attributes of the options available. Perimetry: Frequency Doubling Technology (FDT) Zeiss Humphrey's FDT is a portable visual field analyzing device that's demonstrated relatively high sensitivity and specificity for detecting visual field loss in eyes with moderately advanced glaucoma. The patient observes a series of alternating light and dark bars, which rapidly switch between black and white. This causes most patients with healthy visual function to perceive twice as many bars as are actually there. (The level of contrast is set so that 99% of normal subjects observe the same effect.) This frequency-doubling stimulus is presented randomly to a total of 17 different visual field locations within the central visual field. How it works: We believe the stimulus is detected primarily by a subset of magnocellular retinal ganglion cells that have nonlinear response properties. These magnocellular ganglion cells may be among the first casualties of glaucoma. Hence, inability to experience the doubling phenomena indicates early glaucomatous damage. Results of an FDT screening are considered abnormal when the following are present: any defect in the central five locations two mild or moderate defects in the outer 12 spots one severe defect in the outer 12 spots. Results are also considered abnormal if total test time for each eye is greater than 90 seconds. When any of these criteria are present, the FDT is considered "positive." When you obtain a positive result, you can either quickly repeat the test or perform conventional threshold perimetry. Advantages of the FDT. These include: The FDT is very easy for a technician to use; it requires only a few minutes of instruction. The menu is simple, and operation leaves little room for error. It features a screening mode and a full threshold mode. (The screening algorithm is a quick and accurate tool for glaucoma detection.) The machine isn't at all intimidating for the patient. It has no perimetric "bowl," so the patient can feel comfortable without claustrophobia. The FDT tolerates up to 6 diopters of blur, so the technician usually doesn't have to worry about proper spectacle correction. The test requires no eye drops; it's unaffected by pupil sizes as small as 2 mm. The test can be performed under normal lighting conditions. The procedure takes only 45 to 70 seconds per eye to perform. The FDT has a unique pre-test capability to help you determine which threshold perimetry algorithm (if any) would be best to use. The instrument is relatively portable. (It weighs about 15 pounds). Other points to consider. These include: The test is subjective; it depends on the patient's response. Because structural loss of retinal nerve fibers may precede functional loss, this technology has limited usefulness for early detection of glaucoma. Determining which results are normal and which indicate early glaucoma can be difficult. The FDT may not be useful for long-term follow-up and detection of change. The FDT printout looks different from the printouts produced by other instruments, which most of us are used to. It requires a little practice to interpret. Perimetry: The Swedish Interactive Thresholding Algorithm (SITA) SITA algorithms (used by the Humphrey automated visual field perimeter) have done a lot to revolutionize perimetry. SITA algorithms are designed to perform visual fields similar to those that use the full threshold algorithm, but with one important advantage: SITA algorithms don't depend on the conventional staircase method. For that reason they significantly decrease test times, while still maintaining the integrity of the test results. How it works: Instead of using the usual staircase methods, which test each area in the visual field once, SITA returns to check a second time -- but only if nearby areas show a suspicious result. (This helps keep the test time short.) As the test proceeds, these functions are updated. SITA fast. SITA fast differs from SITA standard in the number of crossings, the step size and perhaps most important, the amount of allowable error in the threshold estimate. If a given test result is reliable (based on the patient performance indices the device provides), it can dependably detect scotomas along with their relative depths and help quantify the level of glaucoma damage. For patients who still can't perform a reliable test with the SITA full threshold because of problems with attention span or rapid fatigue, the SITA fast test can often be quite useful. Advantages of the SITA algorithm. These include: Patients and technicians are happier with the shortened test time. Quicker testing allows you to perform almost 30% more examinations in a given time period. This, in turn, allows you to recoup the cost of the perimeter much more quickly -- and make more efficient use of your technicians' time. This test has a slightly higher mean sensitivity than tests using earlier algorithms, perhaps because of the shorter testing time and reduced patient fatigue. Both inter- and intra-test variability of the SITA is comparable to conventional full threshold perimetry. In fact, it displays a little less variability between repeated tests, probably also as a result of reduced fatigue, which allows for earlier and more reliable detection of visual field deterioration. Other points to consider. These include: The test is subjective. It doesn't detect nerve fiber loss at its earliest stage, and therefore doesn't detect glaucoma at its earliest stages. SITA can't calculate short-term fluctuation or corrected pattern standard deviation. One of the remarkable things about SITA fast is that it operates most of the time right at threshold. However, this characteristic can limit its utility in a screening situation because its high speed is less tolerant of patient errors than SITA standard. Note: Some doctors who have worked with this algorithm have concluded that the relative sensitivity of the tests depends on how far the disease has progressed: SITA standard is much more sensitive than either SITA fast or full threshold in early field loss. SITA standard and full threshold are comparably sensitive in moderate loss. In advanced disease, they show minimal difference in sensitivity. Perimetry: Portability and design advantages A new perimeter, the Oculus Easyfield, uses familiar technology, but offers practical advantages because of its size and cost. It's the first portable and relatively inexpensive device that can both screen patients for glaucomatous damage and quantify results (making it possible to monitor progression and accurately follow these patients). Despite its relatively small size and cost, the Oculus Easyfield is a capable glaucoma detection device. Preliminary comparative studies suggest the Easyfield may be more sensitive and specific to moderate and severe glaucoma damage than the FDT test. (Evaluations are currently under way comparing full-threshold perimetry testing by the Easyfield and Humphrey instruments.) How it works: The technology is similar to conventional computerized static perimetry. Advantages. These include: The small size and relatively low cost may increase the cost-efficiency of glaucoma detection. Unlike most conventional perimeters, the Easyfield doesn't require the patient to put his head inside a bowl, which some patients find claustrophobic. If you screen for glaucoma and results are positive, threshold determinations can be made with the same instrument. Other points to consider. These include: The Easyfield doesn't provide a large normative database for statistical comparison. The Easyfield lacks statistical packages for longitudinal follow-up. The Easyfield and Humphrey FDT are similar in size and price (about $7,000), but the FDT instrument weighs 19 pounds, compared to the Easyfield's 13 pounds. Scanning laser ophthalmoscopy The Heidelberg Retina Tomograph II (HRT II) uses confocal scanning laser imaging technology to create a detailed, 3-D topographic map of the optic nerve head. The measurements permit analysis of rim and cup volume, cup shape, and indirect analysis of retinal surface height and other topographic parameters. The HRT II also indirectly calculates the thickness of the nerve fiber layer (NFL). It includes a normative database for comparison, and graphically displays deviation from that database. (It can perform a similar comparison to previous visits by the same patient.) How it works: The HRT II uses CAT-scan-like technology to record three sequences of cross-sectional images during a 4-second period, and then assembles the resulting data into a 3-D topographic map. First-time measurements are analyzed using regression techniques developed by Moorfields Eye Hospital in London, which evaluate the relationship between neuroretinal rim area and optic disc area. The instrument also divides the optic nerve and surrounding region into six sectors and evaluates each sector separately. An on-screen color map indicates whether each section falls within normal, borderline or abnormal parameters. Advantages of scanning laser ophthalmoscopy. These include: Images may be obtained through undilated pupils and early cataracts. Low level light is used. Minimal operator training is required. The HRT II features single-button operation. The color-coded maps are relatively easy to read and interpret. The HRT II automatically rejects images that are blurred by poor focus or patient movement. It provides a standard deviation figure for each image that tells you how accurate that measurement was. (Heidelberg has also recently enhanced the capabilities of the HRT II with an optional macular edema module. This module provides a way to measure macular thickness changes over time using topographic retinal thickness measurements and macular mapping techniques.) Other points to consider. These include: Image resolution depends on the optics of the human eye. Cataracts may impede the quality of the image. Variations in topography can be caused by blood vessels in the cup and fluctuations in IOP, and the optic nerve head. Scanning laser polarimetry The GDx and GDx Access nerve fiber analyzers (from Laser Diagnostic Technologies Inc.) measure the retinal nerve fiber layer (RNFL) thickness with a scanning laser polarimeter based on the birefringent properties of the RNFL. Measurements are obtained from a band 1.75 disc diameters concentric to the disc. How it works: This technology uses a polarized near infrared (780 nm) laser beam to scan across the fundus at the optic nerve head and peripapillary retina. The birefringence causes a change in the state of polarization of the reflected light, known as retardation. The amount of retardation that occurs is linearly related to the thickness of the RNFL. In vitro measurements in an animal model show excellent correlation between retardation and RNFL thickness, with resolution of measurements at about 13 microns. The GDx displays higher retardation values in the superior and inferior regions of the disc, corresponding to greater RNFL thickness in these areas. The scan also shows reduced retardation over blood vessels, corresponding with the observation that vessels embedded within the RNFL reduce the thickness on top of the vessels. Advantages of scanning laser polarimetry. These include: Clinical measurements are highly reproducible. Readings can be done very quickly. Operation is straightforward. The technician doesn't need to mark the optic nerve, just center a circle within the optic nerve region. This technology has a higher sensitivity than the Glaucoma Hemifield test. Using this technology doesn't require pupil dilation. Results are independent of the optical resolution of the eye. This technology is specifically designed to measure the critical retinal nerve fiber layer, where glaucomatous damage can be seen first. A Both GDx instruments feature an age- and race-related normative database for valuable first visit comparison. Other points to consider. These include: Polarizing structures of the eye other than the RNFL may interfere with the retardation values; the cornea (and to a much lesser degree the lens) are also birefringent. (Both instruments include a compensator unit to correct for retardation arising in the lens and cornea.) Peripapillary atrophy and chorioretinal scars may increase retardation values, although these artifacts are apparent on the image. Note: Even though retardation values of structures of the eye other than the RNFL can interfere with the accuracy of these measurements, values are constant for any given individual. Consequently, serial scans may be used to follow a patient over time and determine progression of disease. RNFL thickness values in normal and glaucomatous eyes show considerable overlap because of large variability in the number of axons among normal subjects. Accordingly, the mean retardation values of the GDx vary considerably among normal subjects. However, retardation ratios of the superior or inferior region compared to the temporal area have good correlation with visual field mean deviation for both normal patients and those with glaucoma. (Sensitivity and specificity can be as high as 96% and 93% respectively.) The two formats. Differences between the GDx Nerve Fiber Analyzer and the GDx Access include: The GDx Nerve Fiber Analyzer captures the image with four times more pixels than the GDx Access. The Access unit is a smaller, more portable unit available for lease only, with a fee-per-exam program. (In contrast, the Nerve Fiber Analyzer must be purchased.) The GDx Access includes software upgrades and services. The GDx is better suited for a large volume practice with a sizeable glaucoma population. The GDx Access is better suited for a smaller glaucoma population. Optical coherence tomography Optical coherence tomography (OCT) is similar to ultrasonography, but it makes its measurements using light instead of sound. For that reason, it has much higher resolution in both axial and lateral dimensions. (The OCT instruments from Zeiss Humphrey have a resolution of 10 microns axially and 20 microns for transverse.) Because this technology has obvious potential for glaucoma detection, Zeiss Humphrey has recently produced a new version of the instrument -- the OCT2 -- with added features specifically designed to increase the instrument's usefulness in glaucoma detection. The OCT2 lets you monitor three relevant variables: the optic disc, the RNFL, and macular thickness and structure. How it works: Optical coherence tomography uses low-coherence interferometry to measure the echo time delay of light, which is backscattered from different layers in the retina. (The OCT uses a super luminescent diode with a bandwidth of 30 nm as its light source; the OCT2 uses a broad band of wavelengths.) The instrument then uses the time delay of the backscattered light to calculate the distance between reflecting surfaces, based on the refractive index of the medium. A constant value of 1.36 is assumed for retinal tissues. By scanning the beam across the retina, the OCT2 creates a two-dimensional cross-section of the area being scanned. This makes it possible to "see" the structural condition of the internal tissues, including photoreceptors, retinal pigment epithelium and choroid. The instrument can measure retinal changes directly using nerve fiber analysis or monitor progression using volumetric analysis and checking cup-to-disc ratios. OCT measurements of the RNFL correlate well with the functional status of the eye as measured by automated visual fields. Coding and Reimbursement In 1999 the American Medical Association approved procedure code 92135, known as "scanning computerized ophthalmic diagnostic imaging" (previously known as scanning laser glaucoma testing). This code encompasses all of the laser imaging technologies of the optic nerve and nerve fiber layer, including the HRT, GDx and the OCT. The Health Care Finance Administration (HCFA) has approved the code for reimbursement for Medicare patients. Some other useful facts about reimbursement: The national average Medicare reimbursement allowable for these procedures is $59.68 per eye. These tests can only be billed once a year for patients diagnosed as glaucoma suspects. For all other glaucoma diagnoses, the code can be billed twice a year. Fundus photography can't be billed the same day if code 92135 is used. However, your office can bill visual fields on the same day. The code for an FDT screening is 92080. (In Baltimore, Md., it's reimbursed at $60.43 for two eyes.) The SITA visual field test is coded as 92083. (It reimburses at $65.95 for two eyes in Baltimore, Md.) Coding for perimetry and fundus photography is per patient, but coding for computerized imaging is per eye. -- Mireille P. Hamparian, M.D., and Alan L. Robin, M.D. Advantages of OCT technology. These include: Unlike ultrasonography instruments, OCT instruments are noncontact. The OCT2 includes a limited age-related normative database. The OCT 2 can compare current scans to previous scans of the same patient. The OCT2 can scan in a straight line, or in a circle (which is particularly useful for scanning the optic disc). In addition, it can scan a series of concentric circles and create a donut-shaped retinal nerve fiber layer thickness map, or make a series of straight-line scans through a single point and use the information to analyze disc structure. In most cases, the performance of the OCT isn't affected by the refractive state of the eye, minimal nuclear sclerosis or media opacities. In addition to optic nerve measurements for detection of glaucoma, the OCT can be used for diagnosing diseases of the retina, as well as the anterior segment and cornea. Other points to consider. These include: It requires pupil dilation. Posterior subcapsular and cortical cataracts can significantly impair the quality of measurements. The normative database is still small. Although the depth values of the scan are independent of the optical dimensions of the eye, the length of a scan across the fundus does depend on the optical dimensions of the individual eye. The assumption of a constant value for magnification results in a small error in standard deviation. Although significant differences in RNFL thickness between groups of normal and glaucomatous subjects have been demonstrated, considerable overlap of individual measurements between the groups exists because of variability of RNFL thickness in normal subjects (as discussed earlier). Everybody wins This new generation of technology makes it possible to do a much better job of catching glaucoma early and monitoring its progression. In addition to quantifying various aspects of optic nerve topography and retinal nerve fiber structure that were previously very difficult to assess, the technologies offer our practices a host of benefits: The simpler, more user-friendly nature of the new technologies means that a less-trained technician (requiring less salary) can operate them. This also allows for better utilization of manpower. The need for less training means less trauma when a technician leaves your practice. (In contrast, performing fundus photography requires great skill, so replacing a good technician can be a real problem.) We can evaluate our patients more profitably because tests take less time. Future advances in technology and design will no doubt offer even greater benefits for patients and practices alike. But in the meantime, today's options have plenty to offer, and both your practice and your patients stand to benefit. If you've been considering purchasing some new instrumentation to help bring your practice into the 21st century, there's no time like the present. Characteristics that Count For these new technologies to have value in today's clinical practice, certain requirements should be met: The technology must be able to detect glaucoma earlier and be more sensitive for assessing disease progression than previous technology. The new technology should provide immediate validation of the quality of its results. Research must demonstrate the clinical relevance of the measurement data. For example, can the data be used for categorizing individual patients? Can it differentiate between early glaucoma and late glaucoma? Can it distinguish patients with ocular hypertension and other risk factors from primary open-angle glaucoma (POAG) patients? Costs associated with the use of the new modality -- including the cost of the machine itself and the cost of necessary associated equipment and manpower -- must be justifiable. Does using the instrument result in cost savings for the practice? Or, if there is increased cost, can this be justified by benefits such as reduced numbers of patients under review, less frequent or time-consuming visits, and/or improved data from which treatment decisions can be made? The time required to acquire and analyze data must be reasonable. The new technology should be easy to integrate into existing clinic structures. The technology must be patient-friendly. The patient should be able to perceive a benefit from using it. The instrument should be easy for a technician to use and maintain so that minimal additional training is required. Results should not require extra processing (i.e. film processing). Resulting data should be easy for a clinician to understand so that he can instantly put the results into clinical practice. Testing time must be short enough to prevent patient fatigue from becoming a confounding factor. -- Mireille P. Hamparian, M.D., and Alan L. Robin, M.D. Dr. Robin is a world-recognized leader in the diagnosis, medical management and surgical treatment of glaucoma. He's clinical professor of ophthalmology at the University of Maryland, an associate professor at the Wilmer Institute of the Johns Hopkins School of Medicine and adjunct clinical professor for the Department of Veteran Affairs in the Maryland healthcare system. He has published and lectured extensively, and is a member of the editorial board of Graefe's Archives of Ophthalmology. Dr. Hamparian is a glaucoma specialist in Enrico, Calif. Email Address for article to be mailed to:
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AMERICAN COUNCIL OF THE BLIND

AMERICAN COUNCIL OF THE BLIND

trufocal

TruFocal eyeglasses from Zoom Focus Eyewear. (Zoom Focus Eyewear)

For many people past the age of 40, focusing on close objects restaurant menus, — for instance — just gets harder and harder.

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Most people with this condition, called presbyopia, eventually give in and get reading glasses, bifocals or glasses with progressive lenses.

But what if there were another alternative that didn't require people to carry an extra set of glasses or have only part of their field of vision in focus at any one time?

Zoom Focus Eyewear LLC, of Van Nuys, Calif., has just such an option, and with it won this year's Silver Innovation Award. The solution: eyeglasses, called TruFocals, that the wearer can manually adjust to give clear, undistorted vision whether reading a book, working on a computer or looking into the distance.

The judges praised the potential large-scale benefit of TruFocals. Richard S. Lang, one of the judges and a physician at the Cleveland Clinic, called the technology a paradigm shift in the way it addresses a problem "that has been handled the same way for many years."

Mimicking the Eye

For more than 100 years, researchers have tried to come up with adjustable eyeglasses; a Baltimore inventor filed a patent on the idea in 1866. But a workable product that's easy to adjust, thin, lightweight and accurate proved elusive.

Stephen Kurtin, a California inventor who previously devised one of the first word-processing programs, turned to the problem in the early 1990s. His solution, TruFocal eyeglasses, mimic the way that the lens of the human eye stretches and contracts to adjust focus.

Each TruFocal lens is actually a set of two lenses: an outer lens, and an inner lens made of a flat glass plate attached to a flexible membrane that contains a clear, silicone-based liquid. A manual slider on the bridge of the eyeglasses adjusts the focus by changing the shape of the membrane. The outer lens can be custom made to correct other vision problems besides presbyopia, including nearsightedness and astigmatism.

Once the TruFocal lenses are adjusted, the entire field of vision is in focus, unlike bifocals and progressive lenses, which keep only a limited area in sharp focus. So a user can adjust the glasses to focus only on the book he's reading, then look up and readjust them to focus solely on the TV across the room.

One Shape, Several Colors

There were some false starts along the way. Mr. Kurtin considered using liquid-crystal electronics to adjust the focus, but the batteries proved problematic. The first model weighed seven pounds. But after nearly 20 years of refinements, the first TruFocal glasses were introduced in 2009.

There's a downside for the fashion conscious: The glasses come in one shape — round — and have been compared to the spectacles worn by Harry Potter. (They are sold in several colors, though.) The circular lenses are necessary to the workings of the technology; with any other shape, the flexible membrane couldn't keep a spherical shape when compressed.

TruFocals aren't the only glasses with adjustable lenses. But other products are mainly designed for users in the developing world, where optometrists aren't widely available; they are meant to be adjusted once by the user to correct the focus at a given distance and then set that way. The Zoom Focus product is aimed at wearers who want to make constant adjustments in their vision.

Next month, TruFocals will be rebranded as Superfocus glasses. The company will also change its name, to Superfocus LLC.

___

Causes

CausesI have some ideas as to what you could do to fast track investments in the power sector. We need to borrow a leaf from the Americans. In the 70s, America did an audit of its power infrastructure in relation to its anticipated population growth and came to the conclusion that if something drastic was not done about ensuring heavy and radical investments in the power sector, the United States would have rolling black outs down the road. They analyzed their problems and came up with a plan.

The plan did work for them and I don't see why we should not borrow it here and implement.

What they did was to open up the power sector to private sector investment without any restrictions as to how much power you can generate and how you can distribute it. The current requirement in NIGERIA that private sector and state governments must surrender the power they generate to the national grid if it exceeds 100 MW MUST be abolished. It is the number 1 obstacle to investors readiness to come in boldly to invest. Your administration must by Executive order abolish this - the order must state as follows:

"individuals, private companies, Housing Estate Developers and Residents, Cooperatives, private and public consortia, state governments and local governments can generate any amount of MW of electricity that they wish. They also do not have to surrender the power they generate to the national grid. Every state government can generate the power that its state will need and pass any excess power to the National grid if it so desires."

An amendment should be proposed by the Presidency to the Electric Power Sector Reform Act 2005 which states that a single company cannot own and control the generation, transmission and distribution for the same power project. This is wrong. The only way an investor can be confident enough to invest is if it can have some level of control over how the power it has generated gets to the final consumer. Even if a power purchase agreement is signed it may not yield the desired results because a lot of communities across the country tap electricity for free from transmission lines and PHCN does not have the logistical capabilities, vision and integrity to plug those leakages. What it means is that the PHCN may sign a POWER PURCHASE AGREEMENT but may not be able to pay for the electricity it is purchasing from the company. After all, PHCN will have to use the funds it gets from the end consumers to pay the company that it is purchasing the power from. The whole system is bound to collapse eventually if the companies generating the electricity are not allowed to control the transmission and the distribution channels. A government guarantee of such a scheme where PHCN still has full control of the power transmission lines would have a high rate of default and will not be sustainable. The exigencies of the times make it necessary to sweep away these archaic provisions of the Electric Power Sector Reform Act 2005. You need to adopt a no 'holds barred' "gloves off" approach to end the hydra headed monster called power failure in Nigeria.

The US government gave SOVEREIGN GUARANTEES/IRREVOCABLE STANDING PAYMENT ORDERS (ISPO) to companies who expressed their readiness to invest. Not 1 cent of the US government's treasury funds came into the hundreds of power projects that sprung up from this deliberate policy. All the UNITED STATES government did was to guarantee the debt finance or loans that these power companies got from both UNITED STATES banks and foreign banks. Because of this, policy the banks were bullish about lending to the owners and sponsors of these projects. In order to protect itself the US government ensured that the companies that received the benefits of these guarantees were capable of carrying out and implementing the projects.

GEJ: You should do the same thing. Just copy the AMERICAN MODEL that worked perfectly well for AMERICA.

I am part of a consortium of EUROPEAN Companies that has in its possession 3, 000 MW GAS TURBINES. It still has it in its possession as a result of the failure of the original consignee to take the consignment in EUROPE as a result of the bankruptcy of that company. Typically turbines take 1 to 2 years to fabricate. Fortunately these turbines are in storage and on ground in EUROPE and are brand new. With your full support we can bring these turbines and deploy them in AKWA IBOM STATE (because of its high level of gas infrastructure) and get them up and running within maximum of 9 months.

If we can get expression of interest from you directly and your full weight and support behind the project I can assure you that we will implement it 100% without a dime of Federal Government money. What we will need is the Sovereign Guaranty of the Nigerian Federal Government and a POWER PURCHASE AGREEMENT that takes all the things I discussed above into consideration. We will raise the funds 100% and execute the project within 9 months and add the power to the NATIONAL GRID for the enjoyment of Nigerians.

SUPPORT FOR SMALL BUSINESSES

Ensure that the N500 Billion you said has been set aside to stimulate the economy gets to the small eatery operator, the businesses center/cyber cafe operator and other similar small businesses. It should not go to only big companies. Kindly study the model of the US SMALL BUSINESS ADMINISTRATION -http://www.sba.gov/ I know we have SMEDAN – http://www.smedan.gov.ng but it has not been an effective organization compared to the US SMALL BUSINESS ADMINISTRATION. From the next link you will see the various units that they have and what they do, are doing and have been doing over the years -http://www.sba.gov/aboutsba/sbaprograms/index.html

Mr. President need to recreate SMEDAN and copy the US Model in order to ensure that the funds that are meant to get to small businesses actually get to them. A situation where $500m that was set aside by the CBN for small businesses by the last administration is 100% released to a single big business is scandalous. This was made possible by virtue of a waiver that was granted at the time to the Banks by CBN. Small businesses are the greatest employers of labour and the biggest tax payers as evidenced by the Success of the LAGOS STATE GOVT's PAYGO TAX Program. This fact is also known globally. It is also the best way to support fresh graduates who may not be able to secure employment immediately after their NYSC. Many of them have ideas for small but effective businesses. We need to accept the fact that the biggest employers of labour are small businesses and we should do all we can to support their emergence and growth.

The Loan Program is SBA’s primary program for helping start-up and existing small businesses, with financing guaranteed for a variety of general business purposes. SBA does not make loans itself, but rather guarantees loans made by participating lending institutions. In this way, taxpayer funds are only used in the event of borrower default. This reduces the risk to the lender but not to the borrower, who remains obligated for the full debt, even in the event of default.

I will urge your administration to put in place a loan program like this one for unemployed graduates to enable them to access loans. Your administration will source for the funds from the Banks and guarantee repayment. The banks will be the source of the funds not the government. U can weave this into the N500 billion program that u just announced. To qualify for it the graduates would submit a business proposal and the proposal should be reviewed by a Unit set up in each branch of every bank to handle such applications. You can put a cap of N1m per borrower on the loans to be given and give them a 5 year repayment term @ 7% interest rate , with zero prepayment penalty for those that want to pay back early. The scheme can allow a past borrower who pays up the loan in less than 3 years to access additional loan of N5m on the same repayment terms. I would urge you to take a serious and hard look at this proposal and let it form part of your agenda for change in Nigeria!

BUNMI AWOYEMI is an Oil & Gas and Energy Consultant.

Comments (1 posted):

Success Alenoghena Eugene on 07/08/2010 04:39:25

I advise the President and his entire team of special advisers to take a critical study of this open letter and apply the methods therein for the
betterment of our dear country, (Nigeria).

Mr. President needs credible people in the likes of Bunmi Awoyemi whose brilliant ideas will move this country forward and not those sycophants that
are parading themselves within the presidency.

I advise the National Assembly members to take a proper study of this letter also and put in place as a matter of urgency,adequate legal and business framework that would make investors comfortable in the country.

This is what Ghana is doing and it;s working. Apart from the framework, Ghana’s democratic credentials are exemplary enough to attract any investors and as you must know, Ghana's economy is rated among the best and safest in Africa right now.

With their brilliant policies and strategies aimed at expanding their economy, there is a call on the global business community to explore and invest in attractive opportunities within the various sectors of Ghana's economy. The Ghana Government is also taking their time on their Oil, just to ensure that Ghana’s oil becomes a blessing rather than a curse to the country.

For example, I have a mandate right now to source for investor(s) for the establishment of a 200,000bpd Export Oriented Oil Refinery in Ghana.The project is purely 100% private initiative and the Government playing the facilitator's role with assurance of sovereign guarantee to investors who expressed readiness to invest.

Nigeria should not be ashamed at this moment to lean from Ghana's policies and strategies. All we (Nigerians) need right now is good governance, meaningful development and peaceful co-existence.

Finally, I urge all Nigerians and the National Assembly members to take a serious and hard look at what Bunmi Awoyemi had proposed and let it form part of your next agenda for a change in Nigeria!

GOD BLESS NIGERIA!

Success Alenoghena Eugene
CEO - Shiolona Ltd, (Marine Oil & Gas).

Causes

Causes

Taking proper eye care

July 27th, 2010 | Author: admin

Everyone knows that the eyes are one of the most important organs during daily activities. Many professionals even call the eyes as a human being’s most prized physical possession. This is quite appropriate that the eyes are essential for a human being to perceive visual tasks and enjoy the beautiful nature. Unfortunately, the eyes are quite delicate that there are a couple of eye problems and even diseases affecting a large population. In this case, proper eye care is very necessary for everyone to deal with common eye problems such as puffy eyes, baggy eyes or the wrinkles around the eyes, as well as other eye conditions.

One of the important aspects is to receive regular eye checkups. This is the most effective and convenient way to detect early signs of underlying vision problems, which will suggest proper prevention or treatment. For instance, a glaucoma test should be done for every old individual on a year basis. This eye disease can damage the eye nerves and lead to permanent vision loss. But it only affects the peripheral vision at the very beginning. Only regular eye exams can detect its early sign. During a glaucoma test, a puff of air will be blown into both eyes once at a time. Once been detected, this deadly eye disease can be effectively prevented or slowed down. Similar conditions requiring regular eye tests include diabetes and macular degeneration and so forth.

On the other hand, prevention is always better than treatment. Eye care also involves another more preferable aspect that is prevention. An old way is to ingest various vitamins, especially vitamin A. And several minerals are recommended to keep the eyes in shape. In addition, several eye exercises are quite popularly recommended by certain eye experts to maintain eye health. In short, proper eye exercises and healthy foods are believed by some people to reduce the chances of injury, diseases, vision loss and so on.

Eye Health Organizations Database Alphabetical List

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A B C D E F G H I J K L M N O P R S T V X

(The) Achromatopsia Network
P.O. Box 214
Berkeley, CA 94701-0214
http://www.achromat.org
• Provides information about achromatopsia and about the resources that are available to meet the special needs of those affected by this disorder that is characterized by severe color vision defect and poor visual acuity. Seeks to promote awareness and education about achromatopsia. Assists patients and family members in networking. Publishes a newsletter and other publications.

AFB Senior Site
1-800-232-5463
seniorsite@afb.net
http://www.afb.org/seniorsite/
• Designed to help older Americans recently diagnosed with eye diseases, and their family members cope with the changes that accompany vision loss. Connects seniors and their loved ones to timely and useful information including links to community-based services, home design tips that maximize safety and independence, tools that help people continue daily activities, and inspiring stories. Created by the American Foundation for the Blind.

Agency for Healthcare Research and Quality (AHRQ)
U.S. Department of Health and Human Services
540 Gaither Road
Rockville, MD 20850
(301) 427-1364
1-800-358-9295 (AHRQ Clearinghouse)
http://www.ahrq.gov
• Promotes effective, appropriate, high-quality health care; increased access to care; and improves the way health services are organized, delivered, and financed. ProvidesNow You Have a Diagnosis: What's Next, a publication designed to assist patients in their decision-making. (Also available in Spanish).

Alliance for Eye and Vision Research
12300 Twinbrook Parkway, Suite 250
Rockville, MD 20852-1606
(240) 221-2905
http://www.eyeresearch.org
• A coalition of organizations that includes ophthalmic and optometric professionals, consumer advocates and industry which is dedicated to educating Congress and the public about the economic and societal value of federally funded eye and vision research.

AMD Alliance International
1929 Bayview Avenue
Toronto, Ontario
CANADA M4G 3E8
1-877-263-7171
(416) 486-2500x7505
http://www.amdalliance.org
• Works to raise the awareness about age-related macular degeneration (AMD) and an understanding of available options for treatment, rehabilitation, and support services. Publishes an educational brochure in five languages.

American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
(415) 561-8500
http://www.aao.org
• Represents ophthalmologists in the United States. Offers public information materials and clinical education programs in a variety of formats. Offers a Find a Doctor service on their website to help people locate local ophthalmologists.

American Academy of Optometry
6110 Executive Boulevard, Suite 506
Rockville, MD 20852
(301) 984-1441
http://www.aaopt.org
• Seeks to maintain and enhance excellence in optometric practice. Fosters research and the dissemination of knowledge in both basic and applied vision science.

American Association for Pediatric Ophthalmology and Strabismus
P.O. Box 193832
San Francisco, CA 94119-3832
(415) 561-8505
http://www.aapos.org
• Dedicated to ensuring quality medical and surgical eye care of children and adults with strabismus. Provides information on common eye problems including strabismus, amblyopia, retinopathy of prematurity, conjunctivitis, and learning disabilities. Offers a website tool to help people find pediatric ophthalmologists in their local areas.

American Association of Eye and Ear Hospitals
1100 Wilson Boulevard
Suite 1200
Arlington, VA 22209
http://www.aaeeh.org
• The American Association of Eye And Ear Hospitals is comprised of the premier centers for specialized eye and ear procedures in the world. Association members are major referral centers, offer some of the most innovative teaching programs in the country, and routinely treat the most severely ill eye and ear patients. The mission of these specialty institutions requires them to maintain leading edge technologies, enabling them to provide highly specialized services not available in general acute care hospitals.

American Association of the Deaf-Blind (AADB)
8630 Fenton St., Suite 121
Silver Spring, MD 20910-4500
(301) 495-4403
(301) 495-4402--TTY
http://www.aadb.org/
• Encourages independent living for individuals who are deaf-blind. Provides technical assistance to persons who are deaf-blind, families, educators, and service providers.

American Autoimmune Related Diseases Association, Inc.
(AARDA)
22100 Gratiot Avenue
E. Detroit, MI 48021
(586) 776-3900
1-800-598-4668 (Literature Requests)
http://www.aarda.org
• Dedicated to bringing a national focus to autoimmune diseases, conditions caused by the body attacking itself. Provides information on eye-related diseases include Behcet's disease, Graves' disease, multiple sclerosis, myasthenia gravis, sarcoidosis, Sjogren's syndrome, temporal arteritis (giant cell arteritis), and uveitis.

American Behcet's Disease Association
P.O. Box 869
Smithtown, NY 11787-0869
1-800-723-4238
http://www.behcets.com
• Provides support and information to individuals with Behcet's disease, symptoms of which include ocular inflammation (uveitis). Publishes a quarterly newsletter and distributes patients pamphlets. Coordinates a pen pal/phone pal network. Provides physician referrals. Coordinates a network of local support groups. Holds an annual international conference.

American College of Medical Genetics (ACMG)
9650 Rockville Pike
Bethesda, MD 20814-3998
• Represents the medical genetics profession dedicated to making genetic services available to and improve the health of the public. Promotes the development and implementation of methods to diagnose, treat and prevent genetic diseases. Offers a “Find a Geneticist” service.

American Council of the Blind
1155 15th Street, NW, Suite 1004
Washington, DC 20005
1-800-424-8666
(202) 467-5081
http://www.acb.org
• Serves as a national clearinghouse on blindness issues for individuals, organizations, and institutions. Provides an information and referral service on Federal legislation, administrative action, and rule making on national and state levels. Offers group insurance plans, coordinates class action litigation, and educates the public about blindness and the abilities of visually impaired people. Publishes The Braille Forum, a free monthly national magazine.

American Diabetes Association
ATTN: National Call Center
1701 North Beauregard Street
Alexandria, VA 22311
(800) 342-2383
AskADA@diabetes.org
http://www.diabetes.org/home.jsp
• American Diabetes Association Hours of operation are Monday - Friday, 8:30 AM-8 PM Eastern Standard Time. The American Diabetes Association funds research, publishes scientific findings, provides information and other services to people with diabetes, their families, health professionals and the public. Contact ADA for diabetes-related questions or to request a diabetes information packet. Spanish language consumer website.

American Foundation for the Blind
11 Penn Plaza, Suite 300
New York, NY 10001
1-800-232-5463
(212) 502-7600
http://www.afb.org
• Serves as a one-stop information and referral resource for people who are blind or visually impaired, the people who work with them, and the general public. Conducts a wide variety of programs to support independent living, literacy, employment, and access to technology. Publishes professional materials for blindness and low vision and Talking Books. Offers consultation services to eye care, rehabilitation, and education professionals. Provides referrals to low vision centers. Advocates for legislative change.

American Health Assistance Foundation
22512 Gateway Center Drive
Clarksburg, MD 20871
1-800-437-2423
(301) 948-3244
http://www.ahaf.org
• Funds research on glaucoma and macular degeneration around the world. Educates the public about the dangers of these diseases and provides important information and resources to patients, caregivers, and loved ones on ways to cope with age-related diseases. Publishes a low vision resource list, the Macular Degeneration Research News, the National Glaucoma Research Report, and other patients education materials on glaucoma and macular degeneration.

American Optometric Association
243 N. Lindbergh Boulevard
St. Louis, MO 63141
(314) 991-4100
1-800-365-2219
http://www.aoa.org
• Represents optometrists in the United States. Provides brochures on eye problems for the lay public and professional materials on eye care delivery. Offers a Find a Doctor service on their website to help people locate optometrists. Coordinates InfantSEE, a public health program designed to ensure early detection of eye conditions in babies. Member optometrists provide a free comprehensive infant eye assessment to children younger than one year. A service of the AOA in partnership with The Vision Care Institute of Johnson & Johnson Vision Care. Locate a AOA participant on the InfantSEE website www.infantsee.org or by phone at (888) 396-3937.

American Printing House for the Blind
1839 Frankfort Avenue
P.O. Box 6085
Louisville, KY 40206-0085
1-800-223-1839
(502) 895-2405
http://www.aph.org
• Promotes the independence of blind and visually impaired persons by providing specialized materials, products, and services needed for education and life. Products include Braille and large-print textbooks, Braille teaching tools, and talking books. Provides free subscriptions to Reader's Digest and Newsweek on disposable audiocassettes. Provides Reader's Digest in Braille.

American Society of Ocularists
P.O. Box 608
Earlysville, VA 22936-0608
1-866-973-4066
(434) 973-4066
http://www.ocularist.org/
• American Society of Ocularists is an international, non-profit, professional and educational organization founded by technicians specializing in the fabricating and fitting of custom-made ocular prosthetics (artificial eyes). Offers referrals to local ocularists.

American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS)
5841 Cedar Lake Road, Suite 204
Minneapolis, MN 55416
(952) 646-2038
http://www.asoprs.org
• Dedicated to advance training, education, research, and the quality of clinical practice in the fields of aesthetic, plastic, and reconstructive surgery specializing in the face, eyelids, orbits, and lacrimal system. Provides information on anophthalmos and orbital implants, blepharospasm, ptosis and other eyelid disorders, excessive tearing, and thyroid disease and the eye.

American Uveitis Society
3535 Bienville Avenue
Suite W380
New Orleans, LA 70119
http://www.uveitissociety.org/pages/index.html
• Increases knowledge regarding uveitis in the medical and research professions through instructional courses, clinics, lectures, and seminars, at which members and guest speakers present subjects of current interest and importance. Promotes and disseminates knowledge of the treatment of uveitis to the public. Encourages and develops uveitis investigation and research. Provides online search for uveitis specialists.

Aniridia Foundation International
at the Hamilton Eye Institute
930 Madison Avenue, Suite 314
Memphis, TN 38163
(901) 448-2380
http://www.aniridia.net
• The Aniridia Foundation International is a non-profit organization dedicated to assisting those with low vision or blindness due to aniridia, a genetic eye disease. Support services, educational and social programs, and medical conferences help educate people with aniridia, their families, teachers, employers, and the medical community. AFI has created the International Aniridia Medical Registry and gene bank which will provide researchers with data and benefits in better health care, treatments, advances in research for those with aniridia. Membership is free.

Associated Services for the Blind
919 Walnut Street, 2nd Floor
Philadelphia, PA 19107
(215) 627-0600
http://www.asb.org
• Offers personal adjustment to blindness training and orientation and mobility training. Provides materials in Braille. Offers computer training using adaptive devices.

Association for Education and Rehabilitation of the Blind and Visually Impaired
1703 N. Beauregard Street, Suite 440
Alexandria, VA 22311
1-877-492-2708
(703) 671-4500
http://www.aerbvi.org
• Includes educators, rehabilitators, administrators, parents, and houseparents of blind children; agencies, schools, and others interested in the education, guidance, vocational rehabilitation, or occupational placement of the blind and partially-sighted. Cooperates with colleges and universities in conferences and workshops. Presents awards, conducts certification programs, and maintains job exchange services. Works with state, provencial, and national governments on legislation affecting services to blind and visually impaired individuals.

Association for Macular Diseases
210 E. 64th Street
New York, NY 10021
(212) 605-3719
http://www.macula.org
• Offers education and information on macular disease through seminars, newsletters, and a hotline. Offers counseling to patients and their families.

Association for Retinopathy of Prematurity and Related Diseases (ROPARD)
P.O. Box 250425
Franklin, MI 48025
1-800-788-2020
http://www.ropard.org
• Dedicated to eliminating the problems of low vision and blindness in children caused by premature birth and retinal disease, by funding clinical research to understand, treat, and prevent retinopathy of prematurity (ROP) and related retinal diseases. Funds innovative work on the development of new low vision devices, teaching techniques and services for children who are visually impaired and their families.

AWARE
P.O.Box 996
Mohegan Lake, NY 10547
(914) 528-5120
info@visionaware.org
http://www.VisionAWARE.org
• Provides extensive self-help information on adapting everyday activities and locating helpful services and independent living resources -- for individuals with vision loss, their family members, and those who work with them. Offers a vast collection of free self-help information and materials to increase personal independence, options, and opportunities for those who are blind or have low vision.

Benign Essential Blepharospasm Research Foundation
P.O. Box 12468
Beaumont, TX 77726-2468
(409) 832-0788
http://www.blepharospasm.org
• Distributes informational materials on benign essential blepharospasm. Provides a support system for persons who suffer from the disease. Publishes a bimonthly newsletter. Coordinates a video lending library.

Blinded Veterans Association
477 H Street, NW
Washington, DC 20001
1-800-669-7079
(202) 371-8880
http://www.bva.org
• Links veterans with services, rehabilitation training and other benefits, and helps them find jobs. Offers spouses and dependent children of blinded veterans a chance to continue their education through the Kathern F. Gruber Scholarship Program.

Braille Circulating Library, Inc.
2700 Stuart Avenue
Richmond, VA 23220
(804) 359-3743
(804) 359-3771
• Loans Braille materials, talking books, audiocassettes, and large print Christian materials.

Centers for Disease Control and Prevention (CDC)
U.S. Department of Health and Human Services
1600 Clifton Road, NE MS D-25
Atlanta, GA 30333
1-800-311-3435 (Office of Communications)
(404) 639-3534
http://www.cdc.gov
• Promotes health and quality of life by preventing and controlling disease, injury, and disability. Provides information on diseases including AIDS/HIV, cytomegalovirus, onchocerciasis (river blindness), schistosomiasis, toxocariasis, and toxoplasmosis.

Children's Glaucoma Foundation (CGF)
2 Longfellow Place, Suite 201
Boston, MA 02114
(617) 227-3011
http://www.childrensglaucoma.com
• Serves to increase the awareness of the symptoms and encourage parents and doctors to screen infants and children for glaucoma.

Choice Magazine Listening
85 Channel Drive
Port Washington, NY 11050
1-888-724-6423
(516) 883-8280
http://www.choicemagazinelistening.org
• Offers selected articles from popular print magazines on special-speed, 4-track audiocassette, available through the Library of Congress. Provides free service nationwide to eligible persons.

Christian Record Services for the Blind
4444 South 52nd Street
Lincoln, NE 68516
(402) 488-0981
http://www.christianrecord.org
• Provides a lending library of books in Braille, large print materials, and cassette tapes. Provides referrals to local low vision specialists and support groups.

Coat's Disease Information for Parents
http://www.coatsdisease.org
• Seeks to educate and inform, to increase awareness of Coats' disease, via a website. Provides links to other sites and resources for parents and families.

Columbia Lighthouse for the Blind
1825 K Street, NW
Suite 1103
Washington, DC 20006
202-454-6400
info@clb.org
http://www.clb.org/
• Is dedicated to helping the blind or visually impaired population of the greater Washington region overcome the challenges of vision loss.

Consensus Development Program
National Institutes of Health
31 Center Drive, MSC 2082
Bethesda, MD 20892-2082
(301) 496-5641
http://consensus.nih.gov
• Distributes Clinical Use of Botulinum Toxin Consensus Development Conference Statement, November 12-14, 1990.

Consumer Information Center (CIC)
Pueblo, CO 81009
http://www.pueblo.gsa.gov
• Offers free and low-cost Federal publications of consumer interest on topics including children, food and nutrition, health, money management, and travel/hobbies.

Cornea Research Foundation of America
9002 N. Meridian Street, Suite 212
Indianapolis, IN 46260
(317) 844-5610
http://www.cornea.org
• The Cornea Research Foundation of America was founded with a mission to restore and preserve vision through clinical research and educational programs relating to disorders and diseases of the eye. Supports research devoted to corneal transplants, intraocular lens complications, refractive surgery, and other specialized procedures.

Council of Citizens with Low Vision International
1859 N. Washington Avenue, Suite 2000
Clearwater, FL 33755-1862
1-800-733-2258
(727) 443-0350
http://www.cclvi.org
• Serves as an advocacy group for the visually impaired. Provides information on low vision technology. Offers scholarship. Publishes the CCLV News.

DB-LINK: National Information Clearinghouse on Children Who are Deaf-Blind
345 N. Monmouth Avenue
Monmouth, OR 97361
1-800-438-9376
1-800-854-7013--TTY
http://www.tr.wou.edu/dblink/
• Offers information that assists education, medical, and service personnel in providing comprehensive services to/for infants, toddlers, children, and youth who are deaf-blind in the U.S.

Eye Bank Association of America
1015 Eighteenth Street NW, Suite 1010
Washington, DC 20036
(202) 775-4999
http://www.restoresight.org
• Establishes medical standards for evaluating and distributing eyes for corneal transplantation and research. Certifies eye banks and technicians. Awards annual grants used for research and transplantation.

EyeCare America
655 Beach St.
San Francisco, CA 94109-1336
1-877-887-6327
1-800-222-3937
http://www.eyecareamerica.org/eyecare/
• EyeCare America provides comprehensive eye exams and care for up to one year, often at no out-of-pocket expense to eligible callers through its Seniors and Diabetes EyeCare Programs. Its Glaucoma EyeCare Program provides a glaucoma eye exam. The EyeCare America Children’s EyeCare Program educates parents and primary care providers about the importance of early childhood (newborn through 36 months of age) eye care and offers a free downloadable educational brochure. EyeCare America is a public service foundation of the American Academy of Ophthalmology (AAO).

Federal Trade Commission (FTC)
Consumer Response Center
600 Pennsylvania Avenue, NW
Washington, DC 20580
(202) 326-2222
1-877-382-4357
http://www.ftc.gov
• Enforces federal antitrust and consumer protection laws. Works to eliminate acts or practices that are unfair or deceptive. Publishes factsheets on making informed decisions about LASIK surgery.

Food and Drug Administration (FDA)
10903 New Hampshire Avenue
Silver Spring, MD 20993-0002
1-888-463-6332
http://www.fda.gov
• Oversees the safety of food, cosmetics, medicines, medical devices, and radiation-emitting products. Provides information on contact lenses, intraocular lenses, refractive surgery, and corneal implants for myopia.

(The) Foundation Fighting Blindness
Executive Plaza 1, Suite 800
11435 Cronhill Drive
Owings Mills, MD 21117-2220
1-888-394-3937
1-800-683-5555 (TDD)
(410) 568-0150
(410) 363-7139 (TDD)
http://www.blindness.org
• Acts as a clearinghouse and distributor of self-help program information. Sponsors research on the cause, prevention, and treatment of retinitis pigmentosa, Usher's syndrome, macular degeneration, and other retinal degenerative conditions. Conducts education programs for those affected by the disorders as well as professionals and the general public. Coordinates a national information and referral service and the Retinal Donor program. Publishes newsletters and other publications.

Friends of the Congressional Glaucoma Caucus Foundation (FCGCF)
1983 Marcus Avenue, Suite 111
Lake Success, NY 11042
1-877- 611-4232
(516) 327-2236
http://www.glaucomacongress.org/
• Coordinates the Student Sight Savers Program, an effort where supervised medical school students conduct screenings for glaucoma and other eye diseases for high-risk groups. Offers grants to cover the free screening of glaucoma in many different regions.

(The) Glaucoma Foundation
80 Maiden Lane, Suite 700
New York, NY 10038
(212) 285-0080
http://www.glaucomafoundation.org
• Coordinates public education activities and encourages routine eye examinations. Funds research on the molecular genetics of glaucoma and on optic nerve regeneration. Provides referral to glaucoma specialists. Publishes public and patient education materials, including a newsletter, Eye to Eye.

Glaucoma Research Foundation
251 Post Street, Suite 600
San Francisco, CA 94108
1-800-826-6693
(415) 986-3162
tbrunner@glaucoma.org
http://www.glaucoma.org
• Founded in 1978, The Glaucoma Research Foundation (GRF)is America's oldest and most experienced national institution dedicated solely to its mission: to prevent vision loss from glaucoma by investing in innovative research, education, and support with the ultimate goal of finding a cure. Glaucoma Research Foundation offers education and support for people and their families through Gleams, a free newsletter providing information about glaucoma treatment and research updates. Gleams is available in print and by e-mail. Additional publications include: Understanding And Living With Glaucoma, a 32 page booklet written by and for people with glaucoma. Childhood Glaucoma, a 32 page reference guide for parents of children with glaucoma.

Guide Dogs for the Blind
P.O. Box 151200
San Rafael, CA 94915-1200
1-800-295-4050
http://www.guidedogs.com
• Provides Guide Dogs and training in their use to visually impaired people throughout the United States and Canada. Services are free.

(The) Hadley School for the Blind
700 Elm Street
Winnetka, IL 60093
1-800-323-4238
(847) 446-8111
http://www.hadley.edu
• Promotes independence in blind and visually impaired people through distance education. Serves students in all 50 states and 90 countries. Program areas include Adult Continuing Education, High School, Family Education, and Professional Education. Course materials are delivered in Braille, large-print, audiocassette, and online formats. Offers all courses free of charge.

Helen Keller National Center for Deaf-Blind Youths & Adults (HKNC)
141 Middle Neck Road
Sands Point, NY 11050
(516) 944-8900
http://www.hknc.org/
• Offers intensive and comprehensive rehabilitation training to individuals who are deaf-blind. Provides evaluation and training in communication skills, adaptive technology, orientation and mobility, independent living, work experience, and other support services.

Independent Living Services for Older Individuals Who Are Blind
U.S. Department of Education, OSERS
400 Maryland Avenue, SW
Washington, DC 20202-2800
1-800-872-5327
1-800-437-0833 (TTY)
http://www.ed.gov/programs/rsailob/index.html
• Provides training in skills of routine daily living, travel, communication, provision of adaptive devices, low vision services, family and peer counseling, and community integration such as outreach and information and referral. Funded through Title VII, Chapter 2 of the Rehabilitation Act. Programs are available in every state and accessible through each state agency for the blind.

Institute for Families
P.O. Box 54700
Mail Stop 111
Los Angeles, CA 90054-0700
(323) 669-4649
http://www.instituteforfamilies.org
• Offers support and information to families of children with visual impairment. Provides direct counseling support to families at no cost after a diagnosis is made. Offers a nationwide telephone counseling service. Publishes Retinoblastoma Support News andParent to Parent as well as the books My Fake Eye, the Story of My Prosthesis and My New Glasses: A Book for Parents and Children. Videos are available.

International Children's Anophthalmia Network (ican)
5501 Old York Road
Genetics, Levy 2 West
Philadelphia, PA 19141
1-800-580-4226
(215) 456-8722
http://www.anophthalmia.org
• Provides information on anophthalmia and microphthalmia. Coordinates a patient registry. Offers referrals to local resources. Coordinates gatherings for individuals with anophthalmia/microphthalmia and their families. Publishes a newsletter, The Conformer.

International Foundation for Optic Nerve Disease (IFOND)
P.O. Box 777
Cornwall, NY 12518
(845) 534-7250
http://www.ifond.org
• Promotes research into the causes, prevention, and treatment of optic nerve disease. Disseminates information about optic nerve disease.

Jewish Braille Institute of America
110 E. 30th Street
New York, NY 10016
1-800-433-1531
(212) 889-2525
http://www.jewishbraille.org
• Provides talking books, Braille and large-print books, a circulating library, and a public education program. Offers counseling and referrals to low vision care in the U.S.

(The) Jewish Guild for the Blind
15 West 65th Street
New York, NY 10023
1-800-284-4422
(212) 769-6200
http://www.jgb.org
• Provides free audio library services to individuals with visual impairments by mail (1600 titles, primarily best sellers) and a national radio reading service broadcasting 7 days, 24 hours.

Knights Templar Eye Foundation
1000 East State Parkway
Suite I
Schaumburg, IL 60173
(847) 490-3838
http://www.knightstemplar.org/ktef/
• Knights Templar Eye Foundation provides assistance for eye surgery for people who are unable to pay or receive adequate assistance from current government agencies or similar sources.

Lighthouse International
111 E. 59th Street
New York, NY 10022
1-800-829-0500
(212) 821-9200
(212) 821-9713 (TDD)
http://www.lighthouse.org
• Serves as a national clearinghouse for information on vision impairment across the life span including specific services for children and seniors. Offers a comprehensive selection of educational products, large print materials, talking products, and related specialty items for people with visual impairments. Offers reading and library services, employment and recreation resources, and technology centers.

Lions Clubs International
300 W. 22nd Street
Oak Brook, IL 60523-8842
(630) 571-5466
http://www.lionsclubs.org
• Provides financial assistance for eye care to individuals through local clubs. Coordinates sight conservation activities. (Note: There are Lions Clubs in most localities, and services vary from club to club. Check your telephone book for the address and telephone number of your local club.)

Low Vision Gateway
http://www.lowvision.org
• Provides information and resources for people with low vision and their families. Contains links to information on low vision specialists, low vision aids, organizations that provide support and assistance, and resources for parents and teachers. Sponsored by The Internet Low Vision Society and the Low Vision Centers of Indiana.

Macula Vision Research Foundation (MVRF)
100 Front Street, Suite 300
West Conshohocken, PA 19428
(610) 668-6705
http://www.mvrf.org
• The Foundation’s mission is to find the cause, prevention, treatment and cure for macula vision diseases with the goal of saving sight and providing public education, advocacy and support to those with macular degeneration. Coordinates SupportSight, a service to enhance the quality of life people with macular degeneration through public education programs, small support groups, and a toll-free hotline. Awards the Macula Vision Research Grant to vision scientists and conducts scientific conferences and seminars.

Macular Degeneration Partnership
8733 Beverly Boulevard, Suite 201
Los Angeles, CA 90048
1-888-430-9898
(310) 623-4466
http://www.amd.org
• Provides accurate and timely information to patients and family members about AMD, research, experimental treatments, and clinical trials. Provides connections to a variety of resources for low vision and support. Publishes a monthly online newsletter and offers a free e-mail subscription to AMD Update.

March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
http://www.marchofdimes.com
• Develops and distributes health care materials for health professionals and the public on genetic and congenital diseases and disorders. Offers public and professional health education and community service programs to improve maternal and newborn health. Works with other organizations to initiate and implement community programs for prenatal care education and service. Awards basic and clinical research grants to scientists interested in genetic and congenital disorders.

Medicare
7500 Security Boulevard
Baltimore, MD 21244-1850
1-800-MEDICARE
http://www.medicare.gov
• A federal social insurance program under the Department of Health and Human Services (HHS), Medicare provides healthcare coverage for people over 65 and people under 65 with permanent disabilities. Most Americans are entitled to basic coverage under Medicare if they or their spouse have contributed payroll taxes for more than 10 years.

National Association for Parents of Children with Visual Impairments
P.O. Box 317
Watertown, MA 02471
1-800-562-6265
(617) 972-7441
http://www.spedex.com/napvi/
• Offers emotional support for parents of blind or visually impaired children. Provides information, training and assistance, and help in understanding and using available resources. Publishes Awareness, a quarterly newsletter.

National Association for Pseudoxanthoma Elasticum
8760 Manchester Road
St. Louis, MO 63144-2724
(314) 962-0100
http://www.pxenape.org
• Provides information on pseudoxanthoma elasticum (PXE), a systemic disease that causes the body to produce defective connective tissue, and in the eye may cause retinal disease. Publishes a newsletter.

National Association for Visually Handicapped
22 W. 21st Street, 6th Floor
New York, NY 10010
(212) 889-3141
(212) 255-2804
http://www.navh.org
• Serves as a clearinghouse for information about all services available to the partially-sighted from public and private sources. Conducts self-help groups. Provides information on large print books, textbooks, and educational tools.

National Cancer Institute (NCI)
National Institutes of Health
Public Inquiries Office, Suite 3036A
6116 Executive Boulevard, MSC8322
Bethesda, MD 20892-8322
(301) 435-3848
1-800-422-6237
1-800-332-8615 (TTY)
http://www.nci.nih.gov
• Conducts and supports research on cancer. Offers information for the general public and cancer patients and their families, including materials on ocular melanoma andretinoblastoma.

National Center for Complementary and Alternative Medicine (NCCAM)
National Institutes of Health
P.O. Box 7923
Gaithersburg, MD 20898
1-888-644-6226 (NCCAM Clearinghouse)
1-866-464-3615 (TTY)
http://nccam.nih.gov
• Supports research and evaluation of unconventional medical practices and disseminates this information to the public.

National Council of Private Agencies for the Blind and Visually Impaired (NCPABVI)
8760 Manchester Road
St. Louis, MO 63144
(314) 961-8235
http://www.agenciesfortheblind.org
• Represents, networks and advocates for organizations that serve people with blindness or visual impairment and their clients. Serves as the unified voice in the field of services to people with blindness or visual impairment for advocacy, public policy, education, ethical management, professional growth and enhanced services.

National Dissemination Center for Children with Disabilities
P.O. Box 1492
Washington, DC 20013
1-800-695-0285
(202) 884-8200
http://www.nichcy.org
• Serves as a national information and referral clearinghouse on special education and disability-related issues. Provides information on local, state, or national disability groups for parents and professionals. Emphasizes parent group information. Offers personal responses to public inquiries. Provides prepackaged information to frequently asked questions. Gives technical assistance to parent and professional groups.

National Eye Institute (NEI)
National Institutes of Health
31 Center Drive MSC 2510
Bethesda, MD 20892-2510
(301) 496-5248
http://www.nei.nih.gov
• Conducts and supports research on eye diseases and vision disorders. Offers free publications for the general public and patients.

National Family Association for Deaf-Blind (NFADB)
141 Middle Neck Road
Sands Point, NY 11050
1-800-255-0411
http://www.nfadb.org/
• Serves as the largest national network of families focusing on issues surrounding deaf blindness.

National Federation of the Blind
200 East Wells Street at Jernigan Place
Baltimore, MD 21230
(410) 659-9314
http://www.nfb.org
• Provides a wide variety of services to visually impaired people. Works with agencies and blind people they serve to provide a cost-effective pathway to jobs with good earnings and benefits. Publishes the Braille Monitor and Future Reflections. Distributes a catalog of publications available in large print, Braille, or audiocassette, and a catalog of aids and appliances.

National Graves' Disease Foundation
P.O. Box 8387
Fleming Island, FL 32006
(904) 278-9488
http://www.ngdf.org
• To provide current medical information and referral and resource information to people with Graves' disease, a leading cause of overactive thyroid. Publishes a periodic newsletter. Coordinates public and professional education on Graves' disease.

National Heart Lung and Blood Institute (NHLBI)
National Institutes of Health
31 Center Drive MSC 2480
Bethesda, MD 20892-2480
(301) 592-8573
(240) 629-3255 (TTY)
http://www.nhlbi.nih.gov
• Conducts and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. Distributes information on sarcoidosis.

National Institute of Allergy and Infectious Diseases (NIAID)
6610 Rockledge Drive, MSC 6612
Bethesda, MD 20892-6612
(301) 496-5717
http://www.niaid.nih.gov
• Supports research aimed at developing better ways to diagnose, treat and prevent infections, immune system diseases, and allergies.

National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health
Building 31, Room 4C02
31 Center Drive MSC 2350
Bethesda, MD 20892-2350
1-877-226-4267
(301) 496-8190
http://www.niams.nih.gov
• Conducts and supports research on the many forms of arthritis and diseases of the musculoskeletal system (bones) and the skin. Distributes information on temporal arteritis (giant cell arteritis), Behcet's disease , and Sjogren's syndrome.

National Institute of Neurological Disorders and Stroke (NINDS)
National Institutes of Health
P.O. Box 5801
Bethesda, MD 20824
1-800-352-9424
(301) 496-5751
http://www.ninds.nih.gov
• Conducts and supports research on disorders of the brain and nervous system. Distributes information on topics including Behcet's disease, dyslexia, headache, multiple sclerosis, pseudotumor cerebri, septo-optic dysplasia, stroke, temporal arteritis (giant cell ateritis) and von Hippel-Lindau disease.

National Institute on Aging (NIA)
National Institutes of Health
31 Center Drive MSC 2292
Bethesda, MD 20892-2292
(301) 496-1752
http://www.nia.nih.gov
• Promotes healthy aging by conducting and supporting research and public education. Distributes Aging and Your Eyes, part of the Age Page series.

National Institute on Deafness and Other Communication Disorders (NIDCD)
National Institutes of Health
31 Center Drive, MSC 2320
Bethesda, MD 20892-2320
Voice: (301) 496-7243
TTY: (301) 402-0252
Voice: (800) 241-1044
TTY: (800) 241- 1055
http://www.nidcd.nih.gov
• NIDCD supports and conducts research and research training on the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language and provides health information, based upon scientific discovery, to the public. DistributesUsher Syndrome, and Usher Syndrome: New Insights Lead to Earlier Treatment.

National Keratoconus Assistance Foundation (NKCAF)
2607 Rockefeller Lane, Suite 3
Redondo Beach, CA 90278
(714) 404-8690
• Provides referrals to eye care specialists best qualified to provide contact lens fittings for patients with keratoconus. Offers financial assistance for treatments and surgeries.

National Keratoconus Foundation
6222 Wilshire Blvd, Suite 260
Los Angeles, CA 90048
1-800-521-2524
(310) 623-4466
http://www.nkcf.org/
• Sponsors basic and clinical research as well as a public education program including self-help groups and seminars. Provides information to patients and eye care practitioners.

National Library of Medicine (NLM)
National Institutes of Health
U.S. Department of Health and Human Services
8600 Rockville Pike
Bethesda, MD 20894
1-888-346-3656
(301) 594-5983
http://www.nlm.nih.gov
• Maintains the world's largest medical library collection and coordinates PubMed, a database of millions of references to articles published in medical journals. Provides free online searching of the medical literature through MEDLINEPlus and links to health information topics on the eyes and vision. Provides a drug information guide to more than 9,000 prescription and over-the-counter medications. Maintains a clinical trials database for patients, family members, and members of the public.

National Library Service for the Blind and Physically Handicapped
Library of Congress
Washington, DC 20542
1-800-424-8567
(202) 707-5100
(202) 707-0744 (TDD)
nls@loc.gov
http://www.loc.gov/nls
• Provides free library service to individuals with visual impairments. Offers Braille and large print materials and recorded books and periodicals.

National Marfan Foundation
22 Manhasset Avenue
Port Washington, NY 11050
1-800-862-7326
(516) 883-8712
http://www.marfan.org
• Disseminates information about Marfan syndrome, a genetic disorder of the connective tissues in which dislocated lenses, cataract, and retinal detachment are ocular symptoms. Provides a communication network for patients and their family members. Supports and encourages research. Publishes The Marfan Syndrome, a comprehensive booklet on the disease, and A Guide for Eye Care Professionals.

National Organization for Albinism and Hypopigmentation
P.O. Box 959
East Hampstead, NH 03826-0959
1-800-473-2310
(603) 887-2310
http://www.albinism.org
• Educates teachers, health care professionals, and the public about albinism and hypopigmentation. Provides support to individuals and their families. Encourages research on the cause, results, and treatment of the disorder. Maintains a speakers' bureau. Information packets are available on request.

National Organization for Rare Disorders (NORD)
55 Kenosia Avenue
P.O. Box 1968
Danbury, CT 06813-1968
1-800-999-6673
(203) 744-0100
(203) 797-9590 (TDD)
http://www.rarediseases.org
• Acts as a clearinghouse for information about rare disorders. Fosters networks between families with similar disorders. Educates the general public and medical profession about the existence, diagnosis, and treatment of rare disorders.

National Organization of Parents of Blind Children (NOPBC)
1800 Johnson Street
Baltimore, MD 21230-4998
(410) 659-9314
http://www.nfb.org/nfb/Parents_and_Teachers.asp
• Works to provide information and support to parents of blind children and to develop and expand resources available to parents and their children. Publishes Future Reflections, a magazine for parents and educators of blind children. NOPBC is a division of the National Federation of the Blind (NFB).

National Society of Genetic Counselors (NSGC)
401 N. Michigan Avenue
Chicago, IL 60611
(312) 321-6834
http://www.nsgc.org/
• Represents the genetic counseling profession. Provides information and support to families who have members with birth defects or genetic disorders and to families who may be at risk for a variety of inherited conditions. Offers a “Find a Counselor” service.

New Eyes for the Needy
549 Millburn Avenue
P.O. Box 332
Short Hills, NJ 07078-0332
(973) 376-4903
neweyesfortheneedy@verizon.net
http://www.neweyesfortheneedy.org
• New Eyes for the Needy provides vouchers for the purchase of new prescription eyeglasses. Eligible clients can receive a voucher through a social service agency or a school nurse, or directly from our office. Clients can present a New Eyes voucher to any participating local optical dispenser, who fits the client with the proper prescription eyeglasses. The dispenser then receives reimbursement directly from New Eyes.

Ocular Melanoma Foundation (OFM)
P.O. Box 29261
Richmond,, VA 23242
admin@ocularmelanoma.org
http://www.ocularmelanoma.org/
• Works to increase awareness, enhance education and research, and provide advocacy among both patients and health care professionals regarding ocular melanoma.

Office of Rare Diseases, National Institutes of Health
6100 Executive Boulevard
Room 3B01, MSC 7518
Bethesda, MD 20892
(301) 402-4336
http://rarediseases.info.nih.gov
• Coordinates the Rare Disease Clinical Research Database (RDCRD). Offers information on more than 6,000 rare diseases, current research and clinical trials, and support groups.

Prevent Blindness America
211 West Wacker Drive, 17th Floor
Chicago, IL 60606
1-800-331-2020
(312) 363-6001
http://www.preventblindness.org
• Produces educational materials that address the special needs of senior citizens, agriculture and industrial workers, school teachers and children, nurses, and doctors. Offers guidance regarding current available treatments, eye care facilities and programs, and current eye research findings through the National Center for Sight. Coordinates the Eye Patch Club, a support group for families coping with a child's amblyopia treatment. Administers a research program to provide small start-up grants to young scientists.

PXE International
4301 Connecticut Avenue, NW, Suite 404
Washington, DC 20008-2369
(202) 362-9599
http://www.pxe.org
• Initiates and supports research on pseudoxanthoma elasticum (PXE). Provides support and education in the form of publications, online discussion groups, a website, and conferences for affected individuals and their families. Provides peer consultation for health care providers. Coordinates offices world wide, the PXE International Blood and Tissue Bank, and the PXE Research Consortium.

Recording for the Blind and Dyslexic - Headquarters
20 Roszel Road
Princeton, NJ 08540
1-800-221-4792
(609) 520-8031
http://www.rfbd.org
• Provides free cassette tapes, textbooks for students, and materials needed for occupational pursuits.

Research to Prevent Blindness, Inc.
645 Madison Avenue
Floor 21
New York, NY 10022-1010
1-800-621-0026
(212) 752-4333
http://www.rpbusa.org
• Provides research grants to scientists interested in eye disease and vision disorders. Conducts seminars to encourage communication among scientists, practicing ophthalmologists, and the public.

Resources for Rehabilitation
22 Bonad Road
Winchester, MA 01890
781-368-9094
http://www.rfr.org
• Offers training programs for public and professionals on coping with low vision. Publishes books and materials related to low vision including Living with Low Vision: A Resource Guide for People with Sight Loss.

Retinoblastoma International
c/o Children's Hospital Los Angeles
4650 Sunset Boulevard MS#88
Los Angeles, CA 90027
(323) 669-2299
http://www.retinoblastoma.net/
• Supports research, education, clinical care, safer/more effective treatments, early diagnosis and awareness related to retinoblastoma. Provides online information to parents, family, and friends, as well as medical education and hands-on training in the management of retinoblastoma to health care professionals.

Sight for Students
1-888-290-4964
sfsinfo@vsp.com
http://www.sightforstudents.org
• Sight for Students is a Vision Service Plan (VSP) program that provides free vision exams and glasses to low-income, uninsured children. The program operates nationally through a network of community partners who identify children in need and VSP network doctors who provide the eyecare services. A Spanish website and program fliers are available through links on www.sightforstudents.org.

Sjögren's Syndrome Foundation (SSF)
6707 Democracy Boulevard, Suite 325
Bethesda, MD 20817
1-800-475-6473
(301) 718-0300
http://www.sjogrens.org
• Provides support and education for people with Sjögren's syndrome and information to the medical community through local chapters. Publishes Moisture Seekers (newsletter) and The Sjögren's Syndrome Handbook. Distributes information on the complications of Sjögren's syndrome including dry eye (keratoconjunctivitis sicca).

Stevens-Johnson Syndrome Foundation
P.O. Box 350333
Westminster, CO 80030
(303) 635-1241
http://www.sjsupport.org
• Provides information and support for people with Stevens Johnson syndrome and toxic epidermal necrolysis, skin and eye problems associated with adverse drug reactions. Encourages public awareness of adverse reactions to drugs.

Stickler Involved People (SIP)
15 Angelina Drive
Augusta, KS 67010
(316) 775-2993
http://www.sticklers.org
• Provides information and support to people with Stickler syndrome, a connective tissue disorder that affects bones and joints, the heart, eyes, and ears. Publishes a quarterly newsletter.

Talking Tapes/Textbooks for the Blind
16 Sunnen Drive, Suite 162
St. Louis, MO 63143-3800
1-877-926-0500
(314) 646-0500
http://www.talkingtapes.org
• Provides textbooks on audiocassettes for students with visual, physical, cognitive, and learning disabilities.

Thyroid Foundation of America
410 Stuart Street
Boston, MA 02116
1-800-832-8321
(617) 726-8500
http://www.tsh.org
• Provides information and support for thyroid patients and health professionals. Raises and distributes funds for thyroid research. Offers a referral service, written information, and references about thyroid disorders including Graves' disease.

VHL Family Alliance
2001 Beacon Street, Suite 208
Boston, MA 02135-7787
18007674845
6172775667
http://www.vhl.org
• Provides current information on Von Hippel-Lindau syndrome, an inherited cancer that may cause tumors of the retina as well as other parts of the body. Coordinates an international network of family support groups. Publishes the VHL Family Forum (newsletter). Spanish Resources: Website http://www.vhl.org/es/index.html

(The) Vision of Children Foundation
12730 High Bluff Drive, Suite 250
San Diego, CA 92130
(858) 799-0810
http://www.visionofchildren.org
• Dedicated to curing childhood hereditary blindness, including ocular albinism and other related genetic vision disorders. Sponsors genetic research to gain scientific understanding and develop therapies and cures for these conditions. Provides information and support to families of blind and visually impaired children and to other organizations and service providers. Seeks to increase awareness among parents and medical practitioners of the warning signs of ocular diseases in newborns. Works to develop the first Patient Database Registry for ocular albinism and other genetic vision disorders.

VISION USA
1-800-766-4466
http://www.aoa.org/visionusa.xml
• Coordinated by the American Optometric Association (AOA). Provides free eye care to uninsured, low-income workers and their families.

VISIONS/Services for the Blind and Visually Impaired
500 Greenwich Street, 3rd Floor
New York, NY 10013-1354
1-888-245-8333
(212) 625-1616
http://www.visionsvcb.org
• Offers free services to adults over age 55 and teens with severe vision problems. Services include self-help study kits, counseling, vision rehabilitations training, consumer workshops, and an information center. Provides volunteer and overnight camp services for blind and visually impaired adults and elders and parents of blind children.

Xavier Society for the Blind
154 E. 23rd Street
New York, NY 10010-4595
1-800-637-9193
(212) 473-7800
• Serves as the National Catholic Press and Lending Library for the visually impaired. Provides materials in Braille, large print and audiocassette.