Low vision doctor provides care for those on their last hope

Dr. Richard Shuldiner has seen over 10,000 patients in his lifetime for low vision care.

"I started practicing back in the 1970s in Poughkeepsie, New York," Shuldiner said. "(I) went to a lecture somewhere about low vision and discovered there were no low vision doctors in my area, and I thought that people needed the service so I would learn how to do it."

Shuldiner was trained and found there were few services available to the blind in the area, so he contacted New York Lighthouse and created the upstate New York Lighthouse Low Vision Clinic with them.

"About the year 2000 – because it's very difficult for eye doctors to get trained in doing low vision, I started a training program," Shuldiner said. "I've trained somewhere around 40 doctors to do this kind of work throughout the country, and we have an organization called the International Academy of Low Vision Specialists."

Shuldiner sees patients with different types of low vision problems, two forms being macular degeneration and diabetic retinopathy.

"Macular degeneration is the leading cause of vision loss among seniors in the world right now, at least in the United States," Shuldiner said. "There are two types: there's a wet type in which there's bleeding in the back of the eye by the retina, by the macular part of the retina, and then the dry type the macular cells just die.

"Macular is one part of the retina – it is the most sensitive part because it has the most photocells. When somebody says look at that, you turn your eye and you actually align your macular part of the retina so that you can see it the best," Shuldiner said. "In order to really get that, if you were to take a look at something right now, anything, in detail, and then look an inch or two or three to the side, you'll notice that it's very hard to tell what it actually is even though it's clear."

Anything off the macular doesn't have the clarity due to it not having the same number of photocells, according to Shuldiner.

"The macular degenerates either from bleeding due to wet or just cells dying due to dry – central vision goes, peripheral vision stays," he said.

When you lose your central vision with macular degeneration, Shuldiner said that people complain that they can't see faces; they can't see the TV very well.

"Light becomes very frustrating, and unfortunately there's no cure for macular degeneration," he said. "The dry type (there's) absolutely nothing to do, the cells die and there's no treatment whatsoever.

"The wet type, with the bleeding; there are injections that are done regularly to keep the bleeding at bay or to stop the bleeding, but it still does nothing for the damage that already occurred," he said.

Diabetic retinopathy is similar in dealing with the retina.

"You're dealing with diabetes causing bleeding, and therefore bleeding causes damage to the retinal cells and vision loss," Shuldiner said.

People that have either of these need to see a low vision doctor. After speaking with patients first over the phone to see if they still have enough vision for Shuldiner to work with, he said he'll have them come in for an appointment.

"(We) figure out a way with special types of glasses – microscope glasses, telescope glasses, prism glasses, to get people to do the things they want to do even with the vision loss," he said.

Shuldiner worked with the inventor of the glasses they provide, back in the 1980s.

"(It) was very, very exciting for me to work with the man who actually invented them," Shuldiner said. "I have a very good friend who owns a company in New York that actually produces surgical telescopes and microscopes for surgeons, and so we use those kinds of glasses for people."

To find out more about low vision care, visit https://www.lowvisioncare.com/.

"If they're having trouble doing what they want to do and a doctor has told them nothing more can be done, which happens a lot, they should use a low vision doctor and inquire into what low vision devices and glasses are available," Shuldiner said. "Don't give up."

Lexington Howe can be reached by email at [email protected].