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University of Iowa News Release


Feb. 16, 2009

Photos: (top, left) Robert Nady, 83, stays current with the news by using his video magnifier. After receiving medical and surgical care at UI Hospitals and Clinics, Nady learned to use electronic magnification devices as part of rehabilitation. Credit: University of Iowa

(bottom, right) Mark Wilkinson, O.D., teaches a patient with low vision to read a magazine using an electronic magnification device. Providing high-technology tools is one way the UI Carver Family Center for Macular Degeneration helps nearly 2,000 patients who come to the clinic each year. Credit: University of Iowa

UI expert: macular degeneration merits another look

The construction season will soon pick up for Robert Nady, 83, a civil engineer from Nevada, Iowa. But as an individual who is legally blind, he will be bringing a hired driver and a portable magnification device to his Des Moines office.

Nady's vision noticeably deteriorated around 10 years ago, eventually bringing him to the University of Iowa to be treated for macular degeneration. Approximately one in seven people over age 75 will develop the disorder, the leading cause of legal blindness in the elderly population in the United States. By age 85, nearly one in three people find themselves losing their central vision to macular degeneration.

One facet of macular degeneration awareness is to reshape outdated attitudes toward the disorder, said Mark Wilkinson, O.D., director of the Vision Rehabilitation Service at the UI Carver Family Center for Macular Degeneration.

"Vision loss should not just be accepted as part of getting old," said Wilkinson, who also is a clinical professor of ophthalmology and visual sciences at the UI Roy J. and Lucille A. Carver College of Medicine.

February was named Age-related Macular Degeneration and Low Vision Awareness Month to focus on its prevalence and life-changing effects. At the UI Carver Family Center for Macular Degeneration, physicians and researchers are working to meet the disorder on two fronts: providing care and cutting-edge devices for patients and research into causes and potential cures.

As director of the Vision Rehabilitation Service at the center, Wilkinson sees patients like Nady before, during and after they go through laser surgery and medical treatments.

"In the past, people were sometimes left with the message that there was nothing that could be done," Wilkinson said. "Now, there are very exciting developments, such as injections that not only stabilize, but improve vision in the wet form of macular degeneration. Additionally, there are new and better optical and electronic magnification devices that can help people with vision loss lead qualitatively better lives than they could in the past."

After nearly a decade of treatment, Nady easily sounds off the causes of macular degeneration. It damages part of the retina, a layer of photoreceptor cells blanketing the back of the eyeball.

The retina is richly nourished by blood, which is filtered by a layer called the retinal pigment epithelium. This layer is prone to break down with increasing age, however, which allows certain harmful components of the blood to reach the retina.

The disease progresses in two phases. In the dry phase, the retina loses photoreceptor cells in the macula, the part that focuses images in the center of the field of vision. Then, in 10 to 15 percent of cases, new blood vessels may form beneath the retina and leak, leading to the wet phase.

Currently, there is no specific treatment for the dry stage of the disease. Macular degeneration can lead to vision loss serious enough to constitute legal blindness. And although scientists have found certain environmental and genetic factors linked to its development, macular degeneration is mostly age-related.

Although his vision is still "off the charts," Nady said it has not worsened. He uses two electronic magnification devices to help him read. When he sits down with the local paper, Nady scans the newsprint on a low setting with his video magnifier to find an interesting article. A push of a button increases the magnification, and as he reads he simply slides the paper around on a platform.

About a year ago, Nady upgraded the bulky, cathode-ray reader to a sleek, flat-screen model that allows him to see color. "It's the latest technology," he said. "But there's really no learning curve for using the device."

Sixty years after graduating from Iowa State University in Ames, Nady has not given up his engineering expertise. He spent a Sunday morning working at home with the help of his reader. A smaller, portable one goes with him to the office in Des Moines. It will come in handy in the approaching construction season.

"I've got a whole stack of technical reports waiting for me," Nady said.

For information on age-related macular degeneration or vision rehabilitation services at the UI, contact the Vision Rehabilitation Service at 319-356-8301 or Visit the service online at

PHOTOS: High resolution images of Mark Wilkinson and Robert Nady are available. Reporters may contact with requests.

STORY SOURCE: University of Iowa Health Care Media Relations, 5137 Westlawn, Iowa City, Iowa 52242-1178

MEDIA CONTACT: Becky Soglin, 319-335-6660,; Writer: Zhi Xiong