"STRATEGIES AND SOLUTIONS FOR INDIVIDUALS WHO

ARE BLIND AND HAVE LOW VISION" WEBINAR

~ APRIL 20, 2011 ~

MARTHA RUST: ... and go to the "Options" and click

on "Accessibility," and your options will be there.

So we like to make this interactive. And to the

right-hand side you will see the public-chat box.

Is this better? Can you hear me now? Is that a

little better?

I'm sorry if it's cutting in and out. That tends

to be our firewall here at the state office. It will cut

in and out. Unfortunately, we haven't figured out how to

jump over that with our firewalls. But I'm hoping that you

can hear me and it's a little better now. Okay.

On our right-hand side you will see the public-chat

box. And if you have any questions, there's a box in the

middle where you can just type your question and hit

"Enter," and it will go straight to us or everyone who can

hear that.

All right. So we'll go ahead and get started. As

you see the next slide, we are offering credits for this.

We offer CEUs through our AAC Institute and CRCs too.

So to help us out with the credits that you all

will need, please go ahead and type your name and your

e-mail address in the public-chat-box area, and that helps

us keep up with the CRCs and CEUs.

Again, if you need CRC credits, you can e-mail Liz

at liz@gatfl.org. And for CEUs, please visit the AAC

Institute website, which is aacinstitute.org.

Following our webinar, I would like you all to take

a minute to fill out our survey with SurveyMonkey. We

really value everyone's opinion, and that is how we get

better is to get feedback from you guys.

So there's a link here on this slide that's going

to pop up in just a minute. So please visit the

SurveyMonkey at this link. And we'll put that also in the

public-chat area too. And we really do value your opinion.

So please just take a minute to fill out that survey.

All right. As I said, you guys are in for a treat

this afternoon. We are doing this webinar in collaboration

with the Center For the Visually Impaired. And we have

John Rempel here. He's our AT specialist. He'll be

talking about some solutions.

And then we also are collaborating within our

vocational rehabilitation department within the blindness

services region with our rehab unit manager Jennifer

Thomas. She'll be going over some common eye diseases and

eye charts.

So I'm going to pass the mic over to her right now

and hope y'all enjoy our webinar.

JENNIFER THOMAS: Good afternoon, everybody. It's

a pleasure to be here. And I want to thank Martha and her

team for inviting me to be part of this webinar because for

us it's exciting to share strategies about blindness and

low vision with y'all.

So again, if you have any trouble hearing me

throughout this presentation -- it is my first time on a

webinar using a mic like this -- please just write

something in the public chat so I'm aware that you're

having trouble hearing me.

All right. Well, the first slide we have is -- and

I'm going to be describing -- any time there's pictures on

any of the PowerPoint slides, I will be describing what's

there for any of our nonvisual participants on today's

call.

So the first slide is a picture of the anatomy of

the eye. So as we're talking about the common eye

conditions, you'll have a reference point to the areas of

the eye that I'm speaking of.

Okay. I just got a message that it's difficult to

hear. So I've adjusted the mic. Hope that helps.

But I promise that, even though we're going to be

talking about the anatomy of the eye, that this will not be

an anatomy lesson. I know everybody's coming off of lunch,

so I promise I won't put you to sleep.

But it's more or less to give you a reference to

the different eye conditions that of course cause blindness

and low vision and also talk about eye reports and how to

interpret those.

But before we jump into the eye reports, I wanted

to first give you all the leading causes of blindness.

Next slide.

And they're listed there on your screen. We'll

talk about them individually. It's glaucoma, macular

degeneration, cataracts, diabetic retinopathy, and

retinitis pigmentosa.

So looking a little bit closer at glaucoma,

glaucoma is an eye condition that affects the optic nerve

due to a raised intraocular pressure. And it's often

referred to as the silent thief of sight.

It is a hereditary condition. And with glaucoma,

it can be -- there's two forms of glaucoma. There's

open-angle and closed-angle glaucoma. With open-angle, it

is more chronic, and it tends to be progressive at a slower

rate.

So again, going back to the silent thief of sight,

it can slowly progress where someone may not realize that

they're starting to lose their vision.

On the opposite of that, the closed-angle can be

more sudden and often painful. And with glaucoma it does

restrict your visual fields.

There's not a cure for glaucoma, but it can be

treated if caught early enough during routine eye exams,

checking your eye pressures. And often eye medication

drops are prescribed to help keep the pressure of your eyes

at a normal rate.

The next slide is going to give you what glaucoma

may look like for a patient who is already experiencing a

restricted visual field.

So on this particular slide, to the left you will

see a picture of two boys standing next to one another

holding soccer balls. And then to the right of the normal

picture where everything is clear and in focus, you see to

the right there's a picture of the same two boys, but there

is a restricted field where it's starting to look hazy and

blacked out around the peripheral vision.

The next condition that I'll briefly review is

macular degeneration. And most often it is a condition

that affects our older population. And it affects the

central vision, and specifically it affects the macula,

which is part of your retina.

And the macula, if you look back at your anatomy of

the eye, is the central part of the retina that surrounds

the optic disc. And there's two types of macular

degeneration, the dry and wet types.

The next slide gives you again the visual of what

it may look like with someone who suffers from macular

degeneration. Again, the picture to the left is clear and

in focus; the one to the right you'll notice that the

person cannot recognize the faces because again the central

vision is affected, and they cannot see the faces of the

two boys, but they are able to see detail around it.

The next condition is cataracts. And this is a

condition that is one of the ones that can often be

corrected with surgery. It is the clouding of the lens.

It's a clouding that develops in the crystalline lens of

the eye.

And it usually progresses slowly where there's

someone -- they recognize a clouding of their vision to the

point, in some cases, that it becomes opaque, obstructing

passage of light into the eye.

Again, it is progressive. But if it's untreated,

it could potentially cause blindness.

Okay. I see we have a question. So let's go ahead

and talk about that.

Joy has asked, "What's the difference between wet

and dry macular degeneration?"

So I wanted to go back and answer that question.

Let's see. This is where there's -- with the dry -- I'm

sorry. I'm reading back through my notes, so I had to flip

back a few pages here.

It's where debris can accumulate between the retina

and the choroid, and it can cause the retina to become

detached.

And the wet form is considered more severe. And

this is where blood vessels grow up from the choroid behind

the retina, and the retina can also become detached.

Oftentimes some laser treatments could be performed

to help reduce the progression of that. And medication can

sometimes stop or reverse the growth of the blood vessels

that do form if they're treated early enough.

And I have to give a disclaimer I forgot to give at

the very beginning. I am not an eye physician. So, you

know, I can of course -- my knowledge of working with

people who are blind and visually impaired and the research

that I've done over the years helps me to understand these

conditions. But when it comes to real technical questions,

I may be a little out of my realm of being able to respond

to them.

Oh, you're welcome.

For cataracts, just in brief, the causes. The most

common is senile because it does occur when someone ages.

There is -- congenital cataracts can occur in a young

child. Someone can be born with them. Or trauma to the

eye can cause cataracts as well.

And again, like I mentioned before, it is one of

the eye conditions that often can be corrected by removing

the cataracts and either placing an intraocular lens

implant or using glasses and contact lenses to correct

refraction errors.

And then the slide that we're currently on is a

picture of an eye showing the cloudy capsule that forms

behind the lens.

The next condition is diabetic retinopathy. And

this condition is secondary to diabetes.

And here is an interesting statistic for you:

Diabetic retinopathy can affect up to 80 percent of all

patients who have had diabetes for ten years or more.

So I think this really speaks to the fact that, if

someone is diagnosed with diabetes, how important it is to

control it through diet and exercise and medication and

monitoring it daily because it can absolutely affect your

vision.

And with diabetic retinopathy, it affects the

retinal blood vessels and causes hemorrhaging and abnormal

growth of new vessels into the vitreous of the eye. So

basically it blocks the light because of the bleeding that

occurs.

And again, the best thing for this condition is

controlling your diabetes. There is a treatment that has

been used not to correct it but maybe, you know, to slow

some of the bleeding. It's photocoagulation, and it's a

laser treatment that treats more than just this eye

condition, but it can be used again to help reduce the

bleeding.

And the next slide, of course, is a picture like

we've been going on here with the other conditions with the

picture of the boys to your left that is clear and in focus

and the one to the right where you'll see splotches of

black.

So it's not necessarily defined to the central

vision or the peripheral. It can be at different places

within your line of sight.

So this is an example of it where there's an area

that's blacked out in the upper right-hand corner and then

some central vision loss, and so you're not able to see the

full field of vision.

The next and last one that we'll talk about is

retinitis pigmentosa. A lot of people refer to this by

it's acronym, RP. And this is a degenerative retinal

condition. It is hereditary, and it is a severe and

progressive loss of your peripheral vision.

A lot of people will refer to it as tunnel vision.

And it often will begin where someone will experience what

they refer to as night blindness. And then over time

they'll begin to lose the peripheral vision to the point of

no light perception or maybe some light perception.

And then the next slide again will show you what

someone may experience that has RP that is fairly

progressed, because as you see to the picture on the right,

you only see a very small portion of the boys' faces, and

you do not see the remaining area. Another way to describe

it is like a pinhole vision.

All right. Now that we've talked about some of the

most common eye conditions, I wanted to give you all the

definitions of legal blindness and low vision, which is an

important piece before we start going into interpreting our

eye reports.

This definition that I have up on the screen now is

from Georgia's Vocational Rehab Program Client Services

Policy Manual. And it's what we go by to determine someone

eligible under blindness or low vision.

So someone who is legally blind will either have

visual acuity of 20/200 or worse in the better eye after

best correction. So this is once they've been corrected,

whether it's with glasses or magnifiers, and their vision

still remains 20/200 or worse.

Aside from that, like we talked about with RP,

somebody may have good acuities, but they've lost

peripheral vision. So if someone has visual fields that

are no greater than 20 degrees at its widest diameter, then

they are also considered legally blind.

So that's important to know because they may be

able to see clarity and still read printed materials, but

they're only seeing very limited central vision, and their

degrees are less than 20. So they would also be considered

legally blind.

For low vision where some people are still referred

to as a visual impairment, with low vision it's defined --

for Georgia Vocational Rehab defined where the corrected

vision is no better than 20/60 in both eyes -- or in the

better eye, as the definition states.

And then we also look at visual fields. If their

visual fields are no greater than 40 degrees.

Or there's some conditions that cause hemianopic

defect where they may only see half of their visual field,

whether it's to the right, to the left, or up and down.

Then they can also qualify as someone with low vision.

And when we talk about low vision and the field of

low vision, it means that it's not corrected by standard

glasses, contact lenses, medication or surgeries, but it

still interferes with their daily functioning.

And it's also important for us to define our

different eye care professionals that someone may work with

when they evaluate or treat a patient. So I've listed

those as well.

An ophthalmologist is a medical doctor who

diagnoses and treats all diseases and disorders of the eye

and can prescribe glasses and contact lenses.

An optometrist, as it states, is a primary eye care

physician that prescribes glasses and contact lenses and

can treat other conditions as well.

Specialists in low vision -- and we'll talk about a

low-vision exam here in a few minutes. But a specialist in

low vision can be either an ophthalmologist or optometrist

who specializes in low-vision field.

And again, this professional prescribes visual

devices and teaches someone with blindness or low vision

how to use them.

An optician often works with these professionals

and is trained to fit and dispense glasses when they're

prescribed.

All right. So now that we've defined the

professionals in eye care, I wanted us to take a look and

talk about what is included in a comprehensive eye exam and

the components of a report.

And reports come in many different formats. Most

often they're handwritten by the doctor. We love it when

they're transcribed in a narrative because it's much easier

to read and interpret and make sure we're not missing any

information.

Because, as you know, if you try to read the

prescription pad that your doctor has just handwritten, it

can be often difficult to read. So, you know, anything

that is transcribed is always the best way.

But with an eye exam, there's four main areas on

it. There's the history of the patient, which most

specifically will define history of complaints or what

their chief complaint is the day of their visit.

The examination is going to give you the acuities

best corrected and uncorrected. It's going to give you

intraocular pressures if it's somebody who has glaucoma.

And give you the overall appearance and any observations

they make of the eye health. Also it could give visual

field information for those who have a condition that

restricts their visual field.

The doctor will give an assessment of what they

find on that particular visit, which can be thought of as

the diagnosis. And then the plan. What are they

recommending? And within that, oftentimes they'll talk

about the prognosis of the patient.

The next slide we're going to look at, when you

have this report in front of you in those four areas of the

way the reports are laid out, we want to pull out

information that's going to be valuable to working with an

individual, so basically interpreting that eye report.

And as I stated before, you're going to want to

look for the diagnosis in eye condition that is documented.

And the etiology. How did it occur? Was it because of

diabetes or a trauma that may have happened? It's

important to know how that condition was caused. Or is it

age related?

The visual acuities, again like I mentioned on the

previous slide, for a vocational rehab counselor trying to

determine eligibility for our program, we're going to want

to look for that best-corrected acuity to see if they

qualify for services.

Ocular pressures, visual fields, what's the

treatment plan, and the prognosis. And again, all of this

information helps us better understand the person's

condition.

The next slides gives you some common eye report

abbreviations because, like I said, if you're getting an

eye report that's handwritten, oftentimes it will not be

spelled out for you. So this is the most common ones that

you'll see when a report is written out.

You'll see "Va cc"; and that stands for visual

acuity with refraction correction. And that's the most

important thing for us in determining eligibility for our

program.

You'll see OS. That means left eye. OD, right

eye. OU, both eyes.

A doctor may not write an acuity down because the

person doesn't have it. So NLP is no light perception.

LP, light perception.

Count fingers is where the person is able to still

see some shadowing and figures but not make it out clearly.

So the doctor could possibly hold up fingers in front of

their face, and typically what they'll do with that is they

will hold the fingers up close to the face, and they'll

measure back how many inches back can they still see the

count fingers.

So if you can kind of visualize that type of

examination, they'll be maybe at an inch in front of their

face "Can you still see my fingers?" and then back it out

and come up with a count fingers at maybe four inches. And

it could be more than that, but that's just an example.

Hand motion, which is often written as HM, that's

when somebody will see motion, but they really can't make

out maybe how many fingers the doctor is holding up.

The next slide, I felt this was useful information

to share because there's often times where somebody has a

visual impairment or maybe has just found out that they're

starting to progressively lose their vision, and they

really just don't know what to ask of the doctors.

You know, they may be scared. They may be

embarrassed of the condition. And so these kind of

questions are important for someone to keep in mind. I

won't read through them individually for time's sake. But

I just wanted to give you some questions that are often

overlooked for a patient to ask of their doctor.

And the last question on this screen, "Where can I

get a low-vision examination and eval? Where can I get

vision rehabilitation?"

And really, to me, those are the most important

questions because often, when a patient leaves their

doctor's office, the doctor is looking at it from a medical

model for the health of the eye, and they may not be

looking at it from a functional level.

And that's why we're here today, to talk about

those strategies when someone starts to lose their vision

or has lost it. And John's going to be the exciting

presenter with all the cool stuff that he's going to share

with us, so I'm going to try to get through the rest of my

material to pass it off to him.

But that's really where it's at for these patients.

So when they leave their doctor's offices, they don't feel

like that's the end, that they have no options out there

for them. And that's why we exist, is to provide them the

resources and the aids to help them continue to lead a

productive life. So it's not a scary thing to lose your

vision.

So I wanted to spend just a minute to talk about

what a low-vision examination is. And a low-vision

examination is after someone has a comprehensive eye exam.

It's really looking at their functional vision. And

oftentimes the low-vision provider will correct refraction

errors.

So they may already have eyeglasses, but it's not

to the point where it's maximizing the residual vision that

they have remaining. So oftentimes the low-vision

evaluator will prescribe a more specific prescription that

just helps them to see, to continue to see printed

materials and other things.

The low-vision evaluator is also going to look at

different magnification options for the person. And the

most important thing to let someone know that's going to do

a low-vision exam is take in examples of things that they

do on a regular basis.

If it's reading the newspaper, reading reports that

they have to do at work. If they like to sew or

cross-stitch. It really can run the gamut. Anything that

they do on a daily basis that they want to continue to do,

it's important for them to take those items into the exam

because they can use that during the exam to try out the

different aids.

Because it can be hand-held magnifiers. It can be

video magnification options, which has really come a long

way in the last ten years that I've been in this field from

really big, bulky CCTVs to very small, lightweight,

handheld options.

A low-vision exam will also look at lighting and

glare, because someone who is experiencing a decrease in

their vision, lighting and glare can make such a difference

as to how well that they can see.

Especially just thinking it from a work setting, I

know a lot of us in our offices have the overhead

fluorescent lighting, and that can really cause glare

issues. And if their lighting can be adjusted to have more

direct lighting on the task that they're doing, it can make

a huge difference for what they're seeing.

Going from indoors to outdoors, for mobility

purposes, wearing glare shades can help someone be able to

travel more safely out in public.

And contrast goes in the same way. For example,

someone who is not able to distinguish -- if you just look

at your keyboards that are in front of you, they're black

keys with white letters. Somebody may see much better with

white or yellow background keys and black, bold letters on

the keys. So it can make it much more user friendly for

them.

And then the last slide that I have up there are

more questions when someone goes to see their low-vision

specialist. And again, the questions here are just so

important. How can they continue their normal routines?

How can they get resources on the jobs?

And keep in mind there's a lot of people out there

that may not yet know about vocational rehab and the

services that we can provide. So this may be their first

link to VR.

Or sometimes they come to us directly from their

eye doctor and may not know that a low-vision specialist

exists for them. So then we're able to take a step back

and refer them to a low-vision evaluation.

And support groups and being able to connect with

other people and share community resources. Because, as we

know, with someone who's losing their vision, driving may

be one of the biggest forms of independence that they may

lose because that's the way they're able to access their

community, go to work, care for their families. And so

being able to seek out those resources are vital to their

daily life.

The last slide I have here is what does the rehab

counselor do once they receive an eye report? How do they

proceed with somebody who has come to them that is low

vision or legally blind?

And what counselors do is they, of course, use that

eye exam to determine eligibility for a program. And from

there they look at recommendations and -- or they look for

other evaluations to get recommendations for their

rehabilitation.

And I've listed some examples of that, which

includes a low-vision eval, assistive work technology. And

this is a component of the VR program -- a unit within the

VR program of technologists that go out and evaluate the

job site that the person is on and recommends the best

accommodation in low vision, which can be high-tech or

low-tech aids to help them continue to perform their

duties. And again, John is going to touch on those things.

Vision rehab therapy. This is a component of rehab

where someone learns how to continue to cook, to clean, to

sort their clothes, anything that we do in everyday life to

get us out the door to work is included in vision rehab

therapy.

Communication. How is someone going to now

communicate with low or no vision where it comes to letter

writing or accessing their bank account information and

paying bills. So it really runs the gamut.

And orientation and mobility is training that

provides somebody with travel skills. It's with using the

white cane where they're able to continue to travel in a

safe way.

And then lastly, once the evaluations are

completed, a rehabilitation counselor will sit down with

their client and talk about the services that they need --

individualized services that they need to continue

employment or to live independently.

And I've also included my contact information. So

if any of y'all have further questions about our program,

I'd be glad to take calls or e-mails from you.

And now I promised you some excitement, so John's

going to pick us up and start talking about all the amazing

equipment and accommodations that are out there for people

who are blind or low vision.

So give us just a second to switch the mic over.

Thank you.

JOHN REMPEL: Good afternoon. This is John Rempel

from the Center For the Visually Impaired. Thank you for

giving us those few moments to switch mics here.

And again, if anyone has any difficulties hearing

me, Martha Rust is checking the messages here, so just give

me an indication of that, and I'll try to speak up or hold

the microphone a little bit closer.

So I work for the Center For the Visually Impaired,

which is based in midtown at the corner of West Peachtree

and Fourth Street.

And we work -- it's been said we work from cradle

to grave. So literally we have staff that work with very,

very young children. And today we're going to be focusing

a little more on working-age adults. And we also have

staff that work in the community with the senior population

as well.

And this is an exciting collaboration here to work

with Tools For Life and with Jennifer Thomas here from

Department of Labor. A lot of what she said is going to

reenforce what I'm going to be discussing.

So I'm going to be focusing more on the technology

aspect of this webinar. And the primary target audience

that I'm going to be covering is the working-age adults,

although I'll be touching on other areas as well.

And technology has really changed even in the last

5 to 10 years. We think of technology as dealing primarily

with the computers and laptops and desktops. It's really

evolved to touch on major, major aspects of a person's

activities of daily living.

For example, a lot of us or most of us do online

banking, online shopping. And that's all done with the

help of technology. And that aspect of technology is very

useful for a blind or visually impaired person because very

often transportation issues get in the way of being able to

get to that store or do that shopping. And for a blind or

visually impaired person to be able to do that online is

tremendous.

It involves all other aspects of activities of

daily living such as knowing which color pants you're

wearing, what color your socks are. There are some very

inexpensive color identifiers now that can help in those

aspects.

Jennifer Thomas also mentioned orientation and

mobility. More and more technology is impacting that area

as well. We think of orientation and mobility as the white

cane. Well, more and more GPS technology is becoming much

more utilized and much less expensive than it used to be.

And that is absolutely crucial for a blind or visually

impaired person to maintain their independence.

So in a nutshell, this is what I'm going to be

covering today:

Specifically the operating system. These are

solutions that are free to a person who already has a

computer. There's several modifications that can be made

that can help someone with low vision or no vision at all.

Screen-magnification solutions within the operating

systems as well as third-party software programs.

Screen-reading solutions. So the speech output

that a computer can provide with either the screen reader

built in or third-party screen-reading programs.

And scanning solutions. Individuals who need text

read to them in audio format.

GPS solutions for individuals who are low vision

and blind who need additional information as far as

landmarks and clues, points of interest, intersections,

et cetera.

And then I'm going to discuss a little bit about

the iPhone, the accessibility built into the iPhone itself,

because that seems to be more and more a solution for a lot

of low vision and blind people.

And I'm going to be discussing apps as well,

various apps that are fairly accessible for people who are

blind and low vision.

To start with, though, I'm going to discuss the

importance of the evaluation. One shoe doesn't fit all.

And so this is very, very important because there's a

number of factors that go into what a person's current

needs are and how they may change in the future.

So Jennifer already talked about the functional

vision. This is absolutely crucial when it comes to any

sort of assistive technology recommendations.

What is their current eye condition? And what is

the prognosis? Is their eye condition possibly going to

change in the next three to six months?

Because that could tremendously impact the

technology that's being recommended or being trained on and

may be absolutely of no use down the road if the vision

does change.

Visual fatigue is also very important. Very often

with various eye conditions, like Jennifer pointed out,

contrast is very important. Glare sensitivity can be an

issue. So visual fatigue is a very significant aspect of

the evaluation.

How many hours can a person spend on the computer

before they become very, very tired? And the thing with

visual fatigue is it doesn't just affect their eyes.

So much of -- when a person is straining their

vision trying to gather information in their environment,

it affects the entire body as far as the fatigue factor.

The current technology available to the person is

the next aspect. What do they use now? Do they have a

computer? Have they been successful with that computer in

the past? What kind of things have they done in the work

site? That's going to dictate future success as well.

They may have had 20/20 vision prior to receiving

the evaluation and were very effective at using a computer.

After a vision loss occurs, it doesn't mean that all those

skills are lost. There's a lot of transferable skills that

can be applied.

And this is a very important one: Keyboard skills.

With the sighted population, even a young child who doesn't

know the keyboard, touch typing, can do the hunt-and-peck

method, use one index finger to eventually type something

out.

For a blind or person with low vision, this is a

significant barrier because, not only can they not see the

keys, but if they hit a wrong key, it's very often much

more difficult to back out of something that was done

incorrectly than to hit the right key initially. So it's

really compounded with not having effective keyboard

skills.

Cognition and memory retention. We have a

vocational specialist on staff at CDI who assesses

cognition, memory retention, reading, spelling abilities.

And that's a significant impact as well with learning the

computer. There is a baseline of knowledge required to

operate the computer.

Physical abilities, limitations. Very often, with

some of the eye conditions that Jennifer mentioned, such as

diabetes or diabetic retinopathy, there are secondary

health issues as well. So what is that person's ability to

stay in a stationary position for a long period of time?

Another condition would be multiple sclerosis,

which very often will affect the visual acuities. So

that's assessed as well.

The physical environment. Again, this is another

one that Jennifer touched on, is glare sensitivity. Are

there a lot of open windows in the office, fluorescent

lighting? So those are significant issues in the

workplace.

If the lighting is -- it's not just having enough

lighting. It's having the correct type of lighting that

reduces the glare but increases the illumination of

whatever a person needs to do.

And then the financial resources or resources to

tap into to acquire the necessary assistive technology.

And this is a very important one: Available

support, family and friends. Very often I hear a blind or

visually impaired ask another sighted person, "Can I borrow

your eyes?"

That's very crucial because a lot of these

programs, once the screen reader crashes or the large-print

magnification program crashes, a low vision or blind person

is at a huge disadvantage. So the support of family and

friends can be absolutely crucial as far as successful

integration of the assistive technology.

And none of this is entirely in a linear fashion;

this all overlaps. I just wanted to make that clear.

So we'll start with the Windows operating system

modifications. Some of these modifications will work for

some but not for everyone.

"Low vision" is a very general term. Low vision

can mean -- from a perspective of assistive technology, I

think of the term "low vision" as someone who may not

necessarily need speech output but may require some sort of

screen magnification or screen enhancements.

So the screen resolution -- and this seems a little

bit counterintuitive, but the lower the resolution -- and

by "resolution" I mean the pixels that are displayed on the

screen -- 800 by 600 can very often make a significant

difference in the size of the menus and icons that are

displayed in the Windows environment.

And this can be done in two ways. You can right

click on the desktop. And in Vista or Windows 7, it's

under the "Personalize" menu item. Or you can go into the

control panel, and under "Display Settings" you can change

the resolution as well.

Increase the pointer size. I actually had Martha

Rust do this for me this morning. So the default pointer

is a small, white pointer. Going into control panel and

going to the "Mouse Settings" and changing it to -- very

often the black, extra large pointer can make a huge

difference. So that's definitely something worth

considering.

I wanted to mention this, too, with the pointer.

This is one of the most -- probably the most frequent

problems that people have is tracking that pointer,

especially if there's field loss. It's very, very

challenging.

So what I recommend is choose a corner of the

screen, top right, bottom right, whatever it is. Typically

the corner that is best for your field of view. So even if

you can't see the pointer, push the pointer to one of those

corners and keep moving that mouse movement to one of those

corners, and then slowly track it back to the item you're

looking for. That can make a huge difference in locating

the pointer.

Slowing down the double-click feature can also

help. Slowing down the movement of the mouse. Again,

tracking that mouse pointer. Sometimes it can make a

significant difference just slowing down the movement of

the mouse. And that's also in the mouse options in control

panel.

Changing the Windows themes. This is more

significant in Vista and Windows 7 because the contrast

level -- I think Microsoft has gone backwards here a little

bit. The contrast level is relatively poor in Vista and

Windows 7.

So what I recommend is changing the Windows themes

to -- classic is a really good one because it sharpens the

level of contrast within the entire Windows environment.

And this is probably one of the quickest and most

useful tips I can give individuals who just need a little

bit of additional magnification and aren't necessarily

using a large-print software program. The "control" and

the "spin wheel." This actually increases the viewable

area, whether it's Word, Excel, Internet Explorer. It even

works on multiple web browsers, FireFox, Opera.

Holding the "Control" down and spinning the wheel

on the mouse between the left and right mouse button, if a

person is in Microsoft Word, it's actually going to blow up

the text. And it can blow it up to five times

magnification. And changing it the reverse direction will

also decrease it.

So it's a very quick way of making the viewable

area larger. And it's free. It's built right into the

operating system. That goes back as far as Windows '95 and

'98. Very, very quick and easy feature.

The built-in magnifier in Windows 7, the latest

operating system, is the best one that Microsoft has made

so far. It's superior to Vista and definitely superior to

the little thin bar that Windows XP used.

And the nice thing about Vista and Windows 7 is, if

you press and release the "Windows" key, which is between

the "Control" and "Alt," you get an "Edit" box. You can

simply type "Magnifier" in that box, hit "Enter," and it

will pull up the magnifier.

By the way, that same search edit box works for any

program you want to open up, whether it's Word or Internet

Explorer or Excel.

There is a built-in screen reader in Windows called

Narrater. And it's better than nothing, but it still has a

long way to go. The speech output is very choppy and still

very robotic. And it really doesn't allow a person full

access to the Internet the way that some of the other

programs would.

Okay. And Macintosh, the operating system in the

Mac. Primarily they -- a lot of what I just said about the

Windows environment will also work with the Mac. Changing

the pointer size, decreasing the resolution.

And instead of the magnifier program, they have a

program called Zoom which does basically the same thing as

the magnifier in the Windows environment, and it does a

fairly good job as well.

The area that the Mac really excels in here is the

VoiceOver, which is the screen reader built into the Mac.

It's actually fairly robust, and people can actually get on

the Internet and surf the Internet relatively effectively

with VoiceOver.

It's not a quick and easy system to learn. It is

fairly sophisticated. But for individuals using it for

personal use or who want to save money and not buy a

full-blown screen reader, the VoiceOver does actually a

fairly good job.

There are a couple of downsides to it, obviously,

because it's free. It doesn't do a great job with things

like spreadsheets. So in the work environment, VoiceOver

itself would probably not be the best solution.

So screen-magnification solutions. There are a

number of screen-magnification programs out there. And

I've only listed four here, two of which are by far the

most popular ones: MAGic and ZoomText. And then we have

two that are a little less popular: WinZoom by Clarity and

iZoom by issist.

And I'm going to go through each one of these

individually, but I thought this would be a good time to

talk about LCD monitor arms before I launch into this

because the two can really complement each other.

For a lot of people, their optical focal distance

is fairly close. So very often the people I evaluate,

their optimal focal distance can be a foot or less.

So we're talking about a lot of people who've

probably spent significant time crouching over a screen to

increase that optimal focal distance.

That causes a lot of problems. It causes a lot of

neck and back strain, a lot of fatigue. So very often an

LCD monitor arm can really solve that problem.

And if a person's reading a piece of paper at six

inches away, that's the same distance that the monitor

should be located away from their face.

Very often -- and I've done this myself for years,

is I would try to get as far away from the screen as

possible and still strain just so I could see the words on

the computer. That causes a lot of unnecessary visual

strain.

So with an LCD monitor arm, if a person can pull in

that monitor to the optimal focal point that's best for

them, that also reduces the visual strain.

And it also could have a secondary benefit. If a

person's already using a large-print software program, it

may help to reduce the level magnification they're using.

So the importance of this is, if a person is using a

program -- a large-print program at four times

magnification, they're only seeing 1/16th of the screen.

At three times magnification, they're already able to see

1/9th of the screen.

So even if it's reduced by one level of

magnification, that can also increase productivity and

effectiveness with using a computer.

So there are a number of different LCD monitor arms

out there. This wasn't so much an option even 5 or

10 years ago because LCD monitors weren't as popular. But

because they're so very light these days, very often less

than 15 pounds, the hardware needed to support these are

very much readily available.

The one example I gave was Office Depot. I use an

LCD monitor arm at work, and it cost less than a hundred

dollars. Very low-cost solution.

There's higher end ones. For example, Access

Ingenuity carries one that I actually use at home that with

shipping and handling is about $300.

The advantage to this is the higher-end monitor

arms can carry a heavier monitor, a larger monitor. But it

can also be simply weight bearing where you can literally

move the monitor with one finger.

So it depends on what your needs are. It depends

on what your budget is or what your employer's budget is.

But there's a wide range of options when it comes to LCD

monitor arms.

So in the light of that, let's go back to

large-print magnification. And the most popular -- one of

the most popular large-print programs are MAGic -- is

MAGic, I should say, from Freedom Scientific.

Most large-print software programs have a few

features that are very important. A lot of them have extra

bells and whistles which they try to market it to people to

say that they're the best. But there are some essential

things that they do.

Number one is they obviously magnify, increase or

decrease the viewable area. Secondly, they are very good

at inverting the colors for the most part. So if a person

is glare sensitive and they're looking at black text on a

white background, maybe inverting the color to white text

on a black background will reduce that white glare that the

computer can often generate.

You can also modify the mouse pointer on most

large-print magnification programs. And the ones that I

have listed here you can also change the viewable area,

whether it's a little box, whether it's a portion of the

screen, or whether it's the entire screen that's being

magnified.

So with MAGic -- I thought it was important enough

to put the price tag on these because that's often a factor

of whether a person is able to afford these or not.

So MAGic professional is $495 with speech. And so

a lot of these do come with speech. And I want to qualify

this by saying that, just because it comes with speech,

doesn't mean that it's as good as a screen reader such as

JAWS or Window-Eyes.

The speech is secondary, and it's not nearly as

robust as the software programs like JAWS or Window-Eyes

that are specifically designed to read various portions of

the screen.

So MAGic Professional with speech is $495. It's

$200 cheaper without speech. And then MAGic standard is

$445 and $245 without speech. So MAGic professional, the

different versions of Vista and Windows will dictate

whether you would need professional or standard.

If you have a home edition of Vista or Windows 7,

the standard version of MAGic will suffice. If you have

Windows 7 Professional or Vista Professional, the MAGic

Professional would need to be purchased.

These also come with a 40-minute demo. So they'll

run for 40 minutes, and you can restart the computer and

run it for another 40 minutes.

And there is a USB option with MAGic. It's a

little more complex than some of the other ones because

they don't actually -- they give you the directions on how

to load the USB device, but it's not nearly as intuitive as

ZoomText, which I'm going to be getting into in a little

while.

And I also left the websites -- if you wanted to

download the demo and try it, it's at

www.freedomscientific.com.

I'm just looking at my time here. Okay.

So ZoomText is the next program that's very, very

popular. ZoomText tends to be more often used in the

school systems. And I know the Veteran's Affairs

individuals who are our vets often use ZoomText.

So a lot of these are comparable in price. Speech

with ZoomText is $595. Without the speech is $200 less

expensive. ZoomText USB drive is $695 with speech and $200

less without speech.

ZoomText USB drive is actually much more intuitive

and easier to use than trying to use MAGic with USB. So

you can literally plug it into any computer and pull up

ZoomText and then just pull the USB drive out as needed.

They also sell a lighter version of ZoomText called

ZoomText Express. It's only $50. This only goes up to two

times magnification though. And from what I've seen, most

people with enough knowledge can usually get that level of

magnification with changing the operating system

configurations like I talked about earlier.

And my e-mail is on this webinar PowerPoint. So if

you do want to -- if you do need more information on that,

just feel free to e-mail me, and I can give you more

information.

So ZoomText is distributed by ai squared. And the

website is www.aisquared.com.

One other thing that I wanted to mention quickly

about ZoomText. It has what they -- one of the things they

boast about is their X font, which means that there's a

much less frequency of pixelation. And by pixelation I

mean that the rigid little boxy sort of formation when you

blow up the screen, there's a pixelation that takes place.

There's actually a smoothing feature that the X

font provides which is superior to MAGic. However, it's

questionable for some people if that's even a necessity

because, for people who are low vision, very often that

pixelation is of minimal importance.

For some individuals it is more important. For

example, a coworker of mine switched from ZoomText to

MAGic, and she noticed it the first two weeks. But after

that, it didn't even occur to her. I mean it was

noticeable but not significant enough that it deterred her

from doing anything.

WinZoom. So we're getting to the less expensive

screen-magnification programs. And WinZoom is $399. I

know that doesn't sound that much less expensive, but it is

a little less expensive. And they have a 30-day demo if

you're wanting to try it.

In my opinion, it's not in the same category as

MAGic or ZoomText. The level of contrast with the

interface that's used with WinZoom is not as effective.

And the reader that comes with it, the screen reader, is

much more robotic is much less human sounding than MAGic or

ZoomText.

And you can also get it -- I'm sorry. The USB --

sorry. The WinZoom USB screen magnifier is $399, and that

actually works fairly effectively. So just like ZoomText,

you can plug it into any computer and start using it. And

then the software itself, which is installed onto the

computer, is $299.

I think I have these numbers mixed up, and I

apologize. The WinZoom screen magnifier and reader is $495

and then without speech is $299.

They have a version called WinZoom Light, and it

only magnifies up to four times magnification for $60. But

very often that may be all that a person needs. And the

company that produces this is Clarity. And their

website to get this download is actually very creative:

www.getWinZoom.com.

How are we doing on time here? All right.

So the next one is iZoom, and it's very similar to

WinZoom. It has similar features. It has a USB thumb

drive as well. And that goes for $459. And again, this is

a 30-day demo.

And there's a standard iZoom with magnifier and

speech as well for $299. Again, the speech output is a

little bit robotic and not as human sounding as MAGic or

ZoomText.

Now, there is -- this is unique. They do offer a

monthly subscription to iZoom, and it's $19.95 a month for

the subscription. And there is something that they boast

about with iZoom, and it's a feature that tells a person

whether they're sitting too close to the screen or not.

This is one of those extra bells and whistles that

may appear at first blush to be useful but not so much

because a lot of people with low vision are going to get

closer to that screen, and there's going to be a learning

curve as far as how close they can get to that screen and

what can they effectively do at the current level of

magnification.

Also, if they get one of those LCD monitor arms,

they're going to be too close to that screen, according to

this application.

But this is distributed by a company called issist.

And the website is www.issist1.com. And they also have a

demo, free demo, you can download and try.

Okay. Now we get into screen-reading solutions.

So one of the things that I personally find when I do an

evaluation is -- one of the very, very important questions

I need to answer for myself when recommending training or

any sort of assistive technology is: Is the person going

to be using a screen reader? Are they going to be using

large-print magnification? Or are they going to be using a

combination of the two?

The answer to this question, there's a number of

factors. It depends on their prognosis. It depends on

visual fatigue. Sometimes it depends on the person's

personal preference.

A lot of the people we work with, they've spent the

majority of their life learning visually; and to deny them

of that is not our job to do, but our job is also to try to

educate individuals as to the best modality that they may

work in in a work situation.

And I'll give you an example of this. If a person

wants to simply print out a document and they're using a

mouse pointer -- and I'll go back to -- we teach in Office

2007, but I'll give you a simple example of Office 2003 or

previous.

You'd go to "File" menu, you click on "Print."

Then you click on "Okay." It's a whole lot easier to press

"Control" plus "P" and press "Enter."

So that's just a simple example. But learning the

shortcut keys and accessing a computer that way versus

trying to do it visually with the mouse is much less

visually fatiguing and also can be much faster.

So that's what we try to incorporate, is what's the

most effective method of carrying out effective tasks.

We want to ensure their success in an employment

situation. So this is a pretty important piece for us to

assess.

And I'll mention this about JAWS, which is a

screen-reader program that I'm going to be talking about.

JAWS and MAGic are produced by the same company, Freedom

Scientific. And they work very well together.

And so if a person has a degenerative eye condition

such as retinitis pigmentosa, or they're having further

vision loss due to diabetic retinopathy or other eye

conditions, the combination of JAWS and MAGic can be very

powerful because it allows the person to incorporate a lot

of the same key strokes, whether they're using JAWS or

MAGic.

So there's not a large transition from one program

to another as there would be with other screen-reading

programs, large-print programs.

So the four common screen readers that I'm going to

talk about today -- and not the only ones, definitely --

but some of the more common ones are JAWS, which I've

already talked about. That stands for Job Access With

Speech. Window-Eyes by GW Micro. SystemAccess by Serotek.

And NVDA by NV Access.

So I've been told I have 20 minutes, so I'm going

to try and move this along.

JAWS. It is an expensive program. For JAWS

Professional -- and once again, this is if you were using

Windows Vista or Windows 7 -- it's over $1,000. It's

$1,095.

And this is very important. If you have a 32- or

64-bit computer, it's very important to indicate that

before ordering the version of JAWS that you'll be needing.

And then there's JAWS Standard, which again works

with home premium Windows -- Windows Vista Home Premium and

Windows Vista Home Basic and Windows 7.

So depending on the computer you'll be using, that

will be very important to determine. And this again is

distributed by freedomscientific.com.

One thing I do like about their demo is, again, you

can download this and use it for 40 minutes, 4-0 minutes.

You can restart your computer and use it again for

40 minutes. And I believe you can do that up to ten times.

It used to be indefinitely, but I believe they've

discontinued that.

And the next very common screen-reading program is

called Window-Eyes. And it's a little less expensive.

It's $895. It's not as popular as JAWS is.

And it's worth mentioning, too, that very often

with a lot of these screen-reading programs, they work well

in more of the common applications like the Office suite.

But if you're dealing with proprietary software on

the work site, it's necessary to have some scripting done,

which means that a program like JAWS or Window-Eyes would

need to be scripted in order to read specific portions of

the software that's being used and to work seamlessly with

that.

Microsoft has actually worked fairly closely with a

lot of the assistive technology companies, but not all

companies do, and not all companies feel like they can

afford that, the smaller companies.

So if it's a proprietary software program, very

often it needs to be scripted. And as far as script

writers go, JAWS is a much more popular program to be

scripted than some of the other ones.

Now, they do have a 60-day evaluation, which is

$39. So you actually can't try this for free,

unfortunately. But their website is www.gwmicro.com.

Now, SystemAccess by Serotek, this is worth

mentioning because this is actually a free screen reader,

and it's only free to people who have an Internet

connection, a high-speed Internet connection.

I've had clients I've worked with who have been in

their college or university or library system where a

screen reader wasn't available at the time, and they could

simply have someone open up the Internet Explorer or Web

browser and, in the address bar, type satogo.com, hit

"Enter," and it actually is a web-based screen reader that

will actually start reading the screen at that point.

It's not nearly as robust as some of the other

screen readers like JAWS or Window-Eyes. But I've known

people who, in a pinch, this allowed them to access the

Internet and gather information that they needed at that

time.

There is a downside to the free version, and there

always is. The downside is that the voice quality of the

default screen reader is not great. With any screen

reader, the more exposure a person has to it, the better

they'll be able to understand it.

Just like a heavy foreign accent. It may sound a

little odd at first, but the more a person uses it, the

much better they will be understanding the speech output.

So that was a free version. They also have the

SystemAccess standalone for $399, which means that you

don't need Internet access. And it actually resides on

your hard drive.

And then they also provide the USB or the thumb

drive version which you can plug in to any computer and

carry with you for $499. And the company to that is

Serotek.com.

The last screen reader I'm going to talk about is

called NVDA, and this is open source, which means that

there's no one individual that controls the source code for

it. Other people can improve this product.

But there's also -- I've heard recently there's

some funding issues for this to continue as a development

and to continue to provide this as a free service. But for

now it is another screen reader option.

And I know Georgia Tech right now, their

sonification lab, they're actually doing some work in

Africa with some blind schools, and they're actually using

this program out there as an option. And the website is

www.nvaccess.org.

Okay. Now we get to scanning solutions. And why

are scanning solutions important to people with visual

impairments?

Well, we do live in an electronic age. But it's

interesting, even this morning when I arrived here, Martha

Rust was busy sending a fax to someone. And for a sighted

person, that fax would not be -- for a visually impaired or

blind person, that fax would not be accessible.

So for a person to scan that in and have it

translate through the optical character recognition, OCR,

technology, that text on that fax can be scanned into

speech output that a program such as JAWS or Window-Eyes

could actually read to a person.

So in a work site, there's very often hard-copy

material that is not in electronic format that a person can

scan in.

Keep in mind at this point the technology is not

good enough that it will interpret handwriting. But any

computer-generated text it will do a fairly good job with.

So I've listed three text-to-speech programs for

scanning solutions that can be installed on a desktop or

laptop: Kurzweil, OpenBook, and Text Cloner Pro.

Kurzweil and OpenBook are two of the more common

ones, and they're actually fairly inexpensive. Kurzweil is

almost $1,000. It's $995. So with a program like this,

you wouldn't need a screen reader. Kurzweil has its own

screen reader built in.

And with an off-the-shelf scanner and with a

computer that's generally five years old or newer, you

could load Kurzweil and have no problem with scanning in a

document and having it read to you.

OpenBook does the same thing, and it's the exact

same price. These two have been fierce competitors for

years. $995. And they essentially do the same thing.

They'll scan in printed material and provide you with audio

output.

Now, there's a much less expensive solution here.

If a person already has a screen reader such as JAWS or

Window-Eyes, there's a program called Text Cloner Pro. And

this is only one of them. It does the same thing that

Kurzweil and OpenBook do, except it utilizes the screen

reader that's already available on the computer.

So if a person has JAWS, a program like Text Cloner

Pro can do essentially the same thing that Kurzweil or

OpenBook can do.

One of the reasons why Kurzweil and OpenBook are so

expensive is because they come with their own screen

reader, whereas Text Cloner Pro assumes that you already

have a screen reader available. And the website to Text

Cloner Pro is www.readingmadeez.com.

I definitely want to get into some of these apps

for the iPhone. So let's talk a little bit about these

standalone scanning solutions. These are fairly expensive

solutions.

And by standalone scanning solutions, it's

essentially a computer that works almost exclusively for

the purpose of scanning in printed material and providing

audio output. So it's not necessarily designed to

interface with a desktop or laptop computer.

And I'll just go through these quickly. There's

Sara by Kurzweil, is one of the more popular ones. It's

almost $1,000, $995. There's ScannaR, and this is by

Freedom Scientific, and that's $995. And there's the

eClipse Scanner-Reader, and that ones goes for almost

$2,000.

So they're fairly expensive solutions. And unless

there are other extenuating circumstances, the standalone

scanners really only serve the purpose of a person that's

not using a computer. Because to purchase an off-the-shelf

scanner and to purchase a program like Text Cloner Pro will

essentially do the same thing as these standalone scanners

do.

Portable scanning solutions. So these are -- for

the sake of time, there's all Eye-Pal Vision, which is a

standalone scanner for $1,275.

But I'm going to talk about a couple of portable

scanning solutions here. The Zoom-Ex. So this actually

would be a solution for someone in a school environment,

college environment possibly, who needs to bring a portable

scanner with them to hook up to their laptop.

If, for example, a professor hands out some

hardcopy material or there's flyers that need to be scanned

in, a solution like Zoom-Ex can actually be a solution for

that, and it's $1,775.

There's another one here called Zoom-Twix. And it

essentially has the same features as Zoom-Ex except it

comes with two cameras. So in a college or school

environment, the second camera can actually be used as a

video magnifier as well.

So if a person is trying to look at a PowerPoint

presentation at the front of to class, they can use that

second camera and actually blow up the screen or the

viewable area on their monitor, on their laptop. But it

also provides the scanning options as well. And that one

is $2,895.

I will mention some of these solutions are

available in the visibility store at CDI. So if you have

any questions or you want some more hands-on on some of

these solutions, it may be well worth it to check out the

visibility store at CDI.

So I'm going to talk a little bit about the

accessible iPhone apps that are available. And before I do

that though, I'm going to talk about the accessibility

built right into the iPhone itself.

It also has a speech output software program called

VoiceOver, which is the same name that the Mac has in it.

And it's actually very accessible. Out of the box it's by

far the most accessible cell phone or smart phone

available.

So VoiceOver actually does a fairly good job with

many of the apps that you can download. And there's also a

program that increases the viewable area called Zoom, which

I actually use on a fairly consistent basis.

So with the simple tapping of three fingers, tap

twice, depending on how the settings are in the

accessibility features, I can actually bring up the Zoom

feature very quickly.

The downside is that you can't run VoiceOver and

Zoom at the same time. So you can't have magnification and

speech output at the same time with the iPhone.

That sounds like a huge disadvantage, but it's

actually really not because there's a way that I can very

quickly load one accessible program such as VoiceOver,

close it very quickly, and load Zoom without even looking

at any of the features. It's a very simple fix.

And for anyone that wants more details on that,

feel free to e-mail me, and I can break that down for you

further.

But keep in mind the iPhone 4 has some features

that the iPhone 3 doesn't. For example, the camera is

better quality. And also the LED light on the iPhone 4

works very differently from the iPhone 3. So that's a

significant difference.

Don't assume that, just because you have an

iPhone 3, it's going to work with all of these

applications.

Okay. So the next page gives a general overview of

accessibility. And I'll read this really quickly.

"Accessibility features available on iPhone 3 GS

and later are designed to make it easier for users with

visual, auditory, or other physical disabilities to use

iPhone. These include VoiceOver, Zoom, White on Black" --

so again you've got the high contrast just like the

screen-magnification programs use -- "Mono Audio, Speak

Auto-text."

And let's go to the next feature here.

Now, when you open these up under the "Settings"

options on the iPhone, it actually tells you how you can

access these more quickly.

For example, if you go under "Settings" and you go

to "General" and then you go to accessibility, under Zoom

it actually tells you: double tap with three fingers to

load it; move around the screen by dragging the three

fingers; and changing the zoom by double tapping three

fingers and dragging them up or down will increase or

decrease the zoom level.

And then I just had the accessibility -- the next

shot is the accessibility options blown up a little larger.

All right. Now getting into some of the accessible

apps on the iPhone.

The Navigon. A very powerful GPS program used for

navigation. It does some things very, very well. And the

price can range, but typically it's $45 or less. I've seen

it bounce around a little bit. I've seen it as low as $25,

but generally you'll find it for $35 to $45.

It has its own speech output. Just like you think

of a GPS that a person is using in their car -- it speaks

to them -- Navigon has that, but it also works quite well

with VoiceOver. So if you need additional speech output to

get into various menus on it, you can use VoiceOver as

well.

And it doesn't conflict. I've never had Navigon

crash on me because I've had VoiceOver running or because

I've had the Zoom feature on it -- Zoom feature built into

the iPhone running. And it's available as a download from

the iTunes store.

It does have one disadvantage, and this can be a

significant disadvantage, but there's a solution to it. If

you have a destination from point A to point B, and you

have three intersections between those two points, it's not

going to read to you every intersection you cross, whereas

some GPS solutions do.

And some of these GPS solutions can be very

expensive. You're looking at anywhere from $300 upwards of

$700 or $800 for some of them.

So that's what it doesn't do well. But as far as

its GPS accuracy, it's very high actually. I don't

understand all the mechanics of it, but it actually uses a

cell phone signal as well as a GPS signal as well.

So there's a triangulation of using the GPS and a

cell phone signal that allows for a higher level of

accuracy. So it's actually much more accurate than some of

the other GPS solutions that are geared for people who are

low vision or blind.

And the next page I just have an image of what the

Navigon GPS looks like.

Okay. Martha is saying that -- I think it was a

larger file. So it just took a little longer to download.

Okay. And Martha is telling me it's 3 o'clock now.

So can I just discuss one more app here?

This is a very important one, I think. This is

called the Lookaround. And let's go to that and see if

Martha has it up here. It's actually loading.

It's called Lookaround by Sendero GPS. This is a

very powerful app, and it's only $4.99. Now, with this

app, it does tell you the nearest intersection. And you

literally -- the way it's designed, you literally just have

to shake your iPhone.

You don't even need to put anything in as far as

input. You just literally shake it, and within 30 seconds

to a minute, it will read to you the next intersection that

you're at.

It can also do things like search for the nearest

five points of interest. And you can specify the points of

interest, whether it's a bank, a restaurant, a convenience

store. You name it. It has all kinds of different

options.

Okay. So there's a question: "Does Navigon tell

you the names of the streets you're going to need, or does

it just tell you the distance?"

Navigon has a lot of options to it. One of the

options is pedestrian mode with speech output. And in

pedestrian mode, what it will do is it will tell you that

you're .1 miles from your destination -- or sorry -- the

intersection that you need to turn at; it will do that at

300 feet; and then when you actually reach that

intersection you need to turn at, it will announce that as

well.

So it tells you very specifically whether you need

to turn left or right long before you get there. And it

does it in three intervals. Like I said, .1 miles, 300

feet, and then right when you're at the intersection.

It also does another thing. It tells you whether

the destination is on your left or right, which is very

helpful.

Now, that's a good question with Navigon. Because

what I said was Navigon doesn't tell you the intersections

you're crossing. If you have a route that's a mile long,

and you have three or four intersections you're crossing, a

program like Lookaround does.

So you could close Navigon temporarily, open up

Lookaround; and with a $5 app, you could find out your

nearest intersection at any point.

Okay. And there are some other apps I was going to

discuss, but I think we're pretty much out of time here.

Did we have time for any other questions?

Okay. I'm going to pass this on to Martha Rust.

And thank you very much for your attendance here.

MARTHA RUST: Thank you, guys, so much for joining

us this afternoon. We did run out of time, but we had so

much great information, especially when it comes to apps.

So I just want to put a tickler out there that we

will be creating a webinar this June on apps, just all

types of different apps for the iPhone, the iTouch, and the

iPad. So please stay tuned for that.

Again, the slides that we did not get to will be

posted on our website, GATFL.org.

And, Liz, if you're still on, I want to ask you to

go ahead and, in our public-chat box, if you wouldn't mind

putting the survey link up on again.

And I'm going to release the mic if there's any

questions.