Real People #3

This month's story comes from a fellow Stargardt-er from my city. We live on opposite sides of Sydney and as yet have not met in person, but thanks to social media we have been able to connect and be supports for each other.

Mike Lainis, 53, Sydney, Australia

When were you diagnosed with Stargardt's and how did it affect you at the time?

My Journey with Stargardts began 5 years ago in January 2010 When I was 48 years old.  After loads of testing including blood tests and chest x-rays for TB! I was sitting in the ophthalmologist surgery blurry eyed from the "drops” and the numerous flashes of light from the fluorecein angiograph procedure (they pump you with green fluorescence in your veins and take photos of your macula all at the same time). She finally turned to me and said you have a late onset of Stargardts! I thought yes I am seeing stars at the moment,  Ok...., so my next question was what are you going to do? Laser, medication or an operation? What ! No cure! Just avoid the sun and Vitamin A supplements and see you in a year’s time, cheers.....

Wow. Went home told my wife and family, we climbed on the net for hours researching. Nothing. No cure or procedure.  I thought surely in this day and age all diseases have some kind of cure, nope, not this one. For the first three years it was more of an irritation not been able to do things I had done countless times before. 

What do you do for work and has the condition impacted you?

Throughout my life I have worked in the construction industry. I ran my own cabinet making business, for 10 years, producing some fine solid wood furniture. I slowly moved up to be a project manager.  I worked in London for 6 years on upmarket residential apartments in Kensington and Kew Gardens. I worked in Brisbane for 5 years on the prestigious David Jones Queens Plaza and Chermside stores. I worked in Sydney for the last 5 years on Hugo Boss, Coach and Thomas Sabo stores to name a few things I have done. However now I work at my kid’s school on a casual basis doing maintenance work. A far cry from what I was doing but I am at peace with that. The school has been very supportive.

What would you say are the defining moments since being diagnosed?

Late 2013 I had a "near miss" whilst driving. Nearly took out a traffic officer. Silly man was standing in the middle of an intersection! The traffic lights had stopped working, and he was directing traffic. I was looking to the left for other cars coming out of the intersection and did not see him. He was in my "blind" area of vision. I had to screech the car to a stop right in front of him. He wasn't happy with me, had the finger waving. Realizing I could have killed him I decided my driving days were over.

Then after last December holidays, maybe after too much fun in the sun, my left eye, central vision finally all went. After a visit to the ophthalmologist he declared me "legally blind". A shock to the emotions as I thought I still had a few more years to go.

What would you tell someone who is struggling with a vision impairment?

Being positive is critical in coping with this condition.

When I was at school I was involved in Scouting. Achieved the highest award (Chief Scout Award) and went on a Jamboree to America. After school I went into the army for a couple of years. In later years I was a river guide and then also lead an expedition to an Malawian Gamepark whilst been a member of the Royal Geographical Society in London.

During this time I was taught survival techniques and even ran a few courses myself. The greatest life lesson I learnt was, when you get lost in the bush or end up in a life or death situation, it is “the will to survive”. You can have all the training on how to light a fire or how to find water and food but if you give up mentally you die. The same with this condition, you can't let it take over. You need to fight it each day, develop new skills and ways of doing things. Accept the situation, you can’t change the fact you are going or are blind, and then move on with your life.

Lastly my faith in God has increased dramatically over the last few years.  God gives me the strength when I am feeling weak. My favourite scripture now is “I walk by faith not by sight" 2 Corinthians 5 vs 7. Whilst I believe Jesus is able and is willing, for us to be all healed of all diseases, I believe it is all in God's timing. There is a purpose and process to this condition in my life right now, to teach me perseverance and strength of character. 

My hope and prayer is that God will give someone the insight and wisdom to find a cure not only for one person but for all who have this condition. Hopefully one day I can be part of that process.

Thanks Mike for sharing!

How a person reads with limited central vision

I had a thought whilst lying in bed wide awake. I want others to get a sense of what it's like to live with Stargardt's. It's really hard to explain what it is like to lose something that you take for granted and use every second of the day. Then I thought to a chain email that circulated a long time ago, some of you might remember - a passage of a story was sent except the middle letters of the word were jumbled. Once you got to the end of the passage, it said that you had just read the whole story essentially spelled incorrectly, but you were able to read it.

This demonstrates how I read - my blind spot covers the middle of words, so I see the start of the word, possibly the end, and it's all a jumble. Yet I can still read it (it still needs to be in a larger font).

I've put together an example for you, have a go at reading this (beware I threw some tricky words in!):

• Sagdtrart's Dasisee is a tpye of macualr degaeentiorn. It afefcts ynoug polepe, lkie me, and cehagns our levis frveoer. Tnihk aubot tihs, jsut as you are gitnteg uesd to lnviig yuor lfie, fgrniiug out yuor dermas and anirtapsois, tehn rnmldoay you ncoite sthniemog a liltte off in yuor viosin. The nxet tnhig you konw you're bneig tlod you hvae an ibunclrae dsasiee and wlil lsoe yuor shigt.

And just in case you got stuck, here it is written properly:

• Stargardt's Disease is a type of macular degeneration. It affects young people, like me, and changes our lives forever. Think about this, just as you are getting used to living your life, figuring out your dreams and aspirations, then randomly you notice something a little off in your vision. The next thing you know you're being told you have an incurable disease and will lose your sight.

Imagine reading like that all the time, it does get tiring. It's as though the brain has adapted to read in a different way. The image below is of a meme that was circulated and a response was written by the Cognition and Brain Sciences Unit in Cambridge, UK, which you can read here. They explain some of the reasons behind how we are capable of reading words with jumbled letters, although we apparently read 11% slower. This makes sense as I have noticed it takes me longer to read. 

I'd be really interested for those who aren't vision impaired to share their experience reading this. I hope this gives a little more understanding into how myself and others with SD read.

Update on Stem Cell Treatment

If you haven't already heard, results from the phase I trial using human embryonic stem cells for patients with Stargardt's Disease and Macular Degeneration have been published in the Lancet, and the results are very promising!

Nine patients were treated from each disease which involved surgical implantation of the stem cells into the retina of one affected eye. The main aim of phase I trials is to test the safety of the intervention, so whether there were an adverse events or complications from having the stem cells implanted, and in this case whether the stem cells 'stuck' to the eye. The investigators also looked at whether there was any improvement in vision.

Excitingly, the results were very promising - there was no major adverse events (although some patients with Stargardt's developed cataracts but this was treated surgically and didn't affect vision after treatment), no rejection of the implanted cells, no abnormal tumour growth and it looked as though the cells remained functioning at follow-up (which was up to two years after initial implantation). To top it off, there was also objectively reported improvement in vision in the treated eye!

To put it in perspective, this is still early days and we won't be running out to get stem cells injected tomorrow. Although it is definitely looking like a very possible treatment in the future and in our lifetime! The next step is to proceed to a phase II trial which will include a larger number of patients and find the best dose (number of cells to be injected) to gain the best results. Further evidence of the effectiveness will be developed to show how much vision can be restored, if it is permanent, whether the implantation needs to be done in the early stages of the disease and many other questions.

This is extremely exciting and shows how amazing modern medical science can be. It can give us all a little more hope that potentially in the future we may be able to see better, and if not us, the generations to come who will unluckily have to experience the hurdles we have faced. 

For more information here are the links to the results and news reports:

Wall Street Journal

The Lancet

The things you don't get told!

Over the past few years I've learnt so much more about what is actually involved in being vision impaired. When I was diagnosed, I was not told much except I will progressively lose my central vision. I was not warned of any of the other aspects I might experience. Here's a list of things I've learnt and what I do to help. Please share any other tips!

1. Eye pain: Typically I experience eye pain after a day at work or a solid studying session (usually after about one hour). I'm assuming it is related to the strain I put on my eyes to try and see everything as best I can! I experience this daily and it gets VERY frustrating.
What helps: Before reaching for my Panadols (paracentamol) I first try and rest my eyes. Since I always have to be doing something I will either close my eyes and meditate or have a nap. Obviously I can't just lay on the floor for a nap at work (I have tried!) so in worst case scenarios I go for pain killers. I also have found an eye drop that has helped with the burning and heat (Systane Ultra) and you can use this as much as needed. I usually use this after being on the computer. 

2. Headaches/Migraines: This is something I've struggled with for a few years. Generally I get a migraine on my left side which is the weaker eye. Migraines can be extremely debilitating as not only is the pain intense it can cause nausea and further sensitivity to light. I've learnt my triggers for an attack, including sun glare and overworked eyes, so I try to intervene as soon as I feel it starting to take over. Sometimes the attacks are so severe I have to take time off work. At the moment I get about one a month which has reduced. 
What helps: If I am having an attack, I sit (or sleep!) in a dark room and usually wrap a scarf around my head (the pressure helps the pain). Generally I don't find over the counter pain killers effective and I avoid taking anything stronger. My migraines have improved since changing other medications I was on so it's best to talk to your doctor too. Someone also told me to put a drop of lavender oil on each temple and I find this relaxing. To prevent an attack, I'll avoid spending too much time outdoors on a day with high glare and always wear sunglasses outside, which is a given for Stargardt's. And drink loads of water!

3. Sensitivity to light: Some days are ridiculously hard to be outdoors and even inside with the curtains open. Not only does it lead to headaches and migraines, I find it harder to focus and see. I'm guessing this is because the peripheral vision uses light perception to form vision, and since that is what I rely on to see, I am extra sensitive to it. 
What helps: If outdoors always sunglasses! Otherwise unfortunately it's a day where instead of being outside I put on a movie and stay inside!

4. Neck/back pain: I'm surprised my neck is still attached to my body after all the bending it does to read! I'm constantly leaning closer to the computer screen, iPad or whatever is I want to see! This is another constant pain. 
What helps: Making sure that the desk you are working off is set up well, with an arm for the screen. Also any adaptive technology to make the font bigger to eliminate the need to lean. I've also found that getting a remedial massage once a month to be a great help (and I enjoy massages). Massage also helps with the migraines/headaches. 

5. Anxiety/Depression: This is a HUGE part of diagnosis that is not addressed. It is understandable that when you are told that you are losing your vision, feelings of anxiety and/or depression develop. It is a hard thing to deal with. The most important thing to remember is you are not alone in this!
What helps: Talking about how you feel and what you are going through can help a huge deal, if it means talking to friends or family or speaking to a therapist. There's lots of strategies to deal with anxiety and depression and it's not something to be ashamed of. I for one battle anxiety a great deal. As I've mentioned in a previous post the grieving process ties in with these feelings. Also try mindfulness meditation, I have found it really helpful and it's also a time where I can rest my eyes. 

Our experiences are similar but also unique. The best thing we can do is talk about them and help one another. Sometimes simply knowing somebody else is experiencing the same pain or emotions can make you feel a little better. 

Sore Eyes

I have been having problems recently with constant sore eyes and migraines. It's really starting to get on my nerves because I can't be outside in the sun or even in bright rooms. The only thing that seems to work is to lay down in the dark and close my eyes, which is very unproductive.

I find I constantly strain my eyes and the only way for me not to do this is to pretty much do nothing. Which is not going to happen.

So I've taken to wearing sunglasses in the house to try and minimise my light exposure. Right now I'm wearing sunglasses in my dark room on the computer (I must look pretty strange), but let me tell you it's helping! Bright light is really painful. Maybe I'm related to Edward Cullen?

As for the constant headaches and eye strain when I don't have a choice but to keep doing what I'm doing - I have yet to fins a solution. I will though!

Until then I will wear sunglasses indoors, and if somebody is boring me I can close my eyes and doze off and they won't even notice!

The London Project

I have been told by several people to check out 'The London Project' as they are making strong progress in finding treatment for blindness. The organisation aims to cure blindness through stem cells, and with what I have learnt to date about Stargardt's, this seems to be the future in our treatment. Their main focus is on macular degeneration, but this could definitely lead to treatment for Stargardt's, as they are focusing on finding a way to replace the damaged RPE cells of the eye. 


The London Project has finished the safety phases of its trials and will proceed to human clinical trials in 2012, which is very exciting news. Like Advanced Cell in the US, The London Project uses embryonic stem cells and hopefully success is in the near future.


The organization is currently asking for donations to make the next phase of trials happen. Anybody wishing to donate can do so on the link below.


The London Project

Goggle Vision

As we welcome a new year, we all hope that 2011 will bring a breakthrough for Stargardt's patients! Finger's are crossed!

I have been doing a social experiment over the last couple of months. My mum brought home from work goggles from Vision Australia that a person can put on to see what it looks like to have different eye conditions. Specifically interesting to us were the macular degeneration goggles. Igot friends and family to try on these glasses to see how they react to seeing through the eyes of a person with a macular problem, such as Stargardt's. Their responses were quite interesting:

"I'm never getting in a car with you again!"

"I can't see anything!!"

"There's a big white blob in the middle?! Is that right?"

Everybody was shocked. My eyes are not currently at this stage, but it was interesting to see how people reacted to having their vision impaired. It helped those around me to understand what I see and what I may be experiencing.

In response to my friend who remarked about my driving, I had to remind her I wear glasses for that reason and my eyes are not at that stage at this time! Yet other's can get the gist of what I mean when I say "I just can't see what's in the centre unless I look around it."

I feel that these goggles have been a useful tool and are great for helping others to understand my situation. It would be helpful if they were more widely available so our friends and family could understand our struggles even better!

Has anybody else had any similar experiences?