A visionary nurse seeks to improve care for the blind

SALISBURY — There are millions of Americans with serious vision problems, according to Gale S. Pollock.

And these people are not receiving the care they need.

Pollock, a retired major general in the U.S. Army Nurse Corps, is now the executive director at the Louis J. Fox Center for Vision Restoration at the University of Pittsburgh Medical Center.

She spoke to the Salisbury Visiting Nurse Association on Wednesday, Oct. 21, along with Louis J. Fox, a Salisbury resident with continuing and life-altering vision problems.

Fox donated $3 million to the center.

Pollock said that Americans in general are unaware of the prevalence of blindness.

“Look at the continuum of disabilities,� she said. “Where is vision? In the top 10 percent. But the average American has no clue.�

Seventy percent of persons when diagnosed with blindness become recluses, she said. And 80 percent of those people become depressed.

“This is a big danger. Many become suicidal.�

Pollock said that between 10 and 13 percent of combat injuries involve the eyes. Citing federal Department of Health and Human Services statistics, she said the 70 percent of people diagnosed as blind amounts to some 4.5 million people. And she thinks the actual number is even larger than that.

And just as the extent of the problem has been underestimated, the available treatment is outmoded.

“Insufficient attention has been paid to  mobility, independence and other  quality of life issues,â€� Pollock said.

“After World War II  we told them to learn Braille, which is fine as far as it goes, but only about 20 percent do so. It’s like learning a foreign language.

“So we send them to a mobility class, give them a little white stick. This is not helpful in unfamiliar surroundings. Or a seeing eye dog — if you can’t take care of yourself then how can you care for the dog?�

Pollock described blind Americans as being either engaged, reclusive or suicidal.

“When you see someone with a stick or a dog you think, he’s getting along. The reality is that the 70 percent are doing pretty crappy.�

“We don’t ask the right questions. For instance, can the spouse read the directions on the medication?

“It appalls me as a nurse when a doctor says, ‘I’m sorry, there’s nothing we can do.’ It takes away a person’s hope. No wonder they become recluses.

“But nurses have an edge. They talk to us, we listen to them.�

The Fox Center will function as a national clearinghouse for information and referrals. A Web site is scheduled for launch in December, and because the University of Pittsburgh “is tops in regenerative medicine,� the center is working on new technologies to help the blind.

Until recently, Pollock said, there has been little effort to restore sight using technology. But devices such as the BrainPort, which uses the tongue to transmit an electronic image to the brain that allows the patient to identify spaces and obstacles, are currently being tested.

Researchers have been successful with regenerative techniques, replacing finger tips and even performing arm transplants. Since many eye injuries are related to burns, researchers are trying to grow new tissue that can replace eyelids.

And, less exotically, efforts are underway to get insurers interested in preventive care for the blind.

“Corporate people didn’t think patient education was a part of clinical care,� said Pollock. “Currently they won’t pay for preventive measures but will pay when someone falls down the stairs.�

Pollock predicts an increase in the numbers of blind people. “Assume a third of the population is obese. Then assume half of them get diabetes, and half of them fail to act to control their diabetes and get diabetic retinopathy.

“It takes 15 years to go blind, so we’re looking at 6- to 8-year-olds now who will be blind in their 20s.

“What will we do with all these people? We have to get ahead of this.�

Pollock took over the Walter Reed Army Medical Center in Washington, D.C., in 2007, after a scandal involving poor care of Iraq and Afghanistan war veterans, so she is no stranger to daunting tasks.

“I learned a long time ago if you think something’s impossible you can’t do it,� she said cheerfully. “You have to have bodacious goals.

“I don’t really care how we do it, but our goal is to restore sight.�