Glaucoma patient regains independence
Low-vision rehab and AI technology offer tools to help
Four years ago, Donshae Hillary nearly lost hope that she’d ever regain her independence.
The Houston native has been beset by vision problems since she was 12 years old. Glaucoma damaged her left eye to the point where it needed to be removed in the fall of 2018, while Hillary was serving time in prison.
Doctors hoped that removing Hillary’s left eye would stop the glaucoma from spreading, so she was despondent when she began to experience blurred vision in her right eye just six months later.
“I felt hopeless,” she said. “They were doing all this to my eyes, but nothing was getting better.”
But Hillary, who is now 26, began to find hope after being released from prison last year. The Texas Workforce Commission referred her to the Cizik Eye Clinic at UTHealth Houston, where Dr. Bhavani Iyer recommended the OrCam MyEye, a device that uses artificial intelligence to help her read and recognize her surroundings. She also worked with an occupational therapist who is teaching her to live with low vision and go shopping, read her mail and navigate at home, among other things.
She’s now enrolled at Houston Community College’s Northeast Campus, where she plans to pursue a career as an orientation and mobility specialist, helping others who are blind or have low vision. She’s looking forward to finding a new place to live and a job. She’s also pregnant and expecting a child in the spring.
“It was a life-changing experience because my independence shrunk a lot. I had to learn to depend on people,” she said. “But since I’ve been home, I’ve gained my independence back.”
February is Low Vision Awareness Month, and Hillary’s story is not unusual for those experiencing low vision, Iyer said. Any loss of vision that hinders someone’s ability to function can lead to depression,
she said.
“You don’t realize how much you depend on your vision until it goes away or even goes down to a certain extent,” she said.
There are many risk factors for glaucoma, but the most common is high pressure in the eye, Iyer said. That pressure can cause nerve cells to die out, leading to a loss of vision.
The most common type of glaucoma is hereditary, but it can also be caused by trauma or other eye conditions, Iyer said. It also occurs five times more often in African Americans.
Hillary began to experience blurry vision and floaters as a preteen, though she could still see well enough to drive until she was 18. She also developed cataracts and needed surgery to replace the lens of her left eye in late 2015.
Her vision continued to deteriorate after she was arrested for an armed robbery in late 2015 and sentenced to seven years in prison. Hillary — who said she experienced trauma throughout her childhood — now expresses remorse for what she calls a “very bad decision.”
“I molded myself and changed some things about me that were not good,” she said. “I wouldn’t say I was a bad person, but I displayed a lot of bad behaviors throughout my childhood.”
Hillary struggled to get the care she needed while she was
incarcerated. She wasn’t diagnosed with glaucoma until 2017. By that time, the pain in her left eye had become unbearable. She constantly experienced what felt like a throbbing migraine near her temple, and it hurt to look at a bright light.
In 2018 she suffered a stroke in her left eye, caused by a blockage in an artery that supplies blood to the retina. Doctors told her that her optic nerve was dead and that her left eye needed to be removed.
“I was very afraid, but at the same time, I just wanted the pain to stop … I was in excruciating pain,” Hillary said.
The glaucoma spread to her right eye, though. By the spring of 2019, she needed another surgery to help alleviate high pressure in that eye.
Hillary said she refused to let herself feel hopeless, though. After being released from prison in May 2022, she reached out to the Texas Workforce Commission to find a job. The agency referred her to Iyer to help her obtain the low-vision rehabilitation and equipment that could help her live independently.
At that time, Hillary had 20/250 vision in her right eye; 20/200 is considered legally blind. Her field of vision was reduced to a small “island” toward the bottom of her eye, and even that was blurry. She was having trouble reading and seeing faces, and she told Iyer that she was afraid she was going to walk into a men’s bathroom by accident in public.
Iyer performed a full workup to find the best solution for Hillary. At first she considered a bioptic telescope, which looks like a pair of glasses and can help someone see things at a distance. But Hillary’s vision was too blurry, and the magnification would have distorted what she was seeing even more, Iyer said.
She instead recommended the OrCam MyEye, a wearable artificial intelligence device that can help read, recognize a face or distinguish a color. Hillary can attach the device to a pair of glasses and point to something she wants to read or recognize. The device scans wherever she’s pointing. It then reads the text to her or helps her identify nearby people or objects.
The device will not improve Hillary’s vision, but it will help her with everyday tasks that most people take for granted, like reading the mail or shopping for groceries, Iyer said. The device is “a game changer” for people with low vision, she said.
“It’s not a panacea. It’s not going to fix every function,” Iyer said. “But just to give (her) that little bit of independence … it makes a huge difference.”
The TWC is waiting to find out what type of job Hillary gets before approving her for a device and helping to pay for it — it costs at least $3,500. Iyer doesn’t recommend patients buy it themselves. It needs to be set up in a specific way, and her clinic helps patients to do that.
Hillary continues to work with an occupational therapist, who is teaching her how to live with low vision. She’s also seeing a glaucoma specialist and an ophthalmologist who are working to prevent further vision loss, Iyer said.
For now, though, Hillary has a much better outlook on life than she did a few years ago. And her determination to regain her independence is inspiring, Iyer said.
“It just speaks volumes about how resilient she is,” she said. “And that’s the message. Not everything is fixable, but the hope kind of drives you along.”
Hillary hopes others who are living with low vision will be inspired to remain optimistic, too.
“Just because your vision is gone or you vision is low,” she said, “your hope is sill very much alive.”