The Newsletter of Retina New
Zealand Inc
A Member of Retina
International
Winter Newsletter August 2006
No. 30
1 From
the Editor
2 From the President’s Desk
3 Annual Report from the President
4 Glossary
5 The
6 Telephone Information Service
7 Research - Update on Vitamins and AMD Therapy
8 Coping - Eating at
Home and Dining Out
9 Kapiti VIPs
10 Book Review
11 Notices and Branch News
To promote public
awareness of retinal
Degenerative disorders
To provide
information and support
And to foster research leading
to treatment and
eventual cure
Editor
Susan Mellsopp
108B
Phone: 07 8533 612
Email: editor@retina.org.nz
Please note: Deadlines
for articles for the spring, summer and autumn issues are the 15th
October,
14th January
and 13th April respectively
To order:
EMAIL COPIES: contact the National Secretary
if you would like your newsletter emailed to you
TAPE COPIES: contact the National
Secretary if you require your
newsletter on cassette tape and advise if you also require a print copy.
National Secretary
Janet Palmer
Retina
Telephone: 04 299 1801
Fax: 04 472 9490
Email:
secretary@retina.org.nz
Peer
Support Coordinator
Elizabeth East
Telephone: 04 299 1801
Retina New Zealand Inc is grateful to the
Royal
1 From the Editor
The response to our survey has
been amazing, thank you to all those people who took the time to fill in the
survey questionnaire, it is very much appreciated. The results will be published in due course,
but as newsletter editor
I have included several of your requests in this newsletter. I am also looking forward to including your
ideas in future newsletters, I have enough for about 2 years! Several members pointed out that they did
not understand some of the terms we used in the questionnaire, so I have
included a glossary to explain some of the terms. This is something we often do when we understand a language
pertaining to a world we are comfortable with, but often fail to realize that
others are not au fait with the specialized language. Also, to those people who suggested some colour may be nice in the newsletter, this is not possible
as the PVI printer only prints in black and white.
Setting out and producing the
newsletter on my own computer is proving very valuable both in time, what can
be included, and using up the available
space on the pages. The final few days
before printing and taping can be very stressful if articles arrive on the
deadline. As a result I have moved the deadlines for articles to be included in
the newsletter to the middle of the month before,
therefore the deadline for the November newsletter is the 15th of October. The other new deadline dates are listed on
page 2.
My garden is looking a little
worse for the wear, and my lawn needs some attention also. I have pruned my
roses but strawberries need transplanting, and the
climbers a few extra ties to ensure they travel in the correct direction. I have been enjoying long walks in the
afternoon on the fine sunny days. I am trying to get both myself and Chocolat fit to take part in a 10km walk here in
This issue of the newsletter is
larger than normal. I have included Kaye Newton’s annual president’s report,
information about the Jerusalem Eye Hospital, an article on the telephone
information service, a research article on vitamins and AMD, and the coping section explores ways of
dealing with dining both at home and in a restaurant.
I am looking forward to meeting
some of you at the AGM/Conference in
Susan Mellsopp
Ph: 07 8533 612
Email: editor@retina.org.nz
2
From the President’s Desk
We are delighted to congratulate
June Ombler and Gordon Sanderson for receiving
recognition in the Queen’s Birthday Honours in
June. June Ombler
was the driving force behind what has become Retina NZ today and has been an
honorary life member since 1999. She has
held all the executive positions over the years, most recently as editor of our
newsletter. However, her award is
recognition for being a strong advocate for vision-impaired and blind people in
the community and for disabled people generally.
Gordon Sanderson has been on our
SMAB, Scientific and Medical Advisory Board, since its inception and it would
have been June who brought him into the Retina NZ fold.
His award is for services to people with vision impairment which he has
done over many years in many organizations including many years with the RNZFB
board. June will receive her Companion
of the Queen’s Service Order award on the 7th of September. Gordon receives his NZ Order of Merit award
on the 5th of September. Best wishes for
the presentation of these well deserved awards.
We have exciting news about a
fundraiser for Retina NZ. Yates sell
seed packets for the flower called Cosmos Bright Eyes. Retina NZ will receive 40 cents for every
packet sold in
We hope to see many of you from
the
Kaye Newton
Phone: 03 3795 807
Email:
president@retina.org.nz
Ecoglo
Ecoglo are
strips 590mm long which can be affixed to steps, stairs, handrails, paths and
decks. The strips can also be cut to length. They come with a non-slip mat which provides
additional safety. They glow brightly
all night having absorbed natural or artificial light during the day. They are easy to install with glue. On purchase the strips must be charged by
exposure to natural or artificial light.
To find out more phone 03 348 3781, 0800 232 645 or email
sales@ecoglo.com
3
Retina NZ Inc Annual Report
from the President to the Members: July 2006
I look back over the last twelve
months and take pride in some of our achievements. However, I am also conscious of areas where
we would like to do more, but we are hampered by our voluntary capacity.
The National Executive remained
the same as last year. We are fortunate
in the range of skills, experience and networks we have available to us.
My thanks go to our team of Janet
Palmer, Secretary; Kaye Clark, Policy Secretary; Fraser Alexander,
International Delegate; Camille Guy,
Vice-President; Elizabeth East, Peer Support Coordinator; Denise Keay, Wellington Branch Representative; Lynn Keogh, Dunedin
Branch Representative; and Susan Mellsopp, Newsletter
Editor. Without their support and effort
I could do little.
I would like to thank Petronella Spicer who has been sharing answering the peer
support 0800 phone line with Elizabeth East.
The service handled 420 calls in and out for the year to the end of June. Some of these calls can be quite
lengthy. It is a valuable core service
provided to all who use it and many (if not most) calls are not from existing
members.
Last year we had a successful
AGM/Conference in
After the conference we had a peer
support training session on the Sunday taken by Allen Little. The group was rather large, including the
national executive and branch delegates, so the Aucklanders
met again to have practical follow up sessions which were organized by Camille
Guy. Our new peer support manual was
launched which provides valuable information to the peer supporters and the
executive members.
Publications
In September we published the
detached retina pamphlet. This was
collated and handled by Kaye Clark.
Copies of these were distributed to all optometrists via their
newsletter mailout at no cost to us. Although this is not a common condition,
people do need to be aware of it, and the need to seek professional advice
without delay to save sight.
The newsletter is the core service
that reaches all members. Susan Mellsopp has taken over the whole production process, using
the printer of Parents of Vision Impaired in
Our Macular Degeneration booklet
is now out of print. We have been
photocopying copies to keep us going.
The RNZFB is producing a large print book on MD, so it seemed pointless
for us to update and reprint our book as well.
Scientific and Medical Advisory
Board (SMAB)
As always the SMAB network is in
the background ready to provide advice and comment on particular issues when
requested. Their professional expertise
covers a range from molecular genetics, psychiatry, optometry and
ophthalmology. Dr Andrea Vincent
represented Retina NZ at the International SMAB meeting in
Survey Questionnaire
In May this year we sent out a
questionnaire to all members receiving the newsletter. There were questions about the newsletter,
how people access printed media, telephone peer support service, the website,
and whether people want
meetings or phone contact.
We have been absolutely astounded to receive back more than
165 replies. We thought we would do well
if we got back 50 replies. There was an
excellent response rate from people who receive the newsletter on tape, and I
presume many had to get others to fill in the responses. Thank you to all of you. We are heartened by the supportive comments
received. It has been a humbling
experience for me to read them, and realize just how many of our members are
older people who do not have access to any special equipment but just box along
using magnifiers or family to read to them.
As the
responses have still been dribbling in, we will produce a full report of what we learned in the
November newsletter.
Membership
At the end of March 2006 we had
473 members compared to 464 members at the same time last year. There have been many new members but the total remains
static. We have not actively sought to
join up new members. Our subscriptions
were increased this year from April.
Only two members have resigned rather than pay the increase. People are making donations just as
generously as before in spite of paying a higher subscription.
Website
There has been little change here,
other than putting up-to-date newsletters on site. We hope to get outsiders to revamp the site
for us. We know what we would like to
see on it, but haven't
had the manpower or skills to do it ourselves. Again, the survey showed us how many people
do not have access to computers.
Branches
Some branches have been meeting
more than others. We need more people to
get involved at a local level to ensure that meetings are held. Many of our members are elderly and do not
seek face to face meetings regularly, but would welcome occasional meetings to
make contact with others in their area.
I would like to mention the work of Gael Hambrook
and Heather Tofts in keeping the Kapiti
VIPs going with monthly meetings at a community venue. This is run with only $100 input from Retina
NZ.
The Good Look Book
This has been a personal project
of mine. I will not say too much here as
we are to launch this at out conference.
However, I have been helped very much by the way everybody who was
approached was so positive. Not one
person has said no to any requests I have made.
I hope this will prove to be a useful resource to our society and
relevant to a wider audience
beyond our membership. It
may even boost our finances if it is popular.
I will be now entering my final
year as president. Hopefully I will get
to cross off some of those goals that are still awaiting completion before my
time expires. We acknowledge the
support, especially financially, of the Royal
We also value our good working
relationship with the NZ Association of Optometrists.
The society is in good heart. However, we do need new people to come on
board to ensure that it has a good future in the years ahead. The more you can get involved, the more you
can gain from your membership. Welcome
aboard.
Kaye Newton/President
July 2006
4 Glossary
Adaptive Technology
This is a broad term for
technology that is specifically designed to assist people with a disability to
take fuller advantage of a range of activities. Examples are:
1.
Talking screen reading software that reads out in a
synthetic speech what a sighted person would see on a computer screen.
2.
Paperless Braille displays which render electronic
text in Braille.
3.
Braille embossers which produce hard copy Braille
pages from computer files.
4.
Electronic notetakers and
personal organizers with speaker or Braille output.
Products
which magnify the display of information on a screen to make it easier to see
by changing colour contrast or other settings.
Screen Reading Software
Jaws for
windows is the most popular screen reader. It is a multi-lingual software speech
synthesizer which supports all standard windows applications. It works with a computer to provide access
to today’s software applications and the internet. Jaws internal software speech synthesizer and
the computer’s sound card read information from the screen aloud.
Magic, another screen reader, combines
great magnification features with low vision screen reading when purchased with
the speech option. It offers the ability
to choose the information you want read from the screen as you navigate through
your programmes.
Magic is easy to use with its talking large print instillation, colour coded user interface and hot keys.
OPENBook offers
individuals a powerful tool to read, edit and manage text. It converts a printed page into electronic text to be read aloud
by a voice synthesizer. Printed text can
be scanned into the computer to be read.
OPENBook also has settings for magnification,
character spacing and contains exclusive reading enhancement features.
Quote- Books are
the legacies that a great genius leaves to mankind which are delivered down
from generation to generation as presents to the posterity of those who are
not yet born.
Joseph Addison 1672-1719
5 The
The
A large number of trauma cases
caused by domestic accidents and more recently from the civil and military
disturbances in the
area are treated.
Diabetes is very prevalent in the
region and is detected late and poorly controlled. The major cause is a high
incidence of consanguineous marriage and a population in which 25% are under
the age of 10. One of the major causes
of blindness in adults is diabetic retinopathy.
They require
sight-saving laser or vitreo-retinal
surgery. The specialist vitreo-retinal surgeon performs an average of ten major
operations per week.
For many years the hospital
services were given free of charge as many of the patients were destitute. The huge increase in overheads meant that a
fee for patients had to be introduced.
However only 30% of the running costs are obtained from patient fees,
the remainder of the money required to run the hospital is obtained by
donations and grants.
Gaza has many problems, the least
of which is its isolated position. In
1992 a permanently staffed clinic was opened which included an operating facility
in order to do cataract surgery on a day case basis. Some 8000 patients are seen each year, and
100 cataract operations are performed.
An outreach team goes to the
This information was kindly
supplied by The Order of
6 TIS-The
Telephone Information Service by
The telephone information service,
or TIS as it is more commonly known, is an information delivery system that
callers can access by way of a touch tone telephone. To access the service callers phone either a
local or 0800 number
depending on where they reside in the country. The TIS numbers are listed below:
Napier-Hastings 835-9136
Palmerston North
354-8316
Timaru 688-6921
Oamaru 433-1026
Balclutha 418-3332
Gore 203-3001
Invercargill 218-6470
Everywhere else 0800-363 344
Getting Started
When a caller phones TIS the first
thing they will hear is a welcome message.
Following the welcome message there may be an announcement about new
items of interest on the service. The caller is then presented with a menu of
choices called the main menu. By using
the keys on the telephone a caller can choose which piece of information they
wish to listen to. The menu is
structured in such a way that each item of information is read out and then the
required key to access the information is announced. For example, at the start of the menu the
caller will be presented with the following:
1.
The 1 denotes the key the caller needs to press to
access this information.
Menus are read out three times and
at the end of the third reading if a choice has not been made the service will
assume the caller has gone away and the call will be disconnected.
By use of menus the caller can
move freely through various options and access a wide variety of
information. If at any time a caller
wishes to return to the previous menu they simply press the zero key and this will return them
to the previous menu. Once a caller
becomes more familiar with the key strokes they need to make they can simply
press the key for the information they wish to hear at any time without having
to wait for the options to be read out.
Needing Help?
Any time a caller requires help as
to what they need to do they can press the hash key which is to the right of
the zero. This will cause a help message to be
announced which will provide specific information and helpful suggestions for the caller.
User Numbers and PIN Numbers
The Foundation of the Blind has
secured permission from some copyright holders to freely provide such
information as newspaper readings and radio and television listings. In return the Foundation of the Blind has been
asked to set in place a system that will only allow Foundation members to
access this information. This is why
some menu options require the entry of a seven digit user number and a
five digit PIN number. When a caller
encounters one of these options they will be prompted to enter their user
number by using the keys on their phone.
The caller will then be asked to enter their PIN number by once again
using the keys on their phone. Because
the user number is a seven digit number many members simply choose to use their
home telephone number and then select a PIN number.
The user/PIN number is also used
to access the free directory assistance which is available to members. Following the entry of the user/PIN number
combination the caller is transferred to either the national or international
directory assistance at Telecom without any cost being incurred by the caller.
Helpful Hints
Many phones have a raised dot on
the five key on the keypad. This can be
used as a central point from which a caller can navigate around their keypad
without having to rely on visual information from the keys.
If a caller has difficulty
remembering their user/PIN number combination they can consider either renting
a memory phone from Telecom or simply purchasing a phone with this
facility. This will enable a caller to
use one key stroke for their user and PIN number.
Phones are available that allow
the user to increase volume and TIS also has the ability to either speed up or
slow down the speed of information in bulletins to meet the caller’s
requirements. When listening to an item
of information a caller can simply press the hash key to the right of zero to
hear more detailed information about this topic. TIS is a very user friendly system with spoken
instructions and help options available at
all times. The service is
available 24 hours a day 7 days a week.
Some Items of Interest
Option 3 from the main menu will
take the caller to a menu where they can choose to listen to various items of interest from the
Foundation. This generally includes
information about Foundation services and reports from the Foundation’s CEO and
Board of Directors.
Option 4 from the main menu
presents the caller with local information relevant to where the caller is
ringing in from. Please note that for
the 0800 number selections 1, 2, 3 and 4 are not available from this menu
however options 5, 6, 7, 8 and 9 are available.
Option 5 from the main menu
presents the caller with interactive lines run by consumer organizations such
as the Association of Blind Citizens of New Zealand etc. Generally each week a bulletin is presented
by a narrator and callers can leave a voice mail message which is played to
callers as part of the bulletin. This is
a wonderful way of sharing information and ideas.
There are many other options that
are available and from time to time
these may change as items are either removed or added.
Getting a User Number or Wishing
to Have Further Information
Should you wish to obtain a
user/PIN number combination or would simply like more information please feel
free to contact the Foundation of the Blind’s Information and Advice service on
either Auckland 355 6899 or 0800 24 3333.
Snippets
Sound and Touch
Did you know that if you are a
member of the Foundation you are eligible to receive the library’s newsletter,
Sound and Touch.
It lists new talking and Braille books purchased by the library. Sound and Touch is available in print,
cassette, email or in Braille. Email the
library at library@rnzfb.org.nz or phone 0800 24 33 33
to be put on the mailing list.
Equipment Catalogue
The Foundation has published a new
equipment catalogue. The catalogue and separate price list are available in
several formats, and can be obtained
from Equipment Services, RNZFB, Private Bag 99941, Newmarket,
Auckland or by phoning equipment services on 0800 24 33 33. Orders can be placed by telephone, fax,
email, post or at display days.
7 Research-Update
on Vitamins and AMD Therapy
The use of vitamin therapy for
age-related macular degeneration (AMD) moved into public awareness with the
publication of the Age-Related Eye Disease Study (AREDS). AREDS was a 10 year trial looking at the use
of antioxidants and zinc. It showed that a combination of
antioxidants and zinc is most effective in slowing the progression of the
disease and vision loss in people with
intermediate macular degeneration.
People taking the antioxidants only or the zinc only did not have as
good a result. Participants in the study
could also take a daily multivitamin, Centrum.
Many people with AMD now take a vitamin with the AREDS formulation.
Other substances may have a
positive effect on macular degeneration.
These include lutein, zeaxanthin,
omega-3 fatty acids (DHA and EPA). AREDS
ll, a continuation of the AREDS trial, will now study
these ingredients separately and in combination. Another arm of the study will contain people
who take variations of the original AREDS formula, specifically either the
AREDS supplement; the supplement with no beta-carotene; the supplement with a low dose of zinc; or
the supplement with no beta-carotene and a low dose of zinc.
Other Vitamin Research
It will be many years before we
see results from this new AREDS ll trial. Meanwhile, other research on vitamins continues
and can be contradictory.
Lutein and Zeaxanthin-There are many studies that support the use of lutein and zeaxanthin for macular
degeneration. The macula of the eye is
made up of these two pigments. They can be reduced by smoking, sunlight and
other stressors that
trigger free radicals that attack the macula.
There is a logic to replacing them through diet
and supplementation.
The
This study supported previous
research on fats, which also indicated that the quality of fat in a diet is at
least as important as the quantity of fat.
High quality oils such as olive oil and avocados seem to be good for the
eye, whereas saturated
and trans fats are connected with more AMD.
Another study, which used people
without AMD, reported that a daily
supplement of 18mg of lutein and 2.4mg of zeaxanthin did slightly increase the macular pigment. The density of macular pigment seems to be
related to the health of the macula, with a denser pigment indicating a lower
risk for AMD.
Multiple Vitamins
It has been reported that the
benefits of vitamin
supplementation are questionable.
The National Institute of Health Conference recognized that some supplements
were proven, specifically the AREDS formula for AMD, calcium and Vitamin D for bones
of postmenopausal women and folic acid
for women of childbearing age.
They were concerned people may be taking multiple formulae and may be getting
well over the recommended daily value of some ingredients, particularly
vitamins A and E which accumulate over time.
There needs to be more research done to identify the optimal level of
vitamins for both healthy individuals and those dealing with some disease.
What to Do?
The AREDS data for intermediate
AMD is solid. It was not shown to
prevent AMD or effect the early stages. Lutein and zeaxanthin
are contenders and you should discuss this with your ophthalmologist or
optometrist. The best thing you can do
is to eat a varied, healthy diet with lots of fruit and vegetables, fish, low
consumption of red meats and a limited number of products with transfats (snack food and pastries for example).
This information was downloaded
from the Macular Degeneration Partnership at www.amd.org
Cortical Implants
Several researchers are exploring
the possibility of creating vision in the brain through an implant in the
cortical area of the
brain. The patient would wear
specialized head gear consisting of a miniature camera and sensor, connected to
a computer and then to the implant. This
surgery was first done over 20 years ago, with the
ensuing improvement in technology the patient can now discern large letters
against a white background.
Retinal Chips
Could an electronic device in the
retina replace damaged photoreceptor cells?
Scientists are exploring several different avenues to see if this can be
done successfully. Researchers recently
demonstrated an electric ‘artificial retina’ that allows blind people to see spots
of light. A two millimeter square chip
was placed on the non-functioning retina of 15 patients. Dots of light were transmitted wirelessly to
the chip by an eyeglass mounted device.
The patients reported being able to see these dots and to count sequences of
light flashes. Some could make out colours and shapes and even read letters held before their
eyes. The chips only remained in place
during the 45 minute surgery. Animal
studies are planned to discover if the device can be implanted safely.
This research is very experimental
and it will be some years before it is available to patients. Additional human trials are several years
away. People with macular degeneration
will benefit, but those will total blindness will be the first candidates. These devices will provide just enough vision
to navigate, but will not be good enough for reading and driving. The surgery involves risks which may be
acceptable to a person with no vision, but might be too much of a chance for an
AMD patient with useful peripheral vision.
Two major hurdles are the long
term stability of mechanical devices in the neural retina and the visual
impressions created by such artificial stimulation.
This information was downloaded
from www.amd.org If
you would like more information about this surgery it is available on the Optobionics and
FDA Approves Lucentis
The
Lucentis is
injected into the eye on an monthly basis for best
results. The average patient is expected
to receive 5-7
injections in a year. The cost of Lucentis is higher
than other therapies for AMD.
Early detection and treatment are key to good results of any therapy for wet macular
degeneration. Patients with both wet and
dry macular
degeneration should assess their vision regularly with the Amsler
Grid to determine if vision changes have occurred. Use of the Amsler
Grid may identify changes that would indicate a worsening of wet AMD or a shift
of dry AMD to wet AMD. In either case
patients should contact their eye specialist if a change of vision occurs.
Gene Therapy for Halting AMD
GenVec Inc. has
announced that its gene therapy for the treatment of wet form AMD has shown
good results in a 12 month, 28 patient, Phase 1 trial. Though the study was primarily conducted to
assess safety, higher doses of the treatment
were effective in halting disease progression. GenVec’s treatment, known as AdPEDF, involves the delivery of a gene that leads to the
production of a therapeutic protein called pigment epithelium-derived factor
(PEDF). Earlier pre-clinical trials
funded by the Foundation Fighting Blindness showed that PEDF blocks the development of
unhealthy blood vessels that cause vision loss in people with wet AMD.
Phase 1 trial participants
received AdPEDF through an intravitreal
injection. The researchers believe it is
a treatment that requires fewer eye injections than other emerging AMD
treatments and can positively impact on developing therapies for other retinal
degenerative disorders.
A Phase 2 study is underway for
treating patients with early to moderate wet AMD. A total of 20 patients are receiving a single
dose of AdPEDF at either of two dose levels.
The results of the Phase 1 trial
were published in ’Human Gene Therapy’ in February 2006. This information was downloaded from
www.retina-international.org
Snippet
Notice from
Wellington Central Library is now
home to a great new magnifying device, a Smartview
5000KP, which greatly
magnifies any text well beyond large print. It will be ideal to read magazine and newspaper
articles, access discrete bits of information which may be inaccessible in
ordinary print books such as recipes or council plans, and to read family
letters or bills. It is very easy to operate and there are several colour contrast options available.
Quote- There are two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.
Albert Einstein: 1879-1955
8 Coping-Eating
at Home and Dining Out
There are many ways to make it
easier for people who are blind or vision impaired to eat food at home or when
dining out.
Locating Items at the Table
The saying ‘a place for everything
and everything in its place’ applies when it comes to organizing a dining
table. Set your table the same way each
time and encourage others to do the same.
If you
need to locate objects on a table use the ’trailing technique’. This involves placing your open hand face
down on the table, relax your fingers and slightly cup your hand. Gently move your hand forward, from the edge
of the table, in the direction of the object you are trying to locate. Use dark tablecloths, or a similar dark
background. Use coloured
or patterned drinking glasses rather than transparent glasses.
Tactile markers can help to
distinguish items. Salt, pepper or sauce
containers can be marked with Velcro or wrapped in elastic bands. Use a placemat to highlight the boundaries of
your utensils and crockery.
Lighting
It may be useful to have a lamp on
the table shining directly
onto your plate. Make sure
it is positioned below eye level to avoid glare. If you use natural daylight, sit side on or
with your back to the window to avoid glare.
Locating the Food on a Plate
Ask someone to describe where the
contents of your plate are sitting. You
can use the clock face method eg. peas
are at 3 o’clock and meat at 6 o’clock.
Food should be placed with the meat nearest to you, as this is easiest
for cutting. Explore the contents of a
plate by tapping lightly with a fork to identify the various foods. Avoid plates with patterns. The pattern can be visually confusing when
you are trying to locate your food.
Cutting
Cutting meat: Find the edge of the
meat using the knife and fork. Move the
fork about 2cm (1”) from the edge towards the centre of the meat. Cut around the fork to cut a bite sized
piece. Pull the bite size piece away to
check it is free. Lift from the plate
and check that the meat is still on the fork by running your knife down the
fork.
Cutting lettuce: Place a fork into
the nearest part of the lettuce and cut around it. Keep placing the fork a step farther and cut
around that spot. Anchor the bowl or
plate during the cutting with the pressure of the fork. Anchor the remaining lettuce with the knife
while pulling the fork away.
Spreading
Position
one hand on the bread with your fingers at the top and your thumb at the
bottom. Drag your
knife over the bread from top to bottom in 3 sections, starting from the left
side to the right. You can identify the
edges of the bread when your knife touches your fingers at the top and your
thumb at the bottom.
General Hints
Use your knife and fork to keep
checking that the food is not
too close to the edge of the plate, and push it towards the
middle. Mashed potatoes, gravy or sauce
can be used to lift peas and beans up on your fork without dropping them. When raising your fork to your mouth lean
forward over the plate so any dropped food will fall back onto the plate, not
into your lap. If you are not sure which
shaker is salt and which is pepper, sprinkle a little of the contents onto your
palm. The smell of the pepper or the
heaviness of the salt will help with identification. This will also let you know how quickly it
pours. Salt and pepper can be poured
into your hand first and then sprinkled over food.
Grasp a small salad or dessert plate around the edge with your thumb and
forefinger and use them to stop food falling out of the plate. The cutting edge of a serrated knife can be
detected by dragging it along a plate and listening or feeling for the buzz of
the uneven surface. When transferring
from A to B, for example putting sugar in coffee, move
the containers next to each other to avoid spillage.
Adaptive Equipment
Non slip placemats: These provide
a firm grip for your plate when you are trying to cut food or for a bowl when
you are stirring.
Splayds: These
are utensils shaped like a spoon, with prongs like a fork. They can be useful for eating casseroles or
soft foods which can be cut by pressing down on the edge of the splayd.