Dear AccessWorld readers,

Last month, AccessWorld celebrated Disability Employment Awareness Month by providing information about employment resources, strategies, and insider perspectives. Good job search strategies and resources are important all year long, so I encourage you to look back at last month's issue and forward information to anyone you know who may be looking for employment or for better employment opportunities.

As you know, there is now a chill in the air, and the days of fall are well upon us. It's time to start thinking about the holiday gift-giving season. Ready or not, the shopping season is just around the corner. I know some of you have already started shopping, and the AccessWorld team wants you to be ready with information about accessible shopping options and gift ideas for yourself or those in your life who experience vision loss.

In this issue, Janet Ingber provides information, advice, and tips to get the most of holiday shopping using websites and your mobile device. She specifically investigates the always popular Best Buy and QVC websites and apps. If you prefer the hustle and bustle of traditional brick and mortar shopping, or if you will be attending holiday parties or visiting family and friends, Deborah Kendrick's article highlights the accessibility of Lyft and Uber, two alternatives to taxis.

The AccessWorld team hopes this issue provides inspiration for finding just the right holiday gifts for you, your family, or friends with vision loss.

We wish you and yours health, happiness, peace, and prosperity as we enter the holiday season. As Helen Keller once said, "Peace and prosperity will come when we realize, and incorporate into our lives, the truth that we live by each other and for each other and not unto ourselves."

Sincerely,
Lee Huffman
AccessWorld Editor-in-Chief
American Foundation for the Blind

Dear AccessWorld Editor,

I would like to say how timely this article (The Current State of ChromeVox Next (Beta), a Screen Reader for Chrome OS) by Aaron Preece was for me. I am using Chromevox and Google just updated me to Chromevox Next.

Fortunately there were some release notes available but nothing as helpful and comprehensive as Aaron's article. Thanks so much, AccessWorld.

Peter Walsh

Dear AccessWorld Editor,

Re: Making Music with iOS and Android Apps

Hi,

I am an oboe player with RP who plays in a community band. I was to the point of having to give up playing because my acuity was such that I couldn't read sheet music well enough anymore. Enter MusicZoom (musiczoomapp.com)! This is an iOS app that costs $20. The app allows you to scan or take a photo of sheet music and enter the piece into the music library. You can customize the display to your visual needs. You advance the music using a Bluetooth foot pedal. I have close to 200 songs in my library and it is absolutely amazing and easy to use. It gave music back to me. I understand this is not for folks with total blindness, but is a mighty boon to low vision musicians.

Cheers,

Ros Zeltins

Dear AccessWorld Editor,

What a great article on making music on IOS devices (Making Music with iOS and Android Apps). Thank you AFB, Janet, and Jamie for sharing the musical love. All we need now is a podcast where these great authors demonstrate the musical apps they love so well.

Again, thanks to all who made this article possible.

Don Barrett

Newest CTA Foundation Grant Recipients are Enhancing Lives With Technology Programs

Recently, the Consumer Technology Association (CTA) Foundation announced it will award more than $500,000 in grant funding to 10 organizations that help link seniors and people with disabilities with technology to enhance their lives. The recipients include groups that work with accessibility apps, develop digital entrepreneurship among seniors, and bring "smart home" technology to residential living centers.

"Whether it's helping to deliver the on-demand immediacy of app-based services to people with disabilities or exploring the latest innovations in remote care of our loved ones, these organizations recognize the technology sector is changing our lives for the better—regardless of our age or independence," said Steve Ewell, executive director of the CTA Foundation. "The CTA Foundation is pleased to continue our support of programs across the country that leverage technology to promote greater independence, communication, and a sense of community for everyone."

The CTA Foundation—a public, national foundation—will continue its previous support of the following five groups:

• BridgingApps: A program of the Easter Seals of Greater Houston, BridgingApps will expand upon its project to identify accessibility apps that improve the physical, cognitive, and social health of seniors and people with disabilities.
• Lighthouse Guild: At the Grunwald Technology Center, clients receive instruction in everyday consumer technologies, along with instruction available on various adaptive and assistive technology training.
• Oasis Institute: The group will build upon last year's successful Mobile Accessibility Guide, distribute free tools such as tutorial videos and downloadable tip sheets, and offer accessibility classes for older adults.
• OATS: After developing a digital entrepreneurship institute geared toward older adult artists and artisans, the new OATS program will focus on developing new content to train older adults in emerging technologies in creative expression.
• Selfhelp Community: The organization's Virtual Senior Center is an innovative technology solution helping address social isolation among vulnerable homebound seniors.

Additionally, the CTA Foundation will initiate support for these five organizations:

• Beneficent Technology: The creator of Bookshare, the world's largest online library of accessible print materials, will expand use of its library to the state of Texas giving seniors access to e-books, periodicals and other reading materials.
• Jewish Council for the Aging of Greater Washington (JCA): JCA's tech training centers offer computer and technology courses for adults 50 and older, focusing on digital literacy to stay connected to family and friends, and manage finances and health care.
• Meritan: The organization is outfitting two of its residential living centers with Smart Home technology, allowing for an increased level of care, real-time data availability, faster reaction to health issues and improved efficiency for direct support staff.
• Research to Prevent Blindness: The group supports early-stage research aimed at developing new assistive technology for persons with low vision, particularly using smartphones and tablets.
• Fellow Program: This new fellows program will engage academia in advancing knowledge to promote healthy, independent, socially-connected lives for older adults and people with disabilities.

For more information about the CTA Foundation, please visit the CTA Foundation website.

VisionCorps Launches Redesigned Website that Offers Improved Layout for Accessibility and Ease of Navigation

VisionCorps, an agency serving individuals who are blind or visually impaired through rehabilitation services and employment opportunities, recently announced the launch of its redesigned website. The website features an improved layout and updated functionality. Creating an accessible user-experience for individuals who are blind or visually impaired was a critical driver of the project.

VisionCorps partnered with local digital marketing agency, Quantum Dynamix, to redesign the site. "When designing the new VisionCorps' website, we avoided making assumptions regarding how people who are blind or vision impaired interact with the Internet. Instead, we spent time with individuals who have low vision or no vision, and observed website navigation one-on-one," impressed Eric Kazda, President and Co-Founder, Quantum Dynamix.

In addition to updates that meet standard ADA compliance requirements, features such as "High Contrast Mode" and "ZoomText Support" were added to allow individuals to more efficiently access the site. Additional modifications include permanently expanded left-hand navigation, improved contrast, clearly defined text boxes, improved font, and a list-view calendar featuring large-print numbers. Full use of Accessible Rich Internet Applications (ARIA) syntax allows for the proper support of Job Access with Speech (JAWS) and other screen readers.

"As an agency that employs and serves people who are vision impaired in our community, it is our duty and obligation to ensure that our publics have the best user experience possible," said Dennis Steiner, President and CEO, VisionCorps.

The VisionCorps' website will focus on educating the community in regards to its vision rehabilitation services, manufacturing capabilities, food processing capabilities, and administrative services. The website also includes up-to-date content from the VisionCorps Foundation, which continues to support programs that empower individuals with vision loss, and relies on financial support from individuals and businesses.

The Tallgrass Prairie Preserve GPS Project

In this, the 100^th year of the National Park System, a first-of-its-kind project has been completed to make the Tallgrass Prairie National Preserve in Strong, City, Kansas environmentally literate for the visitor who is blind or visually impaired. This groundbreaking work was completed by Craig Phillips, MS Ed. COMS, a Certified Orientation and Mobility Specialist and teacher of the blind and visually impaired formerly of Lenexa, Kansas, and now a resident of Lake Saint Louis, Missouri, who translated the visual environment into an auditory environment by marking the trails, recording routes, defining landmarks, and placing electronic waypoints on the 40 miles of trails with input from Ranger Jeff Rundell. The Trekker Breeze+, a GPS device designed for use by travelers with visual impairments and manufactured by Humanware of Drummondville, Canada, automatically provides the auditory information that relates to the traveler's location and position in real time, as well as recorded anecdotal commentary about the flora, fauna, history, wildlife, and other pertinent information about the geographic position. The Breeze+ provides information to the traveler with a visual impairment that the sighted traveler sees incidentally. For example, the Tallgrass Prairie National Preserve has a trail that winds through a pasture populated by a herd of bison. The device informs the traveler of the surroundings by alerting the traveler of the impending danger of traveling through this area; describing the bison's history, diet, and behavior; providing the sound of a bison for familiarity; and offering information about the grass and vegetation in the area.

The visitor center has purchased four of the devices, which will be available to all travelers in the park since the sighted traveler can benefit from the information as well.

For further information contact Heather Brown, Chief of Interpretation and Visitor Services at the Tallgrass Prairie Preserve at 620-273-6034 or heather_brown@nps.gov or Craig Phillips at 913-645-8262 or at cleep1700@att.net

Freedom Scientific Releases JAWS 18, Featuring Interoperability with Upcoming ZoomText 11, Vocalizer Expressive 2.2, Migration Feature, and Talking Mouse

Freedom Scientific recently announced the release of version 18 of JAWS for Windows, its screen reading software. Significant new features include the following:

• Greatly improved interoperability with the upcoming release of ZoomText 11
• Support for Nuance's Vocalizer Expressive 2.2 synthesizer, adding voices and new language support in Croatia and India
• Migration feature to assist users moving settings from version to version and computer to computer
• Talking Mouse, to help especially when using JAWS with either ZoomText 11 or MAGic 13.1 and above

With the recent addition of AiSquared to the VFO family several months ago, a priority for JAWS 18 and the new ZoomText 11 release was interoperability between the two products.

"Helping our customers who install and use both products at the same time is a priority now, as we strive to make sure the users of ZoomText can now experience the same benefit our MAGic customers have experienced for years when running alongside JAWS. Synchronized visual tracking on the web as JAWS navigation and reading is happening is a real plus," says Eric Damery, Vice President of Software Product Management. "Add the new migration tool, and JAWS users will find the instant access to their JAWS 17 settings, after installing JAWS 18, making this one of the smoothest annual upgrades yet."

The JAWS 18 upgrade is a Software Maintenance Agreement (SMA) release and can be downloaded as either a 32- or 64-bit version from the JAWS downloads webpage. English, German, French, Spanish, Dutch, and French Canadian have all posted simultaneously and DVD shipments to SMA holders and new product customers will commence very soon.

Recruiting Beta Testers for KNFB Reader: Adding Multiple New Languages

Once again, the KNFB Reader team is adding many more languages to KNFB Reader. In June of this year, the grand total of languages available to KNFB Reader users increased to 19. With your help we may be adding as many as 13 in the near future.

In this round of additions, several have proved very challenging. Input from beta testers will be needed to ensure the best functionality for these new languages. We need those familiar with the following languages to volunteer to beta test the next version of KNFB Reader.

• Chinese (both Simplified and Traditional)
• Afrikaans
• Albanian
• Croatian
• Icelandic
• Indonesian
• Japanese
• Korean
• Romanian
• Serbian
• Slovak
• Slovenian

If you are interested in participating, please send a message to support@knfbreader.com. Include the following:

• Your name
• Your location
• The language/s you can test
• Your e-mail address
• The make and model of device you are using
• The version of the operating system you are currently running
• Do you already own KNFB Reader?
• Do you use either TalkBack or VoiceOver?

On a scale of 1-5, please rate your level of proficiency with your device. Please note that we want to find users of all skill levels.

Please spread this message far and wide. Many of these languages may not be commonly spoken in your area. If you know of anyone who may be interested in helping with this project, please do not hesitate to recruit them. Language testers do not need to be blind. Ask your friends, family members and coworkers who may speak any of these languages.

Thank you again for your interest in improving KNFB Reader. The team could not do it without you.

Email: support@knfbreader.com

There was a time when many of us who are blind or visually impaired, once we had our adapting to blindness skills assimilated, would declare in one way or another that, when it came to counting the real hardships of blindness, there were really only two significant losses: reading and driving.

The advent of all kinds of technology to magnify, speak, and convert the written word to braille has all but eliminated the first of those hardships. With optical character recognition software in general and the KNFB Reader app for iOS and Android devices in particular, blind people can access print almost as readily as those with complete sight. While not all print is accessible in electronic form, the inability to read directly with one's eyes holds nowhere near the enormity of challenge that it once did.

The game-changer for those of us unable to drive swept on the scene much more abruptly than the comparatively slow evolution of technology related to accessing information.

Almost overnight, options that would have belonged in the realm of science fiction just a few short years ago have made catching a ride as simple as tapping a button. The primary new mode of transportation is called ride-sharing. Its two leading providers are Lyft and Uber. There are other minor competitors on the scene in some areas of the country, and still more revolutionary transportation options on the horizon, but for now, let's look at Lyft and Uber and how they affect people with vision loss.

The Magic of Uber and Lyft: How Ride-Sharing Works

From the rider's perspective (and most of us reading AccessWorld are probably more likely to be riders than drivers), Lyft and Uber function similarly. From the Apple or Google Play store, you download the Lyft or Uber app. You sign up by providing a few basic bits of information: name, address, phone number, credit card information, and your Facebook account. This final step is to provide your photo.

After the initial sign-up, you never have to handle or contemplate your credit card or cash again. When you need a ride, such as to a store for holiday shopping or to a New Year's party, simply open the app (we'll use Lyft as the example here), confirm that the address identified there is your current location, and tap on "Request Lyft." In usually less than a minute, you will hear a chime and be informed of the identity of your driver and that he or she is on the way.

Both apps then provide the driver's name, photo, make and model of car, photo of car and, in Uber, the license plate number is read by VoiceOver. Near the top of the screen you will find the estimated time of arrival (ETA), which decreases in minutes as you continue to swipe the option and the car gets closer to where you are waiting.

For those who can see the screen, a map appears and displays the movement of the car on that map as it draws nearer to your location.

When the car arrives, you jump in, much like being picked up by a friend, and off you go. At your destination, say goodbye. No cash ever changes hands. The app shows you the price of the ride, and waits for you to accept the price and rate the driver, all of which takes less than a minute.

Advantages of Ride-Sharing Services Over Traditional Taxi Service

I am probably not alone in recalling all too many times in the past when a taxi was promised, sometimes repeatedly, but failed to arrive. Waiting in the cold with a small child and several bags of groceries, feeling panic rising as the time of an important appointment approaches and then passes, or getting into a taxi that reeks of smoke or other effluvia—these are just a few of the many unpleasant memories in my personal collection. Many who read these words are undoubtedly experiencing "aha" moments as you recall comparable experiences in your own taxi-hailing repertoire.

Lyft and Uber offer many advantages to customers over traditional taxis. You know immediately how soon your driver will arrive. Both companies set very high standards for acceptable vehicles, so that all cars are new, clean, and usually stylish! Rates are typically lower than taxis, and Lyft is somewhat lower than Uber. You rate the driver after each ride, from 1 to 5 stars, and while most will warrant a high five, the occasional driver who is not to your liking will never be matched with you again if you select a rating of 3 stars or less.

Ride-Sharing Services: The Blind Perspective

In the last three years, I have taken perhaps a few hundred rides with Lyft and Uber in about a dozen cities. I canceled one ride because the driver spoke no English and could not understand where I was located. Another driver canceled my ride because he got a higher-paying trip. With these two exceptions, I would say that every experience has been pleasant, positive, remarkably efficient, and even fun. Drivers are from all walks of life. I have ridden with graduate students picking up summer or spring break cash; retirees who want to continue working part-time; struggling models, actors, musicians, and writers; at-home moms or dads driving while the kids are in school; people new to this country; and on it goes. Cars are nearly always new and clean and the conversation lively. Of course, if you need a nap, no conversation is required.

Both apps are completely accessible with VoiceOver, although a bit of a learning curve is involved with each. Both seem to update frequently, which can change the feel of the app with VoiceOver. In early June of this year, a Lyft app update caused a problem for a while with rating drivers. Most riders give drivers 5 stars and most drivers give riders 5 stars. For a few weeks, it was not possible to determine which number of stars was being selected. To rank lower than 5 stars is a definite red flag message. Because of the update, I was inadvertently ranking drivers lower than my intended 5 stars. The first time, I received an email message saying that Lyft was sorry I was unhappy with my driver and would never pair me with that driver again. I replied that the problem was with the app, not the driver, and would Lyft please adjust the rating. That happened about four times with four different drivers. I then took the proactive approach of adding a comment. After you rate a driver, you are given the opportunity to add a comment. For several trips in June, my comment was something like, "I would give this driver 6 stars if I could. If the number shown is less than 5, the problem is with using the app via VoiceOver, not with the driver!"

Happily, subsequent updates have resolved this particular issue.

Because I can't see the photo of the driver or the car, I have used various approaches to be sure I connect with my Lyft or Uber driver.

Both apps alert you when the driver has arrived. If I am in a quiet location, like my own home, I go out when the car is a minute or two away and I can hear it approach. Even so, since the app has given me the driver's name, I ask them to confirm their name before getting into the car.

If I am in a noisier environment, such as leaving a store or restaurant or medical building, I use the "Contact Driver" button provided in each app. This affords the customer the opportunity to call or text the driver. My habit is to call and say something like, "I'm out here with a white cane. I won't see you, so just let me know when you are here."

Some blind and low vision customers have made cards with large printed letters announcing "LYFT" or "UBER," to hold up when the car is near as a way to alert the driver. When a driver accepts your ride request, she sees your photo as well, so sometimes this face recognition helps, but doesn't seem to play a large role.

Options and Caveats

Although Lyft has some optional types of trips called Lyft Line and Lyft Premier, I have not been in cities where these options are available so have had no personal experience with them. Lyft Line is for sharing a ride with another customer who is traveling in the same direction, thus lowering the cost, and Lyft Premier is for more limousine-like service.

Uber offers options in every city where I have used it. Usually, these include Uber X, Uber Select, and Uber Black. For all but one ride, I have used only Uber X, which is what most drivers provide—a car that is no more than a few years old and is in excellent condition. Uber Select is a more upscale ride, not much more than a year old, and will cost at least 50 percent more. Uber Black, priced significantly higher, will be a black car that offers some level of luxury.

When ordering an Uber car, some people new to using the app have mistakenly selected Uber Select or Uber Black and thus had an unpleasant surprise at the cost of a trip, so be sure to select Uber X if you just want transportation.

I had a guide dog when I first began using these services, and never had any problems. It warrants mentioning, however, that a few riders with guide dogs have had problems. Most notably, a lawsuit brought by the National Federation of the Blind of California for three individual plaintiffs against Uber found Uber to have discriminated and led to a company policy that any driver refusing a blind passenger with a service animal will no longer drive. There have, to date, been no such charges against Lyft.

Conclusion

Lyft and Uber are headquartered in San Francisco. Uber was launched in 2009 by Travis Kalanick and Garrett Camp, although it would take another year or two for the app to take the form we know today. Lyft was launched in 2012 by Logan Green and John Zimmer. Both now operate in close to 400 American cities and several other countries around the world, and both are constantly hiring new drivers.

Drivers are not employees, but independent contractors. Some drive just a few evenings a week or on weekends, while others work full-time.

My personal bias leans a bit more toward Lyft as the rides cost a bit less, the drivers are required to submit background checks, and the app provides the opportunity to add a tip.

Both Uber and Lyft have completely changed the nature of transportation for those of us who cannot drive. While a car that drives itself is also literally just around the corner, these ride-sharing services are perhaps even better. I might spend $100 or $200 each month on rides, but I can go anywhere anytime I please, and I have no car payment, no maintenance fees, no concerns about where to park—and I didn't have to learn to drive!

Learn more about Lyft or Uber online, or download the apps from the App Store (Lyft or Uber) or Google Play (Lyft or Uber).

Comment on this article.

Related Articles:

• A Review of Uber, the Growing Alternative to Traditional Taxi Service by John Rempel
• The Aware Audible Proximity Solution Navigation App: An Interview with Rasha Said, App Creator and Founder of Sensible Innovations by Aaron Preece

More from this author:

• A Second Decade for Serotek by Deborah Kendrick
• Richard Beausoleil: A Musician Harmonizing with Technology by Deborah Kendrick

On September 13, 2016, Apple released watchOS 3, the new operating system for the Apple Watch. This update offers many new features, such as increased speed and an easier interface when replying to messages. As promised at Apple's World Wide Developers Conference, it has a new feature that lets a person who is blind check the time without use of VoiceOver.

Along with a new operating system, Apple introduced Watch Series 2. The new watches are water resistant and have GPS and a faster processor. You can find out more about the watches at an Apple Store, the Apple Store iOS app, or online.

This article is an overview of the new features of watchOS 3. Both the original Apple Watches and the new Series 2 watches can use this new operating system. For this review, I used an original Apple Sport watch.

No More Glances

Glances, which were certain apps which could be accessed from the watch face, A=Glances are gone with watchOS 3. Instead, there is a Control Center. From the clock face, flick up with two fingers. You can also flick down with one finger and you will eventually get to the Control Center. The first setting will indicate whether your watch is connected to your iPhone. Other settings include Do Not Disturb and the very useful Ping iPhone. Flick right to hear all available settings.

The Dock

The Watch now has a Dock that can accommodate up to 10 apps. Reach the Dock by pressing the rectangular button (it used to be called the Friends button) below the Digital Crown.

By default, Apple has already placed some standard apps on the Dock but they can be removed easily by flicking up or down with one finger on the designated app. There are four options: Move Left, Move Right, Activate, and Remove. Move Left and Move Right refer to arranging the Dock. The Remove button will remove the app from the Dock, but not from your watch.

The Dock can also be controlled via the Dock setting in the Watch app on your iPhone. To do so, activate the Dock button within the app. When the new screen loads, there will be an Edit button in the upper right corner of the screen. The first set listed contains the apps that are currently on the Dock; the next set lists the apps that are not on your Dock. Make changes by first activating the edit button. Flicking with one finger on an app in the Dock will bring up options to remove or activate the app. An Insert button appears above every app that is not currently in the Dock. Below the app's name is a button to re-order where the app is located. Activate the Done button when finished.

Manipulating Apps

It is now easier to arrange or remove apps. On any app, flick up or down with one finger. There are two options: Arrange Apps and Activate. Select Arrange Apps. VoiceOver will say "Editing." At this point, double tapping on the app will bring up a delete dialogue. Flick right once to delete the app and flick right again to cancel the action. Default Apple apps such as Mail and Reminders cannot be deleted.

Once Arrange Apps has been chosen, flicking up or down will prompt VoiceOver to say "Move left" or "Move right." If either option is selected, VoiceOver will announce the app's new position. Any app can be moved.

Find My Watch

The ability to locate your iPhone via your Apple Watch is a very convenient feature. With watchOS 3 the reverse is also possible: your iPhone can be used to locate your Apple Watch. I've already had to use this new feature.

On your iPhone, open the Find My iPhone app and go to your devices. Locate your watch in the device list and select it. VoiceOver will announce how far away the watch is from your phone.

Activate the "Actions" button and select "Play Sound." The sound from your watch is the same as the iPhone's sound. The sound will keep playing until you turn it off with the "Dismiss" button on the iPhone. After using this feature, you will receive an email from Apple, indicating that a sound was played on the watch.

Heart Rate

Since Glances are gone, you can access Heart Rate as a complication or with the Heart Rate app. Once the app or complication is activated, flick right on the screen to hear your heart rate and how long ago it was checked. Take a new reading by double tapping on the screen. Then, flick left and VoiceOver will say "Measuring." A few seconds later, you will hear your new heart rate.

Breathe

A new app in watchOS 3 is the Breathe app. It is designed to give you some calming minutes each day. The app can be set up through the Watch app on your iPhone. Once in the Watch app, activate the My Watch tab, where you'll find a button labeled "Breathe." Activating this button will open the Breathe app's settings.

The first control is for how often you want your watch to remind you to breathe.

Next is a toggle to get a weekly summary of your Breathe sessions from the previous week.

The third control is for setting how many breaths per minute you want to take. Options range from 4 to 10.

The fourth control, Haptics, sets how strong the vibrations on your watch should be during your breathing session. The options are "None," "Minimal," or "Prominent."

The final control is a toggle for whether the length of each Breathe session should default to the previous session's length or be set manually for each session.

Start a Breathe session by opening the Breathe app on your Watch. On the lower right corner of the screen is a "Start" button. When you feel vibrations on your wrist, breathe in. Breathe out when vibrations stop. VoiceOver will guide you through the process at the beginning of each session. The watch will play a tone when the session is over. At the top of the screen will be a summary for the day and your heart rate for the last session. Near the bottom will be a button labeled "Breathe Again." Activate it if you immediately want to do another session.

Taptic Time

This app is specifically geared for people who are blind. Taptic Time transmits the time via vibrations rather than VoiceOver announcement. The app is similar to TimeBuzz, but is activated with just a double tap on the lock screen. Taptic Time does not have as many options for vibration patterns as TimeBuzz, but it is easier to activate. There is no need to turn off VoiceOver when using Taptic Time.

Begin the setup process by going to the "My Watch" app on your iPhone. Taptic Time options are in the VoiceOver section. Go to General > Accessibility > VoiceOver > Taptic Time. If the feature isn't on, activate it. The first option is whether to enable Taptic Time. Make sure the feature is enabled. When you double tap on the lock screen, you will feel hours and minutes. Doing a triple tap will let you feel just the minutes.

Once Taptic Time is activated, choose a Taptic Style. The Digits pattern will do short taps for 1 to 9 hours and a long tap for 10 hours. Therefore, 11:00 would be one long tap and one short tap. Long taps are done for every 10 minutes and short taps for 1 to 9 minutes. Therefore, 15 minutes would be one long tap and five short taps.

The Terse pattern will give a long tap for every five hours and short taps for the other hours. Therefore, 11:00 would be two long taps and a short tap. Every 15 minutes is a long tap. Therefore, 30 minutes would be two long taps. Minutes are given only every 15 minutes.

The final option is Morse code. With this option, each digit of the time is tapped out in Morse code.

Once an option is selected, flick right to the "Preview" button. You will be able to feel how each option tells the time on your phone rather than on your watch. Select the one you like best.

Auto Speak Complications

Complications are pieces of information you can add to the watch face. Examples include, battery level, activity, and temperature. You can now have some complications, such as Battery and Activity, speak when you wake up your watch. On the watch face, locate the complication you want to speak and flick up with one finger until you hear "Enable Auto Speak." Double-tap with one finger. VoiceOver will give confirmation that the feature is enabled. Every time you wake your watch along with the time, you will hear information from the selected complication. More than one complication can be enabled. Turn off the Auto Speak feature by locating the specific complication on the watch face and flick up until you hear "Disable Auto Speak." Double-tap and VoiceOver will confirm that the feature has been disabled for that complication.

Emergency SOS

This new feature lets you hold the side button (the same button that brings up the Dock) to call emergency services. When bringing up the Dock, just tap the button. To call Emergency Services, keep holding the button in. You can also add up to three Emergency Contacts that will be notified in case of emergency.

Set up Emergency SOS by going to the Watch tab on your iPhone. Go to General > Emergency SOS. The button is on by default. Double tap to get into the menu.

Once in the menu, there is a button labeled "Hold to Auto Call." Turn this button on and you will only need to hold the button to reach emergency services.

Next is an "Add to SOS Contact" button. When the button is activated, your Contacts list will be displayed. Select the person you want to add. Their name and cell phone number will now be displayed in the Emergency SOS contact list. If there is more than one number in the contact list, choose which number you want to use. If you contact emergency services, the people you have listed will get a message that you contacted emergency services along with your location when you made the call.

Streamlined Message Reply

The process for replying to a message has been streamlined. After listening to a message, keep flicking right until you find the response you want. The first flick to the right brings you to the dictation button. The next flick brings you to the Emoji button. Next are Digital Touch and Scribble. Following that is the list of the standard responses. Select the option you want to use.

Conclusion

It is well worth updating to watchOS 3. The addition of the Dock is very convenient. Apps are much easier to remove and arrange and it takes significantly less time for apps to open. The Taptic Time feature gives people who are blind another way to tell time without anyone else hearing it. Responding to messages is much faster. I'm very pleased with this new operating system.

Comment on this article.

Related articles:

• Learning to Use VoiceOver on the Mac and iOS with Audio Tutorials from Mac for the Blind by Jamie Pauls
• Watching Without Looking: A VoiceOver User's First Month With the Apple Watch, by Anna Dresner by Jamie Pauls

More from this author:

• An Overview of OS X 10.11 El Capitan by Janet Ingber
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For iPhone users, it has been a longer than two-year wait for Nearby Explorer, the navigation app from American Printing House for the Blind (APH). Unaccustomed to cooling their heels while Android users put new apps through their paces, fans of iOS can finally add Nearby Explorer to their navigation toolbox. The question is, was it worth the wait?

Nearby Explorer combines GPS navigation, turn-by-turn directions in pedestrian and vehicle modes, points of interest, and transit data. The app aims to be a one-stop navigation solution, whether you're plotting a route from point A to B, getting oriented to your environment, or searching for a place to grab a cup of coffee. Using licensed maps, public data sources, and software developed in-house at APH, Nearby Explorer offers an unusual level of flexibility with a focus on the needs of blind travelers.

The Nearby Explorer Home Screen: Getting the Lay of the Land

The Nearby Explorer home screen layout is clean and logical. Like other blindness-oriented navigators, the Nearby Explorer home screen does not feature a map, instead providing text-based information about your surroundings along with options for customizing what you hear as you travel. The home screen is topped with a row of buttons you use to stop and start the GPS receiver, enable the Geobeam and Compass features, and adjust the radius of your surroundings that will be described. Most of the screen (scroll to see everything) is taken up by a series of toggles that let you choose the data points that will be voiced while you travel. These range from the high-level (country, state, county), to the ground level (street name and number, along with altitude and vertical accuracy). Item organization makes it easy to find the item you need, whether you're exploring by touch or flicking through your options. You'll also find some special settings that place you in the environment: heading, speed, guidance, and watch. Current information for all data points updates onscreen as you move around. Select any item, open the rotor, and choose Show Menu for a context-sensitive list of ways you can interact. Save a location as a favorite, watch this location, or pick it as a destination. I'll have more to say about menu options a bit later. When you turn a toggle on, the app provides spoken updates for that item. Nearby Explorer is a self-voicing app, meaning that you can assign any installed voice to the app, and it will speak, independent of VoiceOver. This also means you will hear updates from the app even when the iOS screen is locked and VoiceOver is unavailable. Here's an example of how this works in practice: use VoiceOver to choose the data points you want Nearby Explorer to track — heading, street name, and street number, for example. The app updates this information using the voice you choose for it. If you explore the screen with VoiceOver, you can also hear current information about items you didn't enable, like County, City, and Zip Code.

Getting familiar with Nearby Explorer means deciding how much detail you want the app to provide about your surroundings as you travel. There's a lot of information available, especially if you're in an urban area. Your needs will certainly be different as a pedestrian than as a bus or car passenger. It took a couple of lunchtime walks in the downtown area of my city to decide which toggles to turn on to get the level of information I needed. The choices I made were different when I boarded a bus and was less interested in nearby lunch spots, and more interested in upcoming cross-streets and transit stops. Though Nearby Explorer detects when you've switched from walking to riding and adjusts its information delivery accordingly, the category of information offered is controlled by toggle switches, so it's necessary to "tune" Nearby Explorer a bit when your travel situation changes. A great option would be to have the ability to save a group of settings that could be enabled together, based on the kind of environment, or travel experience you need.

Below the toggle switches on the home screen are two rows of buttons. The upper row, with text labels, leads to lists of nearby streets, the search function, favorites, and transit. The traditional iOS button bar, below, takes you to an Apple Maps-based map, app settings, and the Nearby Explorer user guide. These two rows of buttons are always visible even when scrolling the other parts of the screen.

Nearby Explorer Setup

You can install Nearby Explorer on an iPad or iPod touch running iOS 9 or later, but since these devices don't contain GPS receivers your usage will be severely limited in comparison with the iPhone. The app uses its own set of onboard maps, licensed from NavTeq, a company that produces GPS maps for cars and other GPS applications, downloadable when you launch Nearby Explorer for the first time. Because the maps are contained in a single download, rather than split up by state or region, you'll need approximately 4.2 GB of free disk space to load them. If you have a 16 GB iPhone, it's unlikely you will be able to free enough space to install the map file. The maps cover the United States and Canada. APH says you can use Nearby Explorer without the map download, but your navigation experience will be slower and less accurate. Downloadable maps also allow you to use Nearby Explorer without an active Internet connection and the corresponding hit to your cellular data plan and battery usage. If you are connected to the Internet, you can take advantage of points of interest (POI) data from Google or Foursquare (choose the one you like best). We recommend that you download Nearby Explorer maps while connected to a Wi-Fi network, since the size of the download will tax your cellular plan's data limit. The download will probably be faster over Wi-Fi, too.

Nearby Explorer can also download up-to-date local information for each public transit system you encounter. These downloads are not large, but you should factor the time they'll take into your setup process when opening the app for the first time.

The Nearby Explorer Toolbox

Whether you're using turn-by-turn directions or simply walking or riding with Nearby Explorer active, there are nice touches in the app's narrated navigation. If you've turned on the Approaching toggle, you'll hear the names of upcoming cross-streets, and on which side of the street they occur. A typical announcement is, "Harris Avenue, left side, 50 yards." Street side information is a useful data point that most other apps don't provide. By the way, distances from your position to an upcoming intersection can be expressed in whichever measurement system you like, and accuracy seems to improve as you approach, especially in pedestrian mode.

The Geobeam and Compass features take Nearby Explorer beyond the realm of street maps, and give you the ability to interact with your surroundings by pointing your device. Using vibration, tones, and voice, Nearby Explorer identifies points of interest and how far away they are from your current position. With Geobeam active, hold your device horizontally in landscape mode, and point it in one direction, then another, to hear and feel information about your environment. Geobeam remains active as long as you remain in landscape mode, or don't turn it off on the home screen. Similarly, Compass, which operates when you hold the phone vertically in portrait mode, identifies your heading, along with nearby streets. You may only use these features occasionally, but they're a great way to get oriented in an unfamiliar area, or when you want to ensure that you're proceeding in the direction you intend to go.

Virtual navigation is one of Nearby Explorer's most useful and fun features. It allows you to simulate a trip or "look around" a destination before you go there. You can even use Geobeam and compass in virtual mode. To use virtual mode, begin by searching for a place, or selecting one that you've designated a favorite. Use the rotor to open the context menu, and choose Virtual Go To. From this point, Nearby Explorer, and all its tools, behave as though you're at the new location. Turn on Geobeam or Compass, or select the Streets or Transit button to see what's around you. You can also use Virtual Navigation, a subset of Virtual Go To), to take a walk around the location you've chosen. When you enable it, the bottom third of the screen displays four directional buttons you can use to move north, south, east, and west of the location. You can even choose the distance each move takes you, and tell the app to follow roads, rather than simply moving in the cardinal direction indicated. Other mapping apps offer virtual modes, but the clever implementation of "look around" features in Nearby Explorer makes this tool extra useful for travelers scoping out unfamiliar surroundings.

If you use public transit, chances are you can obtain local schedules from Nearby Explorer. APH gathers data from a national database of transit information, and provides schedule for more than 60 transit systems. When you select the Transit button, the app downloads information for your transit system. You can obtain additional transit info when you travel to a different city, or with Nearby Explorer's virtual navigation feature. APH says it updates transit information regularly, and that if yours is out of date, it will be labeled "expired," indicating that you should seek information from another source. Once you have downloaded transit data, Nearby Explorer lists nearby stops or stations on the Transit screen, along with the scheduled time of the next bus or train and distance from your current location. Select a stop to see a list of routes that use it, along with more departure times. You can drill down again to see stops made by a given bus, or select the stop's context menu to work with it like any other point of interest: get directions, save as a favorite, or navigate there virtually. Nearby Explorer's transit tool is not a trip planner with the ability to recommend a transit route to a destination to which you navigate. You can, however, locate transit stops near a destination you choose. Search for your destination and activate Virtual Go To. Now, when you select Transit, Nearby Explorer shows you stops in relation to the virtual destination, not your current location. This is a great feature. Use it to mark a transit stop as a favorite so you can find it easily when you need it.

Learning Curve

Select the Help button to see Nearby Explorer's 60+ page user guide as an HTML document. Unfortunately that arrangement makes it a challenge to search the document. APH does makes the user guide available online, in HTML format, but it would be helpful to have quick access to a downloadable version, which could be opened and read in an app of the user's choice. The guide functions as a comprehensive reference, and effectively enumerates Nearby Explorer's features. But this is a dense app with many features, and some of the terminology may be confusing to new users. A quick start guide, or, better yet, a tutorial document, would be a great addition to the current documentation, as would a glossary within the user guide.

The Bottom Line

Nearby Explorer is a full-featured app, with enough options to make it your only navigation tool, whether you're walking, using transit, or riding in a car. The use of third-party data sources for points of interest and transit information goes a long way toward future-proofing the expensive app. Finally, Nearby Explorer's offline maps, which account for a large part of the app's cost, are actually a good thing, allowing users to conserve cellular data, as well as providing robust offline simulation capability. Users who are new to navigation apps, or who don't relish having to learn a lot of app-specific terminology, may be overwhelmed by Nearby Explorer's many options and somewhat opaque naming conventions. In its 1.0 form, the documentation doesn't to make the learning process easier for newbies.

If you have already invested in a blindness-specific navigation app, or don't do much walking in urban environments, Nearby Explorer is overkill. But if you travel a lot, particularly in unfamiliar or complex environments, the app is an essential tool, whose responsiveness and attention to the specific needs of blind travelers make it worth the price.

Product: Nearby Explorer 1.01 for iOS, from American Printing House for the Blind (800-223-1839)
Price: $79.99
Available from: Apple App Store

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Cisco Systems Inc., a major manufacturer of network hardware, has been working to address the problem of access to education in developing countries. Networking Academy, or NetAcad, provides education opportunities to individuals in developing countries who might not otherwise be able to afford training.

In 2002, Iain Murray, who is on staff at Curtin University in Perth, Australia, began to wonder if people with visual impairments might be able to benefit from education assistance similar to Cisco's NetAcad program, and Cisco was willing to consider the idea of setting up a philanthropic outreach for vision impaired people similar to that which had been established for the NetAcad program. Murray reached out to Kerry Hoath, at the time a computer consultant, and they both began to explore the possibilities of providing computer training for individuals with vision impairment. By 2007, Murray had established the Curtin Center for Assistive Technology (CUCAT), CUCAT received funding from Australia's Department of Workplace and Training, and the Cisco Academy for the Vision Impaired (CAVI) was established as a part of CUCAT. Upon its launch, Hoath was employed as a full-time instructor for The Cisco Academy for the Vision Impaired (CAVI).

In the early days of its existence, all CAVI classes were offered free of charge. Murray and Hoath had no idea whether their efforts would yield any fruit, but as it turned out, students began completing courses with scores that rivaled those of any of their sighted counterparts. Cisco encouraged CAVI to continue its work.

Today, CAVI charges a nominal fee for its courses, both to help pay costs and to legitimize the work they are doing in the eyes of the public. Hoath points out that not charging or under-charging for classes that normally cost $3,000 to $5,000 causes people to not take CAVI's work seriously. He also points out that scholarships are available to students who need them.

CAVI Courses

If we take a look at the list of courses offered by CAVI for the fall 2016 semester, we can begin to understand just how diverse the academy is.

CAVI offers two types of courses—full-length courses, and short courses. A full-length course might run 12 weeks or more, and a short course might only last for two or three weeks. Among the list of full-length courses is a totally redesigned Audio Ins and Outs course consisting of three separate modules that can be taken individually, or together. In 2012, CAVI introduced an Audio Fundamentals course that covered everything from the basics of microphones, cables, and audio interfaces to discussions of single-track editing with GoldWave and multitrack editing with Reaper. The course cost $150. In 2016, the Audio Fundamentals course has been transformed into three separate modules. Audio Essentials ($50) covers the basics of audio theory and hardware. A second module ($100) covers single-track editing with GoldWave. A third module ($150) covers multi-track editing with Reaper. It is possible to take all three modules for $150. The Audio Ins and Outs course is set up so that it is possible to take all three modules in the same semester. Lectures are conducted using TeamTalk, and class archives are made available to students. Also, class notes and resources are available via an online Wiki. CAVI courses other than Audio Ins and Outs make use of Ventrillo for online lectures, rather than TeamTalk. In all courses, homework is assigned, and a final project is required to complete the course. Most full length courses cost $150, and a payment plan is available.

Continuing down the list of full-length courses, we find a 22-week Intro to HTML and CSS course that will get the student up and running with designing a website for personal or business use.

ITE Essentials is a Cisco Accredited course that provides an in-depth study of computer software and hardware essentials. As stated on the CAVI website, "Upon completion, students will be prepared for the Comp TIA A+ certification exam, if they choose to take it." Quoting from the Website of the Indiana University, "A+ (A Plus) is an entry-level computer certification for PC computer service technicians. The exam is designed to certify the competency of entry-level PC computer service professionals in installing, maintaining, customizing, and operating personal computers."

Computers 101 is a course designed to teach students the basics of using a computer with a screen reader in either the Windows or Mac environment. Topics include file management skills and the safe use of the Internet.

Setting up Linux on a Raspberry Pi, CCNA Networking, and An Introduction to PHP are also included in the list of full-length courses offered by CAVI.

In addition to the courses listed above, CAVI also offers a variety of short courses. These include learning to use Microsoft's suite of Office programs, Skype, NVDA, WordPress and CMS Fundamentals, basic computer file management, and even baking. Hoath points out that the Office coursework is tested for all versions of the program, something that not all courses can say.

If you are thinking about learning to use a Mac, the CAVI OSX course might be just what you are looking for.

The courses mentioned above are only a sampling of what CAVI has to offer, so be sure to check the list of CAVI's current course offerings for the latest additions. From time to time, CAVI offers presentations that are free, and are available as downloadable MP3 files, or "Cavicasts." Topics are too numerous to mention here, but include effective notetaking with iOS, and the NVDA Remote Control.

When asked about the instructors who teach CAVI courses, Hoath says that there is no secret formula for selecting great teachers. Many talented people have come forward and have been willing to put a lot of time and effort into their work as teachers. In some instances, former students have gone on to teach classes, and in others, instructors have been willing to create a course from the ground up. CAVI is able to pay instructors for their work.

CAVI Transcends the Classroom

Knowledge is a wonderful thing, but the sense of empowerment one gets from being able to apply that knowledge is something else entirely. Hoath says that many CAVI students gain self-confidence as a result of the skills they learn through the classes they complete. In one case, a gentleman who had suffered a stroke was able to use the CAVI class he was taking to improve his cognitive skills.

Those successes are what motivate Hoath to continue putting in many long hours for CAVI.

Another benefit of taking CAVI classes is the social interaction that comes with the experience. It is possible to interact with people from all over the world in a CAVI class. New friendships are made in class, and networking opportunities abound.

The Bottom Line

It's no secret that the unemployment rate among the blind community is quite high. Travel is often not as convenient for blind people as it is for their sighted counterparts, and the cost of a good education is often prohibitive for many, whether they have a visual impairment or not. The Cisco Academy for the Vision Impaired brings together talented instructors and willing pupils at a cost that is affordable for anyone who is serious about their studies. CAVI's standards are high, and there are many people, students and instructors alike, who are more than willing to lend a hand to anyone who wishes to learn. When thinking about furthering your education, consider giving CAVI a try.

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In many cases the progression of eye disease can be slowed, even halted, by early detection. Most of the instruments and techniques used to detect eye disease were developed years, even decades, ago—which is in stark contrast to the ongoing cutting-edge advances in treatments we hear about in the news nearly every day.

In this article we describe two significant advances in early detection of eye disease: one for glaucoma and one for diabetic retinopathy. Each holds out hope of significantly earlier diagnosis, and each was prompted by a reassessment of scientific research and technology choices from decades ago.

Early Detection of Glaucoma

According to the BrightFocus Foundation, over 3 million Americans currently live with glaucoma, 2.7 million of whom are over 40 years of age. It's the leading cause of blindness among Hispanic and African Americans, the latter of whom are 15 times more likely than non-Hispanic Caucasians to go blind due to this progressive disease.

There is currently no cure for glaucoma. Early detection is critical. If diagnosed early enough, vision loss can be limited with medications, surgery, or both.

Regular testing by an eye specialist is essential. During the exam a puff of air may be directed at the eye to determine intraocular pressure, which is to say the pressure of the vitreous fluid that fills the eye and holds its shape. Normal pressure is between 10-21 mm Hg (millimeters of mercury). The average pressure reading is approximately 16. Above 21 mm Hg is considered high, which has historically been linked to the onset of glaucoma.

A standard eye exam will also include an ophthalmoscopy. After eye drops have been used to dilate the pupil, the doctor uses a slit lamp to examine the shape and color of the optic nerve to spot any signs of damage. If the intraocular pressure exceeds the normal range, or if the optic nerve appears abnormal, a visual field test may be ordered to detect any vision loss. For this procedure the patient looks into an eyepiece and indicates if and when he or she detects a pinpoint light that is directed toward various retinal areas to make sure they are functional.

Unfortunately, by the time most people display the nerve damage associated with glaucoma, the disease has already robbed them of some of their vision. And glaucoma can be a stealth disease. "One of the misconceptions most people have about glaucoma is that it's caused by high intraocular pressure which damages the optic nerve," observes Michael Kalloniatis, OD, PhD., Professor of Optometry and Vision Science at the University of New South Wales, and Director of the Centre for Eye Health, an initiative between the university and Guide Dogs NSW/ACT. "When I was in optometry school the rule of thumb was that if your intraocular pressure was greater than 21 mm you had glaucoma, if it was lower, you didn't."

According to Kalloniatis, nearly half of people with glaucoma have normal intraocular pressure, including his own mom, who has what doctors now call Normal Tension Glaucoma. "The current thinking is that it's not the high pressure that causes the damage, it's the differential between the intraocular pressure and the blood pressure in the retinal vessels."

This is why a thorough eye exam usually also includes a visual check of the retinal nerves, and, if called for, an optical coherence tomography, which offers an even closer look at potential nerve damage. And if something looks wrong there, the doctor may perform a visual field test.

In a visual field test, the patient gazes into an eye piece and reports when he or she perceives flashes of light that are directed to various locations on the retina. "Sometimes, however, there will be detectable nerve damage, only the visual field test will appear normal," says Kalloniatis. "In those cases most doctors will take a wait-and-see approach.

To Kalloniatis this didn't make sense. "If there are structural changes, we should really expect to see functional changes as well," he says, and Kalloniatis began to wonder if perhaps the visual field test itself might be part of the problem.

"The generally accepted thinking is that glaucoma vision loss begins with the peripheral vision, and then progresses toward the center,  " notes Kalloniatis. "We theorized that this may not be the case, and that the reason some people might show loss of nerve function but still pass the visual field test is because of the limitations of the test itself."

Back when visual field studies were first being developed, there was one standard with varying specifications for the size of light that would be used to trigger the retinal response. Two of these specifications are called Goldmann II and Goldmann III, named after the developer, Dr. Hans Goldmann. Goldmann III uses a light that is the size of approximately one half of a degree of the retinal surface. Goldmann II uses a light that is the size of a third of the area covered by Goldmann III, and is "far more sensitive," says Kalloniatis.

To picture why this is so, imagine the dot of light cast by the Goldmann III standard as a very basic computer screen consisting of 16 pixels. If four of those pixels are not working, the image will still be largely visible. For Goldmann II, shrink that computer screen down to four pixels. Now, those four defective pixels block the image completely. The damage is easily detected.

Kalloniatis and his colleagues began including the more sensitive Goldmann II test in their patient screening at the Center for Eye Health. They discovered that many of the people with detectable nerve damage who had passed a standard visual field test also passed a more sensitive, Goldmann II test?at least at their vision's mid-periphery, which is where conventional wisdom says glaucoma damage begins. They did, however, detect abnormalities closer to the optic nerve—within 15 degrees of the patients' central vision. Additionally, they discovered that these early warning signs were most pronounced in those with normal tension glaucoma, which is far less likely to be diagnosed and treated before serious nerve damage has occurred.

"According to our models of how the disease progresses, this central damage could be occurring years before it shows up on a standard retinal exam or visual field test," predicts Kalloniatis.

So why do standard visual field tests still use the larger Goldmann III specification when Goldmann II is so much more sensitive? "Back when the testing machines were first being developed, the engineers decided that Goldmann III was as small as they could go and still project a light that was strong enough to be perceived," observes Kalloniatis. "The technology has advanced, but now we have decades of published research based on the Goldmann III specification, which makes it the gold standard for research. Also, who is going to invest the millions of dollars to get regulatory approval for a change of resolution when as of today, most experts aren't even aware the change could help with early diagnosis?"

Glaucoma isn't the only eye disease where the reliance on old technologies and ways of thinking may be hampering early diagnosis.

Early Detection of Diabetic Retinopathy

In the US there are an estimated 30 million individuals with diabetes. Nearly one quarter of these people also develop diabetic retinopathy.

As with glaucoma, early diagnosis is essential for those with diabetic retinopathy. The longer an individual has diabetes, the more likely it is that he or she will develop diabetic retinopathy. Unfortunately, according to Rithwick Rajagopal, MD, PhD, Assistant Professor, Ophthalmology and Visual Sciences at Washington University, "Although the standard is that a newly diagnosed diabetic should schedule an eye exam within six months, even among those with excellent access to health care only between 40 and 50 percent actually make an appointment, and among those with limited health care access, this number drops to just 20 percent."

More emphasis on awareness and early medical intervention can make a significant difference. So could more effective screening. Currently, the diagnosis of diabetic retinopathy is only made after a specialist detects changes in the delicate blood vessels that nourish the retina. But according to Rajagopal, "By that time there has already been significant damage."

Rajagopal and his colleagues suspected there might be ways to detect the disease earlier. "Going back to the scientific literature, we found studies conducted in the 60s where diabetic mice were given a vision test called electroretinography that revealed measurable vision loss with no perceivable vessel damage," he relates. Rajagopal suspected there must be another functional defect causing the vision loss. He hypothesized the loss was neural in nature, but he was unable to test his hypothesis because most of the past and current animal-based diabetes research is performed using mice that have been injected with pancreas destroying compounds. "These substances are neurotoxic, so any retinal nerve research using these mice would be flawed from the start," notes Rajagopal.

It was time to build a better mouse.

Rajagopal and his colleagues began overfeeding test mice with a high-fat, high-calorie diet, leading to obesity, high fasting glucose levels and other insulin-related issues. At six months Rajagopal already began seeing retinal nerve damaged as measured by the same electroretinography tests, which track the time it takes the retina to respond to a flash of light and the strength of that response.

"The earliest changes we noted were in the lengths of time between the flash and the response," says Rajagopal. "The test mice responded upwards of 10 percent slower than the control mice. It was another six months before the same mice began displaying the retina vessel damage that has traditionally been thought to cause the retinopathy. "Extrapolating these results to the average human life span, our research indicates we could spot vision damage decades earlier than is currently feasible," Rajagopal predicts. "This could also lead to new neural based therapies once further research reveals what, if any, causal relationship there is between the vessel damage and the nerve damage that precedes it.

Looking Forward

Rajagopal's mice will cost much more than standard lab mice, and, as with the visual field test standards, there are decades of research and professional reputations that are based on the old model. It is not ours to say whether these two developments represent genuine medical advances. After all, there is always the chance the studies were flawed, or unrepeatable. Hopefully, the medical community will not dismiss these potential advances out of hand, but will give them the scientific inquiry and analysis they seemingly deserve.

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