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IN TOUCH – It’s our 60th birthday!

TX:Ìý 12.10.2021Ìý 2040-2100

PRESENTER:Ìý ÌýÌýÌýÌýÌýÌýÌý PETER WHITE

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PRODUCER:Ìý ÌýÌýÌýÌýÌýÌýÌýÌýÌý FERN LULHAM

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White

Good evening.Ìý Now, anyone remember this?

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Music

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White

Well, if you do, you’re even older than I am.Ìý In Touch had its first outing 60 years ago this week, so older than Radio 4 itself.Ìý And in our early days we had a signature tune.Ìý So, in honour of our birthday we thought we’d give it another spin.Ìý Music did spin in those days.Ìý We’ve not made a huge thing of our 60th, we’re waiting for our 75th for the big party, but since our 50th, which was quite a bash, we’ve sadly lost Thena Heshel, the producer whose belief in the programme kept us on the air in the early days and whose conception of what the programme was for has much to do with our continuing survival.Ìý At that 50th bash she explained to over 300 guests from amongst In Touch listeners, what that conception was.Ìý I thought we should hear it again.

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Hershel – In Touch 50th birthday speech

I knew absolutely nothing about blindness and because I had been a journalist before I became a ³ÉÈË¿ìÊÖ producer, I knew the thing to do if you had a new subject was to read about it.Ìý So, off I went and got hold of everything I could read and here I landed into my first controversy.Ìý The second programme I did was based on a very interesting article I read in an American journal on blindness about something called long cane, with which people were taught to move about safely.Ìý In this country, at that time, there was only the symbol cane or guide dogs who obviously had a training programme but nobody taught anybody what to do with a white cane.Ìý I put this out and the very first result was a very sharp retort from the Royal National Institute of the Blind – how dare we give information about something which hadn’t been tried and tested here.Ìý And I thought to myself, well, that’s interesting, I wonder how different American blind people are from English ones.Ìý

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And nothing daunted I went on to another programme about something called low vision aids, which I knew as magnifiers, and I sent off one of our reporters to find out about them and the variety that there was.Ìý This went out and had two immediate results – hundreds and hundreds – I do not exaggerate – letters from blind and partially sighted people all over the country thanking us for telling them about this equipment, it had never been told about and a furious fuselage, from, I think, the College of Ophthalmologists or it might have been Moorfields about how dare we mention this because this was not something for lay people to discuss, it would be for ophthalmologists who never referred people because it was optometrists and not ophthalmologists who knew about it.Ìý

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So, that was the beginning of my first lesson that it was for us to give people the information with which they could then help themselves and if that meant pressing the professionals, too bad, that was our job.

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White

And we’ve been trying to do it ever since.Ìý Thena Hershel, do stay with us.Ìý [Clapping]

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Thank you Thena, we owe you a great deal.Ìý And hopefully you would approve of what’s to come in the programme.Ìý

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Later, we’re going to be looking at an offbeat use of technology.Ìý But first, it seems, that the longer the covid pandemic goes on, the more we’re discovering about its long-term effects, which may not be spotted when medical staff are dealing with more immediate health threatening symptoms.Ìý And optometrists and ophthalmologists are becoming concerned that there may be implications for eye health associated with what we’ve come to call long covid.Ìý We’re featuring this not to alarm people but to make sure people are aware of the steps they can take to find out if there is a problem.

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Dr Peter Hampson is Clinical Director of the Association of Optometrists.Ìý Peter Hampson, what is the concern about the connection between covid and eye health?

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Hampson

The connection, at the moment, is a little woolly, we’re not 100% certain on what’s there.Ìý The research is very much still ongoing, so we can’t be certain of what covid or long covid may do to the eye.Ìý But we can draw some conclusions around similar disease processes that we know that occur in the eye and we know that when there is inflammation or when blood vessels get blocked into the eye and other conditions, certain things can happen, sort of the retina being starved of oxygen, blood vessels breaking and leaking and then that can lead to other complications.Ìý So, that’s the area that we’re worried about because we know that covid can cause blood clots and it can lead to very similar conditions to those seen in diabetes and hypertension, where the retina can be damaged.

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White

You say that we’re not sure exactly what’s going on, I mean are there any figures yet of incidents of eye disease or damage to eyes?

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Hampson

Not at the moment, it really is too early to say.Ìý In practice, myself, I’ve seen a number of patients who’ve exhibited tiredness and follow-on effects linked to the sort of general malaise that’s exhibited in long covid but we haven’t got firm figures on any damage or how long lasting that damage may be or how severe it may be going forward yet.

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White

So, what might be the symptoms, I mean what should clinicians, as well as patients, look out for?

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Hampson

So, from a clinician’s viewpoint when they’re doing an examination and they’re looking into the eye, there’s a chance they may see a small haemorrhage or a larger haemorrhage, potentially, if one of the blood vessels has been blocked.Ìý And they would pick that up on a normal examination.Ìý There’s also the potential that if one of the blood vessels has stopped any supply to the eye the eye might look normal but they might see some visual field damage or damage to the acuity because retinal tissue is very similar to brain tissue in large regard and if it’s starved of oxygen for a period of time it can cease to work properly.Ìý And, again, that would be picked up by things such as visual field tests or an inability for the patient to read well on the letter chart.Ìý

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From a patient perspective, it’s really looking for things such as an inability to see as well as they could, that sounds very obvious but just that they can’t read or can’t see the detail that they could once see or potentially that they’ve got little blind spots in their vision if an area of the retina has been damaged.Ìý If that happens then it’s really important they get it checked out, it may be something very trivial, it may be something sort of very short lived but, as with all of these things, the sooner that they’re looked at and examined, if there is anything that needs doing, the easier it is to intervene.

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White

Because this is the problem, isn’t it, there is a lot going on with covid and maybe this is something, especially if you’re too ill and you’re not going out, you’re not doing the kind of things where this might show up.Ìý I can see how it could very easily go under the radar.

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Hampson

I think it could.Ìý If people have been very ill, then there’s a chance that they’re so busy prioritising getting generally well that they perhaps ignore some of what they might consider more trivial symptoms.Ìý And, obviously, as we know with eye disease early intervention is nearly always the key to getting a good outcome.Ìý So, that’s probably my big take home message – if you’re worried about, if there’s a concern, to get it checked out because the professionals who will be examining you will be able to give you the correct advice to get to the place you need to be or what you need to do yourself to sort of self-manage the problem that you’ve got.

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White

And you made the point that it’s almost like a blood clotting problem, would you know if this had happened?

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Hampson

From a patient perspective, possibly not, it’s remarkable the amount of patients that present, not just from a covid perspective, but where they’ve perhaps had an incident with one eye that isn’t an accident or anything, so there’s not an acute traumatic event where they can say – oh I remember when I got poked in the eye.Ìý You ask them to read the letters and they cover one eye and suddenly realise that they can’t see as well with one eye as the other.Ìý And the brain does this wonderful trick of when we’re walking around with both eyes open, it sort of fills in the blanks and we don’t notice it, so it’s very feasible that a patient could be unaware, unless they happen to have covered the good eye, as such, and have noticed that the other eye suddenly isn’t as good.

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White

Are we at the stage yet where people with covid would be referred for an eye examination if they’re experiencing covid and especially long covid or is that an initiative that the patient would have to take themselves?

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Hampson

I’m afraid it falls on the patient at the moment.Ìý I mean there are a number of good schemes scattered around the country for what we would term sort of normally minor eye conditions or eye problems where you can present to the practitioner, to the optometrist, and get examined but it is very much a sort of self-care, self-managed, self-presentation rather than a scheme that says well we know you’ve had this and we advise that you go and have test A, test B and test C.

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White

But there’s enough concern about this for you to feel that this is something people should know about?

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Hampson

I think that’s reasonable, given just the volume of patients that are out there and given what we do know about how blood clotting is affected, I think it’s reasonable that patients should be taking some steps if they have concerns, just to make certain that everything is normal.Ìý It might be something fairly simple that just because of the general sort of tiredness and malaise after an illness, simple things like being unable to read their smartphone or see their computer screen as well as they could previously and those are things that can very easily be remedied.Ìý Just things like that, any eye disease, if there’s the concern, getting it checked out and making certain that you’re not just ignoring it is always good advice, regardless of how trivial it may seem, it’s always best to seek a professionals’ advice and make certain that you are fully informed.

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White

One other question which is much more general but we’ve heard a lot about the effect covid has had on waiting times for all kinds of conditions.Ìý What about sight threatening conditions?Ìý It seems inevitable that there would be a lot of delayed diagnosis and therefore delayed treatment – is that true?

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Hampson

It is, yes.Ìý I mean from a primary care, sort of optometry on the high street, as your listeners will know it, there is access, they’ve been open throughout.Ìý We know that there is a backlog, we know that if we look at the numbers of NHS tests that have been conducted there was a dip, obviously, when everywhere was locked down and people weren’t going about their business.Ìý And that bounced back to broadly normal levels but over the last few months there’s still a gap.Ìý So, the people that weren’t seen we’re not catching those up, they’re still floating around in the system and not being seen.Ìý

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From a secondary care perspective, so at the hospital for things such as cataracts or glaucoma follow ups particularly, we know that there’s a backlog on those because they just haven’t been seen and people that would have been seen on six months perhaps now have not been seen for 18 months in some cases, and that’s a really significant concern because obviously most of these conditions are progressive and if they’re not being seen there’s a chance that things are getting worse and they’re not getting the interventions that would ultimately save their sight.

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White

Dr Peter Hampson, Clinical Director of the Association of Optometrists, thank you very much indeed.

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Now, we’ve had quite a response to our item last week about the problems of banking and the mixed blessings of ever developing technology. ÌýStephen from Southampton was one of those who pointed out a recent downside for visually impaired people:

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Stephen

Following on from your 5th October podcast about banks and access to money, I’ve come across a problem that could potentially have more far-reaching and imminent problems for VIs and potentially other disabled people.Ìý There’s an increasing number of touchscreen only card readers in use without any tactile feedback, which means that VIs may no longer be able to verify their contactless cards or pay for items above the contactless payment limit.Ìý I tried contacting the RNIB but after a brief exchange of emails, they seemed to lose interest.Ìý Am I overreacting?Ìý

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White

Well, that’s an issue a number of people have drawn to our attention, indeed I must say I’ve come across it myself and very embarrassing it can be.Ìý And we shall be looking into this in a future programme.Ìý As we will a long and thoughtful email questioning whether technology is really going to be the boon in the workplace for blind people that we’ve been led to believe.

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But someone who is using a relatively straightforward form of technology to carry on doing his job, after losing his sight, is Chich Hewitt.

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Hewitt

What I’m going to be doing is I’m going to turn the Victor reader on, it’s going to read a bit of a psalm and I’m going to say those words just slightly behind it.

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Send me your light and your faithful care,

let them lead me;

let them bring me to your holy mountain,

to the place where you dwell.

Then I will go to the altar of God,

to God, my joy and my delight.

I will praise you with the lyre,

O God, my God.

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White

Chich Hewitt there using a reading machine with an eyephone to enable him to read from the Bible to his congregation.Ìý Well, Chich was a kind of locum vicar in the Manchester area when his sight began to fail and he’s been telling me about what happened.

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Hewitt

As I was moving parishes, I lost my eyesight to a rare genetic disorder but I had to learn on the hop, pretty quickly, because I was aged 63 then and I had to learn a technology which would work for me when I was no longer able to read.Ìý

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White

And when you say you did it fairly quickly, I believe that isn’t an exaggeration, you were on to it pretty fast, weren’t you?

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Hewitt

That’s right.Ìý We went on a short holiday and I got a little recording device, a very primitive one, and realised that something like this could work and just practised it.Ìý So, I was able to do it.

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White

And how sudden was this, how quickly did this all happen to you?

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Hewitt

In 2008 I began to lose eyesight in my left eye and it deteriorated over a couple of months.Ìý Nobody could work out what was going on.Ìý And it was only later in the year, actually at the beginning of the following year, in January 2009, that the other eye began to go and that went very quickly.Ìý And then they were able to diagnose a rather rare condition Leber Hereditary Optic Neuropathy which is a genetic condition – women usually pass it on, men tend to get it.

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White

We should explain your circumstances a bit here.Ìý People will perhaps detect South African accent, were you in the church over there before you came over here?

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Hewitt

Yes I was.Ìý My wife and I grew up in Johannesburg and for 10 years I was in an engineering capacity on the railways, I did an initial science degree, then went into the ministry and had most of my ministry in South Africa.Ìý And we came here in 2000 for what we thought was a couple of years but we’ve landed up staying, our daughters followed, so this is where the centre of gravity is now.

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White

At any point, once you realised you’d got this eyesight problem, did you think you might have to stop following your vocation?

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Hewitt

It did cross my mind but I think what was foremost in my mind was entering a new parish they interviewed me when I could see with one eye, they’re now getting me blind, I’d better make this work.Ìý And others have before me, so I thought there must be some way of doing it.

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White

There are quite a number of people who work in the church, for various denominations, did you talk to any of them?

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Hewitt

Not at that stage, no.Ìý I didn’t know anyone and we had to do our own investigation and we stumbled across, through a library, the various avenues which opened up and suddenly equipment became available, I was introduced to Access to Work and I realised there’s a wealth of material out there to help people who are losing or have lost eyesight.Ìý And in fact, I volunteer in sharing with other people some of the equipment that I use.

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White

So, what else do you use?

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Hewitt

The phone which I’m using now, it’s an Apple phone.Ìý The Apple’s technology is quite good at accessibility and I use the zoom function because I’ve got limited eyesight, so I can zoom in and out.Ìý I use the Siri function and the voiceover function which reads everything on the screen.Ìý As well as apps like Seeing AI, where I can hover the phone over a document I might receive in the post, if my wife’s not here to read it and read it for myself.

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White

As we’ve heard, you carried on with the ministry, I’m just interested to know whether there were other differences?Ìý I mean we’ve talked about the technology and your problem solving but what about people’s attitude to you or indeed your attitude to them?

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Hewitt

People in the parish were very kind and understanding.Ìý Taking the services was not such a difficult issue because I was largely in control of what I was doing and had planned it.Ìý The more difficult part came after a service when you meet with people in the hall and not knowing, without being able to see body language, without intruding on a particular conversation and really not knowing who was where.Ìý And if people don’t introduce themselves to you then it’s difficult for me to know who was speaking to me sometimes.Ìý I think I became much more aware and I’d be the first to say that I should have been much more aware of disability issues before this happened.Ìý And once I had this disability of my own, I became much more sensitive, I have become much more sensitive and I’m learning still.

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White

Just going back finally, to what we heard right from the beginning, how you use that equipment, quite a tricky thing to do to talk literally following on from a machine.Ìý Have you had any awkward or embarrassing situations with it?

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Hewitt

Occasionally I’ve lost my place.Ìý This is a device which I prefer using to a laptop because you can recover very quickly, you’ve got bookmarking procedures and so on which help.Ìý So, I have made some mistakes with it in the past.Ìý For instance, if a child is very noisy in the service, then I won’t be able to hear very clearly the words that I’m supposed to be saying.Ìý But most of the time it’s worked well.

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White

Chich Hewitt, good to talk to you, thank you very much indeed.

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And that’s it for the beginning of our next 60 years.Ìý Next week, a special on social care.Ìý It’s often described as the Cinderella service but we’ll be asking – are the services for newly visually impaired people Cinderella’s cast offs?

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We’ll continue to welcome your comments on anything we discuss on the programme.Ìý You can email intouch@bbc.co.uk, leave voice messages on 0161 8361338 or you can go to our website bbc.co.uk/intouch where you can download tonight’s and many previous editions of the programme.

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From me, Peter White, producer Fern Lulham and studio managers Sue Stonestreet and Owain Williams, goodbye.