They are an unusually cheerful group, these patients of the Center for the Partially Sighted in Santa Monica.
Some, in addition to serious vision problems, carry an extra burden: injury from accidents, major physical diseases, family and financial problems. All have experienced the emotional depression that failing sight almost invariably means.
Much of the credit for their good cheer, they insist, goes to the center and its emphasis on how much the person can still see rather than how much vision has been lost.
"Here we never speak of 'blind.' We speak of 'low vision' or 'partially sighted,' " said Sam Genensky, himself legally blind, who founded a facility in 1978 to offer low vision services. It became a department of the Santa Monica Hospital Medical Center, then in 1983 a not-for-profit independent entity as the Center for the Partially Sighted.
Nobody knows more about loss of sight than Genensky: "I have had no vision since I was one day old. I have bad burns from medication wrongly put in my eyes just after birth. I have no vision in my left eye and 20/1,000 in my right eye."
According to legal definition, Genensky is blind. But not to hear him talk about it.
"I use binoculars to find out the number of a bus or to see if the signal is red, yellow or green," he said. "I have glasses with a small telescope on the outside of the lens, and I read and write on a computer screen that enlarges print."
Despite his vision problems, Genensky earned a doctorate in mathematics at Brown University, worked at Rand Corp. as a mathematician and got into designing computer programs for people with severe vision problems. He began to work with the partially sighted, whom he defines as "those who, with the help of glasses or contact lenses, are unable to read a newspaper column 10 inches to 16 inches away from their eyes. They can see more than light and the direction light is coming from and sometimes shape and form and a little bit of color."
By his own admission, Genensky has an advantage over his patients when they resist the center's program or seem to pity themselves.
"When I talk to a patient they can't say to me 'You don't understand,' " he said.
He estimated there are 2 million partially sighted persons in the United States and more than 120,000 in Southern California. One in five is legally blind but three-quarters of those are at least partially sighted, he said: "Most 'blind' people are not blind; they are just so labeled."
The Center for the Partially Sighted, 919 Santa Monica Blvd., has a projected budget for 1987 of $956,000. Funds come from grants, the state Department of Rehabilitation and other governmental entities, support groups and from patient fees and the sale of vision aids.
Patients are charged for services on a sliding scale of zero to $132 for six months of visits, said center psychologist LaDonna Ringering. The cost for visual aids range from about $20 to $600, depending on the device involved. Some costs are picked up by Medicare, the state Department of Rehabilitation and private insurance plans.
The center offers complete optometric services--glasses, special equipment and visual aids tailored to the individual's needs--along with psychological counseling, family therapy, support groups and instruction in independent living skills. Of these, 65% are optometric services.
"We offer low-vision visual examinations to determine functional visual capability, that is, what the patient can do," Genensky said. "The ophthalmologist tells us the pathology of the patient. We supplement that with services to assist the patient in continuing functioning.
"This allows the doctor to prescribe low-vision visual aids. We train patients in their use to determine if they can use a particular aid."
The center staff includes two full-time and two part-time psychologists. The full-time psychologists are specialists also in gerontology, since 71% of the patients are between 60 and 75. They provide individual and family counseling and work with the support groups and volunteers who maintain contact with the patients.
Phyllis L. Amaral, who holds a doctorate in both gerontology and clinical psychology from USC, directs the peer counseling program.
"There are nine peer counselors--people who themselves are partially sighted--who make phone calls weekly to those who can't get here," she said. "There are six who greet new patients in the waiting room, offering reassurance from someone who has gone through the same thing. We also have four in a speakers bureau who talk at schools, service groups, medical auxiliaries and retirement and convalescent hospitals.