The Quest to Create a Bionic Eye Gets Clearer
By SHIRLEY S. WANG
Have scientists finally created a bionic eye? The quest to develop a device that will give some blind people vision again, a retinal prosthesis, has been challenging. Shirley Wang joins Lunch Break with the latest on the research. Photo: Second Sight.
Restoring sight to the blind has proved particularly challenging for scientists, but a new technology combining an eye implant and video-camera-enabled glasses may soon be available in the U.S.
Researchers have been pursuing the development of such a bionic eye for decades, in some cases spending hundreds of millions of dollars to tackle engineering challenges. One device designed to help people with a rare eye condition is awaiting U.S. regulatory approval. It is known as Argus II, made by Second Sight Medical Products Inc. of Sylmar, Calif. Other researchers, including at the Massachusetts Institute of Technology and Stanford University, continue to work on what they believe are even more sophisticated versions.
Second Sight's product uses what is known as a retinal prosthesis that bypasses the dead or damaged cells in the eye needed to detect light. Instead, the device reroutes visual data via the implant to parts of the eye that still work. Like other similar devices under development, it uses a video camera embedded in a pair of eyeglasses to collect visual input in the form of light and transmit it to the implant as an electrical signal.
If Argus II is approved by the Food and Drug Administration, it would be the first retinal prosthesis to hit the market in the U.S. The device is already available in Europe.
The patients most likely to benefit from these devices are those with retinitis pigmentosa, a rare disease that damages and kills the cells in the retina—a tissue layer at the back of the eye—that process light. For people with the condition, their vision grows increasingly blurry until they eventually can't see at all. Some 100,000 patients in the U.S. have the condition.
Another group of patients who may find such technology useful, scientists say, is those with severe macular degeneration. This is an age-related disease that damages the part of the eye that perceives fine detail, according to the National Eye Institute. The various retinal prostheses under development all use video cameras to send light information to chip implants. Most of them use the data to trigger electrodes in the chip to stimulate pixels of light on the retina, which are then processed normally by the brain as images.
The technology tested to date lets the wearer primarily see in black and white. It is most useful for seeing sharp contrasts, such as the painted white line of a crosswalk on a dark road. But scientists hope that they can improve the detail to eventually enable color vision in its wearers.
Barbara Campbell, a 59-year-old vocational rehabilitation counselor, has had virtually no sight since her 40s. She had the Argus II implanted in her left eye in 2009 after hearing about the device through her work at the New York state Commission for the Blind and Visually Handicapped.
Though she was told the device was experimental, Ms. Campbell thought, "anything I gain will be a plus," she said.
Ms. Campbell had a five-hour surgery at New York-Presbyterian Hospital and two months later was fitted for the video glasses. Returning to her apartment, she could see that the light fixtures in the hallway of her building were different from how she remembered they used to be.
While her vision is still limited to discerning large objects such as furniture, she said, she can now see the pole at her bus stop instead of having to locate people standing nearby. When she goes to the theater, she can follow the actors on stage, though she cannot see their facial expressions.
"It's very exciting and it's very cool," Ms. Campbell said. "I felt that my brain now had to become used to using vision again," she said.
Some 50 patients, including Ms. Campbell, have been implanted with the Argus II, with two-thirds of them experiencing benefits. The patients who respond the best can read large letters a few inches tall. Patients report the biggest gains are in improved orientation and mobility, said Robert Greenberg, Second Sight's CEO, who also is a medical doctor.
Designing a bionic eye has been much more difficult than developing other types of aids, such as a cochlear implant for hearing, say scientists. For one thing, visual information is two-dimensional—both horizontal and vertical coordinates must be sent to the brain—while sound waves needed for hearing are one-dimensional.
Another challenge is protecting the implant in the eye, since it essentially has to sit in a bath of organic liquid. "It's like taking your television and throwing it in the ocean and expecting it to work," said Dr. Greenberg. Scientists have spent time working out how to manufacture tiny, airtight boxes that can shield implants when they are in the eye.
A big obstacle has been figuring out how to adequately capture and stimulate enough pixels of light on the retina to produce a clear image. Normal vision is based on more than one hundred million receptors in each eye, but it is impossible to squeeze that many electrodes into a tiny device that has to lay on the retina, said John Wyatt, a professor in the department of electrical engineering at MIT who has been working on a retinal prosthesis since 1988.
Second Sight's Argus II contains 60 electrodes, but some other scientists say that for a retinal prosthesis to be truly useful to patients, hundreds are needed. "In theory, you'd like to have more electrodes, but not if it means an implant that doesn't survive more than a few months" because the device is too bulky and unstable to stay in place in the eye, Dr. Greenberg said. "That was the trade-off we made."
Instead, the company is working to create better video cameras and software, which are external to the eye and easily updated, to better enhance and interpret the information sent to the implant, he said.
Dr. Wyatt and his group at MIT are developing a bionic eye that will contain between 256 and 400 electrodes. They are currently working on their fifth version. Earlier models have been implanted successfully in Yucatán miniature pigs and temporarily in six humans. They are planning to form a company to commercialize their technology.
At Stanford University, ophthalmology professor Daniel Palanker's group has taken a different approach to the problem. Instead of using electrodes, his team developed rows of tiny "photovoltaic" pixels (like solar panels), powered by the pulsed light from the video goggles, which are implanted under the retina. These implants convert light into electric current that stimulates local retinal neurons, which then send signals to the brain, meaning no wires are necessary to stimulate the retina.
Using this technology, Dr. Palanker expects to be able to fit enough light-powered panels to stimulate 5,000 pixels in a space similar to what the other retinal prostheses use. The device is currently being tested in rats and is expected to begin a human trial in a year or two, he said.
Write to Shirley S. Wang at email@example.com
A version of this article appeared January 29, 2013, on page D1 in the U.S. edition of The Wall Street Journal, with the headline: The Quest To Create A Bionic Eye Gets Clearer.
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