Retinal prosthetics offer high tech hope
If you are reading this in the usual sense, then count your blessings. Imagine you one day wake up and you can no longer use your eyes to read. And you cannot see the colors of a sunset, or the glistening sheen of a rose petal or the face of someone you love. Imagine trying to make your way, unassisted, through the military grade obstacle courses that pass for Bangalore foot paths, but without the ability to see.
Bangalore based journalist, author of Lights Out: A True Story of a Man’s Descent Into Blindness, and disability activist, Laxmi Subramani, puts it best in his blog:
Those young follow their family into finding cures that are not available and don’t exist anywhere in the world and those old enough have to bid farewell to their career aspirations and remain at home. Some realise that technology can make a difference (as it has done in the cases of members of the patient group who work and lead a normal life), but they are not convinced that it would be possible in a society where discrimination on the basis of ones disability is quite common. So far the patients have to suffer in the silence of their hearts and within the four walls of their homes. Thanks to the disconnect between health and NGO sectors in vision related areas, we don’t have a system to allow people affected with R.P. and other related, and no less dangerous, retinal diseases to bounce back and continue to live as dignified and respected individuals.
Perpetual darkness is a reality for an estimated 15 million blind Indians, and for roughly 37 million blind people globally, but it looks as though high tech hope is on the horizon- at least for those few who can afford retinal prosthetics.
Technical aid for the blind comes in several forms. Aside from the standard issue cane and seeing eye dog, it increasingly involves the availability of high tech assistive devices from computer and mobile apps such as the 3D Haptic WebBrowser to the haptic shoe, sonar equipped cane and audible GPS. While such advancements certainly go a long way to help the blind adapt to their surroundings, they don’t restore vision like sight restoration surgeries. Until recently, even sight restoration surgeries often involved cornea transplants or cataract removal, which are of no help to someone suffering retinitis pigmentosa (RP), a rare genetic condition causing little to no light perception in both eyes, or to someone with macular degeneration. It seems that for those with retina damage, options for vision restoration are limited to emerging bionic prosthesis technologies, which are among some of the most exciting, yet expensive, medical advancements to date.
In January of this year, two physicians at the University of Michigan Kellogg Eye Center successfully implanted a type of bionic eye called the Argus II Retinal Prosthesis system in a blind patient. The device is meant for adults suffering from advanced retinitis pigmentosa. Second Sight, the manufacturer of the Argus II, recently received FDA approval for the system, under “humanitarian use” principles. It took twenty years and $200 million in funding for the company to achieve this, and the cost of the implant is, approximately, a whopping $145,000.00. American patients who cannot afford the exorbitant price of the Argus II may still be able to avail this surgery, but only if they’re eligible for Medicare or Medicaid, which will help cover some of the expense now that the government has approved payment for the Argus II.
The Argus II is implanted in only one eye. The bulky, multi-piece system starts with a digital camera mounted on the eyeglasses, translates the images taken by the camera into data, and sends that data through a wireless transmitter to a computer chip placed at the side of the eyeball. The chip on the eyeball activates an electrode array implanted at the back of the retina, which stimulates retinal cells to send information to the brain. In time, the patient then learns to interpret new signals as they get accustomed to using the device. Despite the cost and the bulky gear involved, the Argus II does not restore 20/20 vision. Instead, it helps patients see just enough to recognize shapes, read 9 inch high letters, climb stairs and walk through doors without a cane. Shawn Kelly, a scientist from Carnegie Mellon University, was quoted, “The electrode array is not finely tuned enough to produce the same detail of a functional human retina. More advanced technology will be necessary in order to convey colors as well as the type of visual resolution that we have in the center of our vision.”
While some may feel the Argus II is better than nothing, others may choose to wait a while for sight restoration technology to evolve. But the wait might not be that long since an Israeli company by the name of Nano Retina, Inc. claims to be developing a nano technology that can restore 20/20 vision in those suffering from RP, macular degeneration and other forms of retina damage.
Nano Retina, a joint venture between Zyvex Labs and Rainbow Medical, is in the process of developing a device called Bio-Retina. According to the company website, Nano Retina was founded by Yossi Gross and Jim R. Von Ehr, who are serving as the company’s directors, Efi Cohen Arazi, company chairman, and Ra’anan Gefen, Nano Retina’s managing director.
According to the Nano Retina website, Bio-Retina is a miniscule implant containing nano-size components, and implantation requires only local anesthesia and a 30 minute procedure wherein a small incision is made and the device is applied to the damaged retina, then at least a week of recovery time. The company claims that sight restoration is expected to be instantaneous, and that vision will be only 20/200 with the first generation device, but that the second generation device will provide patients with full 20/20 vision.
The company says Bio-Retina works by replacing the damaged photoreceptor in the eye with the retinal implant. The device then transforms naturally received light into an electrical signal that stimulates the neurons responsible for sending received images from Bio-Retina to the brain. The implant is intended to work in tandem with the natural functions of the eye, such as pupil dilation and movement of the eyeball. A battery powered and rechargeable mini laser, once attached to a pair of eyeglasses, is supposed to wirelessly power the implant. Nano Retina says the technology will enable patients to look from one side to the other with their eyes rather than having to turn their heads, as with competing technologies.
While both technologies are intended to restore varying levels of vision, even small improvements can make a huge difference to a person who’s completely blind. The impact of these technologies on quality of life cannot be underestimated, especially when it allows a person to navigate their environment safely and without being forced to depend on others. Retinal prosthetics, such as Argus II and the up and coming Bio-Retina, may well revolutionize the medical community’s approach to blindness; and hopefully, cutting edge technology like the Bio-Retina will someday be available to all blind people in every country, not only the wealthy elite or those Americans who meet the ridiculously unfair eligibility requirements for public assistance.