Implants point way to living life with your eyes closed

Range of innovations help doctors restore vision

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At 81 years of age, British pensioner Ray Flynn can see with his eyes closed. Last year, the former factory supervisor from Manchester was almost completely blind but this summer he became the first person to receive a bionic eye implant to restore his lost vision — without the need for his own eyes.

Mr Flynn was diagnosed eight years ago with age-related macular degeneration. AMD results in the total loss of central vision and affects half a million people in Britain. He could only see out of the corner of his eyes and was unable to get on with activities like weeding his garden or watching football.

He recently had a £150,000 artificial retina implanted, which receives images from a miniature camera mounted on special glasses. The pictures are transformed into electrical pulses that are sent wirelessly to a chip attached to the back of the retina.

This stimulates his working retinal cells, which send a message to the brain. Because the camera and implant act as his eyes, this means he can see outlines of images even with his own eyes closed. With time, he can train his brain to interpret the images more clearly.

The implant, known as Argus II and manufactured by US company Second Sight, is one of a range of innovations that are helping doctors restore vision. Argus II has been implanted in more than 150 patients across the US and Europe who have the rare inherited condition of retinitis pigmentosa.

A system developed by Monash University scientists in Australia can bypass the eye completely. An external camera feeds image information directly to the brain via a neural chip, using a technology potentially able to help more than 80 per cent of clinically blind people to see visual outlines or patterns. A first human implant is expected this year.

Digital developments to treat blindness are not just happening in well-funded laboratories in wealthier regions of the world. Hubs of innovation exist in developing countries such as India.

At the LV Prasad Eye Institute in Hyderabad nearly 15m people have been treated for serious eye conditions, half of them free of charge. It is responsible for research on pioneering ways to improve vision, including 3D printed eyes, grow-your-own cornea techniques and bionic implants. The institute runs the largest eye bank in Asia, implanting more than 40,000 corneas a year from organ donors.

“What is unique about our network of hospitals is we try to treat all patients that need us, irrespective of whether they can pay or not,” says Virender Sangwan, director of LV Prasad’s stem cell centre and innovation labs. “We develop technologies so our treatments can be scaled up to provide access in rural parts of India.”

Dr Sangwan’s team focuses on corneal blindness, a cluster of conditions that affect about 12m people globally, a quarter of them in India. Although transplanting donor corneas is the most straightforward method, it is dependent on having a steady supply of healthy human corneas, donated by people who have recently died.

“Bio-synthetic cornea will eliminate the supply-side problem,” Dr Sangwan adds. “If we can create artificial corneas, that will significantly improve the lives of millions.” He is collaborating with researchers at Sweden’s Linköping university to design a new material, similar to human collagen, that is cheap and easy to synthesise in a lab. The material will be used to create artificial corneas and has been tested in animals. It starts human trials in early 2017.

The corneas could ultimately be assembled by 3D printers. Dr Sangwan says his institute is in talks with printing pioneers such as Pandorum, a Bangalore-based start-up specialising in 3D printing of human tissues such as livers.

Beyond implants, companies such as Google, Samsung and Intel are working on designs for smart, connected contact lenses. Google’s life sciences arm Verily, in partnership with Swiss multinational Novartis, plans to test a prototype on humans this year. This lens is supposed to correct vision in people with presbyopia, or age-related farsightedness, helping them focus between long- and short-range vision.

This year, Columbia University scientists found that smart contact lenses, from Swiss company Sensimed, were the best clinical tool to measure progression of glaucoma. Sensors in the lenses can detect changes in the eye’s internal pressure over an extended time, rather than just by way of a snapshot measurement when a patient comes in for a visit, as users wear them continuously. This gives clinicians clues as to how fast the glaucoma is developing. “With this device we can see the changes that occur over 24 hours, which is the best clinical predictor of progression,” says Gustavo De Moraes, associate ophthalmology professor at Columbia.

Eventually we may even be able to exploit digital implants in eyes that never tire and connect to smartphones. Google filed a patent this year for an injectable artificial lens with sensors that enhance sight and stream data. Conceivably, it would enable us to read electronic bar codes and sense irritating allergens, allowing timely treatment.

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