Once upon a time there were unusual Australian sheep, with exceptionally keen eyesight.
The little flock spent three months last year with bionic artificial eyes, surgically implanted behind their retinas.
These sheep were part of a medical trial that aims to help people with some types of blindness to see.
The specific aim of the sheep trial was to see if the device in question, the Phoenix 99, caused any adverse physical reactions: the bionic eye was said to have been well tolerated by the animals. As a result, an application has now been made to begin testing on human patients.
The project is being carried out by a team of researchers from the University of Sydney and the University of New South Wales.
The Phoenix 99 is wirelessly connected to a small camera attached to a pair of glasses, it works by stimulating the wearer’s retina. The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical messages, sent to the brain via the optic nerve and processed into what we see.
The Phoenix 99 device is able to bypass defective cells in the retina and ‘activate’ those that can still function.
“There were no unexpected tissue reactions around the device, and we hope it can stay in place for many years,” says Samuel Eggenberger, a biomedical engineer at the University of Sydney’s School of Biomedical Engineering.
According to the World Health Organization, at least 2.2 billion people worldwide suffer from some form of visual impairment, ranging from mild to total blindness. The WHO says the financial impact of this, in terms of lost productivity, is more than $25bn (£19bn) per year for the global economy.
The use of bionic eye systems to help treat blindness is an industry that is still in its infancy, but with rapid technological advances, one report expects the sector to be worth $426 million by 2028.
“Technological advances have redefined ophthalmology,” says Dr. Diane Hilal-Campo, an ophthalmologist from New Jersey. “Innovations have not only made diagnosis easier and more accurate, they have also improved patient care.”
As an example, he points to a bionic eye that has already been fitted to more than 350 people around the world: the Argus II from US firm Second Sight.
This works in the same way as the Phoenix 99, and the initial version was first fitted to a patient in 2011.
Second Sight is now continuing to work on a new product called Orion. This is a brain implant, and the company says it is aiming for Orion to be able to treat almost all forms of profound blindness. The project is still in the early clinical phases.
Other bionic eye systems include the Prima device, which has been developed by the French firm Pixium Vision; and Bionic Eye System from another Australian team, Bionic Vision Technologies.
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Dr. Hilal-Campo says that a current problem is the high cost of the technology, which makes it “accessible to very few people.” The Argus II, for example, costs around $150,000.
He adds that since the technology is still in its infancy, the results are not yet perfect. “I have no doubt that technology has transformed the lives of patients who have been fortunate enough to receive these implants,” says Dr. Hilal-Campo. “Currently, however, the technology is limited and only allows the perception of light and shadow and, to a certain extent, shapes.
“[Yet] I am optimistic that in the years to come, biotech companies will continue to find new ways to help restore sight in people with vision loss.”
Bhavin Shah, a London-based optometrist, agrees that bionic eyes still have a long way to go. He compares them to digital cameras, which were first invented in 1975, and then decades passed before they became widely available.
“I think that once the quality of the technology reaches a suitable standard and approaches something close to the vision achieved by a healthy eye, this technology will be much more common,” he says.
“However, there is still a strong push to treat or prevent blindness in the first place.”
Technologies that detect and diagnose vision problems, he explains, are likely to have a much broader impact in the short term. “There are [now] more advanced, easier to use, more reliable and interconnected diagnostic tools,” says Mr. Shah.
“For example, we can quickly take multiple scans of different structures within the eye, examine them at higher resolution, and quickly share them with colleagues. Artificial intelligence can also make decisions [on this]in some cases faster and more reliably than experienced doctors.
Dr. Karen Squier, associate professor and chief of low vision services at the Southern College of Optometry in Memphis, Tennessee, believes that some of the biggest improvements in eye care technology are often the smallest.
She points to things like the accessibility features of Apple’s iPhone. These include a voice-over feature whereby the user can get audio descriptions of what’s on the screen, from battery percentage to who’s calling and what app their finger is on.
Dr. Squier also highlights Microsoft’s Seeing AI app, which uses a smartphone camera to identify people and objects and describe them audibly. He can also check the barcodes and then tell you what the item is, or read the handwriting aloud, like a letter from a grandson.
“That’s probably the technology that people are most excited about, because it does a lot of different things and just uses the camera and operating software that’s already built into the phone,” adds Dr. Squier. “And it’s usually pretty easy for people to learn how to use.”
In the longer term, she believes, some of the main benefits of eye care technologies will come from their integration into disability-friendly public policies and systems. An example might involve the use of technology that can alert vision-impaired passengers to bus schedules and alert them when a bus is on its way, eliminating potential hassles at the bus stop.
That’s not to say that Dr. Squier doesn’t see more sophisticated technologies, including bionic eyes, having a significant impact in the future as technology advances.
“I think even bionic eyes are going in the right direction,” he says. “But we’ll have to see how she goes.”
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