[gui-talk] better article on vision research -- need more like this

[Hoffman, Allen]

Burst of Technology Helps Blind to See 

By
PAM BELLUCK

Blindness
 first began creeping up on Barbara Campbell when she was a teenager,
and by her late 30s, her eye disease had stolen what was left of her
sight. 

Reliant on a talking computer for reading and a cane for navigating New
York City, where she lives and works, Ms. Campbell, now 56, would have
been thrilled to see something. Anything. 

Now, as part of a striking experiment, she can. So far, she can detect
burners on her stove when making a grilled cheese, her mirror frame, and
whether her computer monitor is on. 

She is beginning an intensive three-year research project involving
electrodes surgically implanted in her eye, a camera on the bridge of
her nose and a video processor strapped to her waist. 

The project, involving patients in the United States, Mexico and Europe,
is part of a burst of recent research aimed at one of science's
most-sought-after holy grails: making the blind see.

Some of the 37 other participants further along in the project can
differentiate plates from cups, tell grass from sidewalk, sort white
socks from dark, distinguish doors and windows, identify large letters
of the alphabet, and see where people are, albeit not details about
them. 

Linda Morfoot, 65, of Long Beach, Calif., blind for 12 years, says she
can now toss a ball into a basketball hoop, follow her nine
grandchildren as they run around her living room and "see where the
preacher is" in church. 

"For someone who's been totally blind, this is really remarkable," said
Andrew P. Mariani, a program director at the National Eye Institute.
"They're able
to get some sort of vision." 

Scientists involved in the project,
the artificial retina,
say they have plans to develop the technology to allow people to read,
write and recognize faces. 

Advances in technology,
genetics,
brain science and biology are making a goal that long seemed out of
reach - restoring sight - more feasible. 

"For a long time, scientists and clinicians were very conservative, but
you have to at some point get out of the laboratory and focus on getting
clinical trials in actual humans," said Timothy J. Schoen, director of
science and preclinical development for the Foundation Fighting
Blindness. Now "there's a real push," he said, because "we've got a lot
of blind people walking around, and we've got to try to help them." 

More than 3.3 million Americans 40 and over, or about one in 28, are
blind or have vision so poor that even with glasses, medicine or
surgery, everyday tasks are difficult, according to the National Eye
Institute, a federal agency. That number is expected to double in the
next 30 years. Worldwide, about 160 million people are similarly
affected. 

"With an aging population, it's obviously going to be an increasing
problem," said Michael D. Oberdorfer, who runs the visual neuroscience
program for the National Eye Institute, which finances several
sight-restoration projects, including the artificial retina.
Wide-ranging research is important, he said, because different methods
could help different causes of blindness. 

The approaches include
gene therapy,
which has produced improved vision in people who are blind from one rare
congenital disease. 
Stem cell
 research is considered promising, although far from producing results,
and other studies involve a light-responding protein and retinal
transplants.

Others are implanting electrodes in monkeys' brains to see if directly
stimulating visual areas might allow even people with no eye function to
see. 

And recently, Sharron Kay Thornton, 60, from Smithdale, Miss., blinded
by a skin condition, regained sight in one eye after doctors at the
University of Miami  Miller School of Medicine extracted a tooth (her
eyetooth, actually), shaved it down and used it as a base for a plastic
lens replacing her cornea. 

It was the first time the procedure,
modified osteo-odonto-keratoprosthesis,
was performed in this country. The surgeon, Dr. Victor L. Perez, said it
could help people with severely scarred corneas from chemical or combat
injuries.

Other techniques focus on delaying blindness, including one involving a
capsule implanted  in the eye to release proteins that slow the decay of
light-responding cells. And with BrainPort, a camera worn by a blind
person captures images and transmits signals to electrodes slipped onto
the tongue, causing tingling sensations that a person can learn to
decipher as the location and movement of objects.


Ms. Campbell's artificial retina works similarly, except it produces the
sensation of sight, not tingling on the tongue. Developed by Dr. Mark S.
Humayun,
a retinal surgeon at the 
University of Southern California,
it drew on 
cochlear implants
 for the deaf and is partly financed by a cochlear implant maker. 

It is so far being used in people with 
retinitis pigmentosa,
in which photoreceptor cells, which take in light, deteriorate. 

Gerald J. Chader, chief scientific officer at the University of Southern
California's Doheny Retinal Institute, where Dr. Humayun works, said it
should
also work for severe cases of age-related 
macular degeneration,
the major cause of vision loss in older people. 

With the artificial retina, a sheet of electrodes is implanted in the
eye.
The person wears glasses with a tiny camera, which captures images that
the
belt-pack
video processor translates into patterns of light and dark, like the
"pixelized image we see on a stadium scoreboard," said Jessy D. Dorn, a
research scientist
at Second Sight Medical Products, which produces the device,
collaborating
with the Department of Energy. (Other research teams are developing
similar
devices.)

The video processor directs each electrode to transmit signals
representing
an object's contours, brightness and contrast, which 
pulse
 along optic neurons into the brain. 

Currently, "it's a very crude image," Dr. Dorn said, because the implant
has
only 60 electrodes; many people see flashes or patches of light. 

Brian Mech, Second Sight's vice president for business development, said
the
company was seeking federal approval to market the 60-electrode version,
which
would cost up to $100,000 and might be covered by insurance. Also
planned
are 200- and 1,000-electrode versions; the higher number might provide
enough
resolution for reading. (Dr. Mech said a maximum electrode number would
eventually be reached because if they are packed too densely, retinal
tissue
could
be burned.)

"Every subject has received some sort of visual input," he said. "There
are
people who aren't extremely impressed with the results, and other people
who
are." Second Sight is studying what affects results, including whether
practice or disease characteristics influence the brain's ability to
relearn
how
to process visual signals. 

People choose when to use the device by turning their camera on. Dean
Lloyd,
68, a Palo Alto, Calif., lawyer, was "pretty disappointed" when he
started
in 2007, but since his implant was adjusted so more electrodes
responded, is
"a lot more excited about it," he said. He uses it constantly, seeing
"borders
and boundaries" and flashes from highly reflective objects, like glass,
water or eyes. 

With Ms. Morfoot's earlier 16-electrode version, which registers objects
as
horizontal lines, she climbed the Eiffel Tower and "could see all the
lights
of the city," she said. "I can see my hand when I'm writing. At Little
League games, I can see where the catcher, batter and umpire are." 

Kathy Blake, 58, of Fountain Valley, Calif., said she mainly wanted to
help
advance research. But she uses it to sort laundry, notice cars and
people,
and
on the Fourth of July, to "see all the fireworks," she said. 

Ms. Campbell, a vocational rehabilitation counselor for New York's
Commission for the Blind and Visually Handicapped, has long been
cheerfully
self-sufficient,
traveling widely from her fourth-floor walk-up, going to the theater,
babysitting for her niece in North Carolina.

But little things rankle, like not knowing if clothes are stained and
needing help shopping for greeting cards. Everything is a "gray haze -
like
being
in a cloud," she said. The device will not make her "see like I used to
see," she said. "But it's going to be more than what I have. It's not
just
for
me - it's for so many other people that will follow me." 

Ms. Campbell's "realistic view of her vision" and willingness to
practice
are a plus, said Aries Arditi, senior fellow in vision science at
Lighthouse
International,
a nonprofit agency overseeing her weekly training, which includes
practice
moving her head so the camera captures images and interpreting light as
objects.


"In 20 years, people will think it's primitive, like the difference
between
a Model T and a Ferrari," said Dr. Lucian Del Priore, an ophthalmology
surgeon
at New York-Presbyterian Hospital/Columbia University Medical Center,
who
implanted Ms. Campbell's electrodes. "But the fact is, the Model T came
first."

Ms. Campbell would especially like to see colors, but, for now, any
color
would be random flashes, Dr. Arditi said. 

But she saw circular lights at a restaurant, part of a light
installation at
an art exhibition. "There's a lot to learn," she said. Still, "I'm,
like,
really
seeing this."

Copyright 2009 
The New York Times Company