HOW YOUR OWN DNA COULD SOMEDAY SAVE YOUR VISION
Imagine living with a genetic disease that could cause blindness in your 40s—and your doctor tells you there are no treatment options. It's for patients like these that Johnson & Johnson is harnessing cutting-edge technology in the hope of finding real solutions.
By Hallie Levine October 11, 2021
It can be devastating to watch someone slowly lose their vision.
Just ask James List, M.D., Ph.D., Global Therapeutic Area Head of Cardiovascular, Metabolism and Retina at Janssen Research & Development, part of the Janssen Pharmaceutical Companies of Johnson & Johnson. Before he joined the company in 2014, the Harvard endocrinologist spent his days counseling patients with diabetes. “Many people don’t realize that diabetes can cause irreversible damage to multiple organs, including the eyes,” he says.
New technologies and equipment fortify the abilities of individuals confronting the challenge of entering a world without sight.
The rapid advance of new technologies designed to assist low and no vision folks has vastly supplemented the mobility given by the use of a simple white cane. Advances in adaptive equipment has expanded access to all forms of information. Today, a hand-held “talking” GPS units can guide you step by step, turn by turn to any destination. White canes can come equipped with radar surveillance which warns the user of posts, pillars, truck mirrors, and low hanging branches. Smartphone enhancements now include the ability to “read” signs, board postings, dinner menus, food labels, and will even perform a facial recognition function.
Specially designed to combat the onrush of Mad, Macular Degeneration, are small portable technologies that brighten, boost character and type size, and gives critical color contrasting to what is being read. We have learned that some struggling with MacD see white letters on a black background better than black letters on a white background.
Eye-Link Minnesota provides a wide range of these assistive technologies, free of any charges to Minnesotan’s experiencing uncorrectable sight loss! We do not accept any State or Federal funding. This vital community outreach program helping low and no vision individuals survives only through the generosity of our donors.
The updated iOS app is available in 35 countries.
Article Link: https://www.engadget.com/2017/12/14/microsoft-seeing-ai-app-update/
Artificial intelligence took center stage at Microsoft’s AI Summit in San Francisco on Wednesday. Aside from announcing AI smarts for a range of software — from Bing to Office 365 — the tech titan is also ramping up its Seeing AI app for iOS, which uses computer vision to audibly help blind and visually impaired people to see the world around them. According to Microsoft, it’s nabbed 100,000 downloads since its launch in the US earlier this year, which convinced the tech titan to bring it to 35 countries in total, including the EU.
It’s also getting a bunch of new features. The app now boasts more currency recognition, adding British pounds, US dollars, Canadian dollars, and Euros to its tally. Going beyond the color in a scene, it can also spot the color of specific objects, like clothes. Plus, it’s no longer restricted to just short printed text, with handwriting recognition now part of its skill set. You can also customize the voice that it uses to speak its observations out loud, and set how fast it talks.
Finally, a musical light detector alerts you to the light in an environment with an audible tone — Microsoft claims the tool will save users from having to touch a hot bulb or LED battery to check if it’s on. Despite the big update, there’s still no word on an Android launch.
by Emily Mullin
The prosthesis could help more people who have lost their vision than a device already on the market.
The maker of the world’s first commercial artificial retina, which provides partial sight to people with a certain form of blindness, is launching a clinical trial for a brain implant designed to restore vision to more patients.
The company, Second Sight, is testing whether an array of electrodes placed on the surface of the brain can return limited vision to people who have gone partially or completely blind. For decades, scientists have been trying to develop brain implants to give sight back to the blind but have had limited success. If the Second Sight device works, it could help millions of blind patients worldwide, including those who have lost one or both eyes.
The device, called the Orion, is a modified version of the company’s current Argus II bionic eye, which involves a pair of glasses outfitted with a camera and an external processor. The U.S. Food and Drug Administration has granted the company a conditional approval for a small study involving five patients at two sites, Baylor College of Medicine and the University of California, Los Angeles. Second Sight still needs to conduct further testing of the device and answer certain questions before starting the trial but hopes to begin enrolling patients in October and do its first implant by the end of the year.
Second Sight first won approval in Europe in 2011 for the Argus II, followed by an FDA approval in 2013 (see “Bionic Eye Implant Approved for U.S. Patients”). In Europe, two more retinal prosthetics have since been approved—one is marketed by French company Pixium Vision and another by German firm Retina Implant.
Also known as a bionic eye, all three devices are intended to bring back some vision in patients with a genetic eye disorder called retinitis pigmentosa. The disease causes gradual vision loss when light-sensing cells called photoreceptors break down in the retina—the tissue membrane that coats the back of the eye. An estimated 1.5 million people worldwide, including about 100,000 people in the U.S., have retinitis pigmentosa. That is a small percentage of the 39 million people worldwide who are blind, according to the World Health Organization.But Robert Greenberg, Second Sight’s board chair, says the company has only sold about 250 of the Argus II devices, a number lower than he expected. The device costs about $150,000 and restores minimal vision. Only 15 centers in the U.S. offer the technology, and with competition abroad, Second Sight is hoping its new brain implant could be used by far more people.
Second Sight’s Argus II uses a camera mounted on a pair of glasses to capture images. The images are sent to a small, patient-worn processor, which uses special software to convert the images into a set of instructions that are sent to the implanted chip near the retina. Those instructions are then transmitted as a series of electrical pulses to an array of electrodes, also implanted around the eye.
People with retinitis pigmentosa are able to benefit from the device because the disease destroys only specialized photoreceptors while leaving the retina’s remaining cells intact. These retinal cells are able to transmit the visual information along the optic nerve to the brain, producing patterns of light in a patient’s field of view.
The new device, the Orion, borrows about 90 percent of its technology from the Argus II but bypasses the eye. Instead, an array of electrodes is placed on the surface of the visual cortex, the part of the brain that processes visual information. Delivering electrical pulses here should tell the brain to perceive patterns of light.
“In some types of blindness, the optic nerve is damaged so you have to go downstream. With the Orion, we’re essentially replacing the eye and the optic nerve completely,” Greenberg says. With this approach, “anyone who had vision but has lost it from almost any cause could potentially be helped by the Orion technology.”Second Sight estimates that about 400,000 retinitis pigmentosa patients globally are eligible for its current device, but about 6 million people who are blind due to other causes, like cancer, diabetic retinopathy, glaucoma, or trauma could hypothetically use the Orion.
Greenberg hopes the approach will restore the same degree of vision as the Argus II, possibly a little more. Still, people with bionic eyes have limited sight. They can distinguish light from dark and recognize the outlines of objects in their view, but they can’t see color. Patient experiences also vary. Some can read small letters but others can’t.
A major downside is the device requires a more invasive surgery than the Argus II. A small section of the skull needs to be removed to expose the area of the brain where the array of electrodes is placed. Because electrical brain implants carry risks like infection or seizures, the first clinical trial will be small, and the company will start off by testing the implant in patients who are completely blind.
Last year, Second Sight tried out this approach, implanting an off-the-shelf neurostimulator device for epilepsy in the brain of a 30-year-old patient who had been nearly blind for eight years. The patient was able to see spots of light with no significant adverse side effects.
Researchers at Illinois Institute of Technology in Chicago and Monash University in Australia are working on similar artificial retinas that would connect directly to the brain.
Martha Flanders, director of the Central Visual Processing Program at the National Eye Institute, says a brain implant will be more difficult to get right than a retinal implant because the brain’s visual cortex is so much more complicated than the eye. Flanders says scientists are still in the early days of understanding how the brain processes images to produce vision and how neurons extract information from the visual cortex.
“If we could figure out how to process and filter visual information to correctly stimulate the electrodes we could eventually improve the type of image that person will be able to perceive,” she says.
Because of how complex the brain is, Mark Humayun, a professor of ophthalmology and biomedical engineering at the University of Southern California who spent 25 years developing the Argus II, says Second Sight will need to develop new software and algorithms to convert the visual information the camera picks up and turns into electrical pulses.
In order to get its new device approved by regulators, Humayun says Second Sight will need to show that the changes it made are worth the additional safety risks that come with a more invasive device.
“I can’t believe there‘s such a place that will give this to me,” said Kathaleen Ziese of outstate Minnesota, referring to her Ruby hand-held video magnifier. There is such a place: Eye-Link, Minnesota.
Kathaleen, like a growing number of older Minnesotans, lives with vision loss and wanted to find ways to increase her independence. Her Ruby – supplied by Eye-Link – is a big help in that, she said.
The nonprofit grants technology to state residents with visual impairments who are not veterans and whose technology requests can’t be fulfilled by State Services for the Blind for a variety of reasons.
“I have dominant cone dystrophy,” Kathaleen said. Cone dystrophy is listed on the National Organization for Rare Disorders (NORD) website. “It’s an orphan disease,” Kathaleen adds, saying that it doesn’t draw the research dollars that are aimed at the growing number of adults in this country who live with one or more of the four main causes of vision loss: macular degeneration, diabetic retinopathy, cataracts, and glaucoma.
Symptoms of cone dystrophy can play out differently in each individual, according to NORD. In Kathaleen’s case, it makes her extremely sensitive to light.
“I wore the darkest sunglasses possible,” she said. “I’ve been lucky that I wasn’t legally blind before.” She traces it in her family as far back as her great-great grandfather. Her grandfather, who had it too, was “probably legally blind by age 40.” Kathaleen said she became legally blind when she was 68 or 69; she now is in her early 70s. “I held for years at 70/20 [vision] while working.”
And while Kathaleen worked, she and her husband raised a family, and she went back to school, reading with a 3X magnifier. “Tests were tough with bright light,” in the classrooms, she said, but instructors were very helpful in providing her with accommodation for her eyesight needs. She graduated college at age 41.
Kathaleen also helped herself by shading everything she read and by increasing the strength in her eyewear, plus using stronger magnification equipment. But as the years marched on, it became increasingly difficult for her to do everyday enjoyable things such as reading the newspaper.
“The newspaper has been my judge of eyesight,” Kathaleen said. When she no longer could read it comfortably, she turned to State Services for the Blind (SSB).
Kathaleen said that she and her SSB representative sat and talked about her vision problems, and Kathaleen told her she had a Ruby magnifier that had just been broken. “I didn’t know where to find money for another one.” That’s when the woman from SSB told Kathaleen about Eye-Link.
“She [SSB representative] said, ‘I’ll fill out this application with you, and this doesn’t have anything to do with finances,’ “ Kathaleen said.
Eye-Link, Minnesota does not look at finances when granting requests for assistive technology. Here’s how the process works:
A person who has vision loss and needs adaptive technology applies to State Services for the Blind. If the state, for any number of reasons, can’t fulfill that person’s request, an SSB representative can assist the person in filling out the request for technology form from Eye-Link.
When that form is sent to Eye-Link, it’s crucial that the person who applies includes proof from SSB saying the state did not fulfill the person’s request. Jim Justesen of Eye-Link said, “Any grant application must be accompanied by a ‘denial’ note, fax, or letter from State Services for the Blind. The board will not review requests for adaptive technology unless a denial letter from SSB is attached.” Eye-Link board members then meet quarterly to review applications, he said. The idea is to get the right technology into the hands of the visually impaired person.
The Ruby was right for Kathaleen. Another way she uses it is in church in order to see the hymnals and to be able to join in the singing.
Justesen said, “Each year Eye-Link, Minnesota receives between 25 to 35 adaptive equipment grant applications.” Eye-Link is supported 80 percent through donations, 20 percent through corporate or foundation grants. To donate, go to http://mn.eye-link.org/.
Eye-Link and SSB’s collaboration doesn’t end with the delivery of assistive devices. SSB provides people with the training they need to use the equipment provided by Eye-Link.
Kathaleen said she uses her Ruby to zoom in and out, choosing colors that will enhance whatever she’s reading. The Ruby lets her change the colors of the background and the text. Sometimes it’s easiest for her to read in black and white, sometimes yellow type on a blue background, etc. The Ruby also magnifies whatever Kathaleen is reading.
Kathaleen said, “At the store, I take photos of bar codes or ingredients and the Ruby brings it up to my face,” so that she can read it.
Justesen said that Eye-Link receives requests for a variety of video magnifiers, closed circuit TVs such as Merlins, and basic desktop and laptop computers equipped with JAWS (software that reads out loud what’s written on the screen). Eye-Link also accepts donations of used assistive technology, and then sends the items to people who need them. People who have devices to donate can call Eye-Link at 763-561-6967 to discuss tax benefits and arrange pick up.
And what about Kathaleen reading her beloved newspapers with her Ruby?
“I can read the newspaper,” she said with enthusiasm, adding that without the Ruby, “I can’t read it even with seven-times magnification. And I love to read the Minneapolis Star Tribune.“
Kathaleen and her Ruby had plans for that winter afternoon. “I want to sit down and read National Geographic right now. I’ve been busy with Christmas and to go on trips, but now I’m ready to sit down and read,” she said, her voice brimming with anticipation.
Read more about Eye-Link and the review process.