x Abu Dhabi, UAE Thursday 20 July 2017

Enlightened vision to restore sight

Technology is coming into place that will literally enable the blind to see. An 88-year-old man is already the recipient of a bionic eye, while another method stimulates the tongue so images can be sensed

A man uses a touch screen monitor to test his Argus II eye implant at UCSF medical centre in San Francisco.
A man uses a touch screen monitor to test his Argus II eye implant at UCSF medical centre in San Francisco.

Technology is coming into place that will enable the blind to see. An 88-year-old man is already the recipient of a bionic eye, while another method stimulates the tongue so images can be 'sensed' — but this science is not without its risks , writes Neil Parmar, Foreign Correspondent

For 60 years, a man spent every day living in darkness. Like an estimated 1.5 million people around the world, he suffered from retinitis pigmentosa, an eye disease in which the retina is damaged.

Often it begins with night blindness. Then a loss of peripheral vision. Eventually, for some, it leads to blindness, according to the Foundation Fighting Blindness, an organisation based in the United States.

This particular man, at 88 years of age, underwent a surgery that outfitted him with what is known as the Argus II Retinal Prosthesis System. It is a bionic eye, which is touted as the only one in the world, and it became the technology that returned the man's sight.

"He saw some flashes of light," says Gregoire Cosendai, the vice president of the European division at Second Sight, which manufactures Argus II. "That happens one week after surgery. Roughly after one month, the patient can go home with the system and it stays with them in order to integrate the vision into daily life."

It would be an understatement to say this corner of the biomedical market is risky. Products take years, if not decades, to develop and pass the proper scientific checks along the way. The precursor for the Argus II, for instance, began with a clinical trial in the US back in 2002. But the first discussion about creating Second Sight dates back to 1992.

This sector could grow into a lucrative one, assuming sales of the technology cover costly research and development efforts.

Other segments within this industry have been growing of late. The sale of ophthalmic pharmaceuticals, for example, is forecast to increase at nearly 5 per cent annually through 2016. Combined, medications that battle retinal diseases and eye conditions are valued at more than US$16 billion (Dh58.76bn) globally, according to data from MarketResearch.com.

Demand for these markets overall is expected to rise as the world's population of visually impaired or blind individuals remains high. The World Health Organization estimates that 39 million people are blind, while 246 million suffer from low vision.

About 80 per cent of all visual impairment can be either avoided or cured, notes the WHO. Some companies are working to better these odds. Wicab, a medical device company, has developed a pair of sunglasses with a video camera that works in a range of lighting conditions. When the camera captures white pixels it sends strong stimulation to the individual who is wearing the glasses. But it does not stimulate a person's eyes; it stimulates an array of electrodes that get transmitted by a mouthpiece to the tongue.

People, in essence, effectively sense pictures rather than see them in a conventional way. Grey pixels trigger medium levels of stimulation to the tongue; nothing occurs when black pixels appear.

Known as the BrainPort V100, this device is designed to help the blind and visually impaired without the need for surgery. It is currently being tested among people with no "usable vision", Wicab says, including both those who are congenitally blind or individuals with acquired blindness.

Once it is commercially available, the BrainPort V100 will sell for about $10,000 per unit. It has not yet been submitted to the food and drug administration within the US, although that is expected to happen this month, when a North American research initiative is completed.

"The European market clearance is pending," says Sona Walter, Wicab's European sales manager. "We are currently in the last phase of the review process."

Wicab may also pursue distribution within the Middle East in the future. "We will consider expanding into this territory once we acquire FDA clearance for the device," says Ms Walter.

Second Sight, meanwhile, has opened one of its centres in Saudi Arabia, where one patient has already undergone the Argus II procedure. The company is also starting its Argus II commercialisation efforts within the US during the last half of the year. It has already introduced its product within Europe, including Italy and Germany, and sold more than 60 devices so far. Each unit will cost about $150,000 within the US.

But to become a real game-changer among the visually impaired, Second Sight executives are working to broaden the Argus II's target market. "Right now we treat people who are completely blind and hope that in the future we are helping people who are less blind and also providing them with the ability to see," says Mr Cosendai.

Of course, Second Sight's business development efforts must address risks to patients.

An individual who undergoes the surgery must also go through rehabilitation and a six-month orientation programme that helps them adapt to everyday life with their new vision.

The Argus II implants are designed to last a person's lifetime, although only time will tell whether that claim pans out. "We don't know exactly how long it'll last, but out of the 30 patients that have used the system for up to five years, only one had a problem-and we know exactly what happened during surgery," says Mr Cosendai.

"We're always trying to be careful because there is always some level of risk," he adds. "You want to make sure people you start with - you can't make them worse off."

 

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