The Development Of Bionic Eye over The Last 20 Years?

Humans are ambitious and ultimately want technology to maximise efficiency and function optimally in the shortest time possible. However, when it comes to the eye, there are millions of cones and rod receptors which interact neutrally to create perception – one “of the biggest challenges for prosthetic vision” (Merabet, 2011). While the bionic eye has not reached our high expectations, it nevertheless has the potential to be a future game changer for the rectification of Retinitis pigmentosa (RP) and age-related macular degeneration (AMD). This essay will discuss the advantages, disadvantages and future implication of the Bionic eye sourced from two journal articles.

Background of the two articles

Merabet’s 2011 article ‘Building the Bionic Eye: An emerging reality and opportunity’ takes a more opinionated, scientific view regarding the Bionic eye’s limitations in our present world, but the exciting future it holds. He focuses on technical challenges such as the limitations with retinal prosthesis Overall, Merabet stresses how such technical issues with the Bionic eye are the reason why the Bionic eye has not become a perfect solution for those who are profoundly blind.

Mills et al in their 2017 journal ‘Electronic retinal implants and artificial vision: journey and Present’ discusses the efficacy of two different bionic eye approaches through a more statistical and economical perspective: Argus II and Alpha-IMS from a statistical point of view. Using credible studies, his research group conveys how both devices provide feasible therapy for RP patients. They reinforce Merabet’s point of view, by acknowledging the challenges which can potentially obstruct the Bionic eye from being a mainstream device as for example, the device needs to also cure AMD to thereby quintuple the market for artificial vision devices.

Advantages for the Bionic Eye

An advantage for the Bionic Eye is that vision scientists and engineers have continuously refined their methods to increase the efficacy of prosthetic vision, thus creating a culture where technology in general inevitably improves over time. Artificial vision was viewed as scientific fiction, but now due to the ever-rising interest to halt the progression of vision loss there are new methods to facilitate partial sight, even if at a small magnitude. Merabet reinforces this point of view as limitations in retinal-based visual prosthesis have highlighted and more importantly catalysed advances in other areas of research such as gene therapy and cell transplantation (Merabet, 2011). Since these methods are generally associated with genetics, the quality of life may be increased for patients who suffer from hereditary ocular diseases (Acland et al., 2001). Despite the Bionic eye not being the mainstream technology that we desire it to be, the pursuit of a reliable, functioning Bionic eye has indirectly pushed for other associated technologies to advance as we approach the future. Such inevitable progress cannot be taken for granted by individuals as artificial vision in the future can radically enhance a patient’s quality of life.

Moreover, the Bionic eye is statistically beneficial in terms of visual acuity, albeit with incremental improvements. In comparison to Merabet’s wholistic, subjective point of view, Mills et al states that objective studies on Argus II implanted patients such as the use of objective studies such as Square Localisation (ability to locate and touch a white square at random screen locations) or Grating Visual Acuity (using black and white gratings for 5 seconds, resulting in a logMAR result between 2.9 and 1.6) on 30 Argus II implanted RP patients resulted in a 89% and 33% improvement respectively (Ho, et al, 2015). These tests were conducted over a three year time period, conveying how the bionic eye has the potential to be a reliable solution to vision loss. Reinforcing the scientific objectiveness of these tests was the use of an independent rehabilitation specialist on the impact of Argus II on each of the patients’ quality of life, also using the standardised Functional Low-vision Observer Rated Assessment. Results showed that 80% of patients achieved advantages for their sight. Whilst the study had a smaller sample size, it still creates some optimism for a Bionic eye which can drastically increase visual acuity and clarity in the years to come. Reinforcing this is how the Alpha-IMS implant was tested via geometric shape localisation, identification of white letters on a black and grey background. As seen in Figure 1, only 45% self reported benefits to their daily activities, a lacklustre figure – but shows how the Bionic eye has reached some limited success.

From these fair, independently run assessments, it can be said that the bionic eye, more specifically the Argus II and Alpha IMS devices have shown commendable benefits for RP patients but has not reached our expectations of a fully sight restoring device.

Disadvantages for the Bionic Eye

From above, it is evident how the Bionic eye is beneficial in terms of visual acuity. However, Merabet and Mills et al discuss about artificial vision and the economic uncertainties associated with such a revolutionary device. The World Health organisation states that there are 314 million visually impaired people, however only 45 million of these individuals are profoundly blind with a Snellen acuity worse than 20/400 (WHO, 2009). Unfortunately, most of these blind people reside in third world countries with curable conditions (Merabet, 2011). Argus II may be able to achieve enough visual acuity to overcome the €6 billion in which RP creates due to reduction in employee productivity and healthcare costs, however this is an optimistic, mathematically driven model and is susceptible to failure (Mills et al, 2017). It is imperative that artificial vision reaches an economy of scale, thereby mass production can be utilised to reduce the manufacturing cost and facilitate increased third world country access to more advanced bionic eye devices. For ocular prosthetics to reach our high expectations of a fully functioning model, the bionic eye needs to first reach a level of function, before rectifying these economic issues.