👀 Vision 2.0

Last updated 2/24/20

How close are we to vision 2.0?


Vision 2.0 is a remarkably complicated topic – most successful research so far is focused on the cornea.

As of 2015, 940 million people suffer from a form of visual impairment. Today, some forms of blindness can be cured by cornea implants and other procedures. Other forms of blindness like glaucoma (where the issue is related to the optic nerve) are beyond our abilities to fix. Despite advances in bioprinting and camera miniaturization, the issue of optical connection remains when attempting to replace the human eye. So far, technological progress has largely not risen to the challenge that vision 2.0 poises. 

via Lumen

Vision 2.0 Progress: 42%

42%

Phase 1: Restoration of sight using synthetic components

Proof of ConceptAnimal Testing/R&DClinical TrialsApprovalMass Adoption
CompletedCompletedCompletedCompletedCompleted
100% Completed

Phase 2: Restoration of sight using stem cells/gene therapy

Proof of ConceptAnimal Testing/R&DClinical TrialsApprovalMass Adoption
CompletedIn Progress
30% Completed

Phase 3: Optic nerve reconnection

Proof of ConceptAnimal Testing/R&DClinical TrialsApprovalMass Adoption
CompletedIn Progress
30% Completed

Phase 4: Direct connection with occipital lobe

Proof of ConceptAnimal Testing/R&DClinical TrialsApprovalMass Adoption
CompletedCompletedIn Progress
50% Completed

Phase 6: Full eye transplant (biological or bionic)

Proof of ConceptAnimal Testing/R&DClinical TrialsApprovalMass Adoption
0% Completed

    Transplanting the human eye


    Parts of the eye can be transplanted but it will be at least a decade until full eye transplants can be completed.

    Cornea transplants, also known as corneal transplantation or corneal grafting, are the most popular and reliable eye transplantation surgery. The cornea is the outermost part of the eye, a transparent lens responsible for focusing light into the pupil. In the surgery, a cornea from a donor is grafted directly onto the eye after the residual cornea from the patient is removed. Dating back to 1905, the procedure has been extremely reliable and successful method of sight restoration. Because the optic nerve cannot be reconnected, we have no way to transplant the rest of the human eye today. That said, research toward repairing the optic nerve is progressing

    Recreating the human eye


    Although corneas can be replicated, recreating other parts of the eye is a daunting task.

    Despite the world having a long history of cornea transplants, there is an estimated one donor cornea available for every 70 people who needs a transplant. Because of this and the limits of our technology, progress in the creation of synthetic corneas are furthest along of any component in the eye. As of 2010, the Boston KPro was the most widely implanted synthetic cornea being having been implanted in over 4,500 patients. In early 2021, an Israeli man received the first synthetic cornea that was able to restore sight to someone who was legally blind. The cornea developed by CorNeat Vision replicates the structure of the human extracellular matrix resulting in a better, more biocompatible product.

    We have not used synthetics to replicate each component of the eye but we have created synthetic eyes. We call them cameras. Digital cameras today are arguably more powerful than the human eye in just about every way by using larger lenses and sensors. Our cameras rely on the exact same principles that the human eye does, a lens/cornea focuses the light through an aperture/pupil onto a sensor/photoreceptors which relays the image to a microcontroller/brain. Recent advances in computer vision and sensor miniaturization prove that creating a bionic eye with a similar resolution and form factor to the human eye is certainly possible. However the issue of connection to the optical nerve still remains.

    Some researchers hope to be able to bypass the optical nerve problem by connecting a bionic eye directly to the brain. Renewed interest in BCIs have pushed research into connecting directly to the occipital lobe forward. One research project out of Spain allowed a blind woman to regain a binary sense of light by implanting an array of 100 electrodes directly onto her brain. Although the process was incredibly invasive and nowhere near getting out of the lab, it offers a proof of concept for the future of optical technologies. It is certainly possible that connecting bionic eyes to the brain may leapfrog progress on reconnecting the optical nerve.

    Regrowing the human eye


    We can regrow parts of the eye but establishing connection to the optical nerve makes lab grown eyes currently unfeasible.

    In 2016, researchers at Osaka University were able to cure blindness in rabbits. Using pluripotent stem cells, they regrew the corneas of rabbits born with deformed corneas. The researchers believe that this method will not stop at corneas and will able to be extended to retinas and the rest of the eye. This could be an important step toward achieving ocular morphogenesis in humans, the technical name for the science of regenerating the eye. Another promising area is the research into the stem cells of zebra fish. Zebra fish, and other fish species, have curious regeneration abilities that allow them to fully regenerate their eyes within a week of the inflicted damage. Scientists believe that the GABA inhibitor is responsible for for the reactivation of stem cells that can heal the eye in the animals. The hope is that studies like this will eventually be able to help those with age related eyesight degradation like macular degeneration.

    For those with a severed optic nerve, even if lab grown eyes are successfully engineered, the breakthrough will be unable to restore sight. Reattachment of the optic nerve is the single biggest challenge facing the field this moment. Some of the most promising research on the topic is based on recent advances in gene therapy. in 2020, Cambridge University researchers were able to regrow damaged optical nerves in mice using gene therapy. The therapy turned back on a protein, protrudin, responsible for the regeneration of the optical nerve. Although this work represents a stunning breakthrough, regeneration of a damaged optical nerve is very different from reattachment. 

    What to look forward to


    The future of optical technology is clear: the optic nerve will be reconnected and digitized vision will contain GUIs.

    When the optic nerve can be repaired and reconnected, blindness will be solved. Much like polio and other debilitating illnesses of the past, future generations will view the condition of blindness as a cruel relic. Scientists are optimistic that a breakthrough will come within the decade. Perhaps several decades after the original breakthrough, the cost curves of treatment will come down and blindness will be solved for all.

    The concept of direct occipital lobe connection is fascinating for a number of reasons. Mainly because this requires a BCI that will translate the visual signal into the brain. That means that the developers of the project will literally be able to control what people see. Although this could enable dystopian futures explored in sci-fi entertainment, proper security and compartmentalization should shut down those fears. What is more likely is that users will have some form of a heads up display embedded into their vision that will serve as form of next-level augmented reality. Not only will bionic eyes be able to see better, they will be able to take advantage of technologies traditionally reserved for computers. Computer vision is already powerful today, by the time occipital BCIs are common it is hard to imagine what kind of use cases will be common with real time data. By combining multiple different lenses and sensors like in the latest smartphones, bionic eyes will have abilities far beyond the human eye today. Someday we may be able to equip our eyes with infrared sensors and telephoto lenses to be able to see the cosmos in all their glory.