Contemporary approaches to visual prostheses
Open accessAbstract
Visual prostheses serve to restore visual function following acquired blindness. Acquired blindness (as opposed to congenital blindness) has many causes, including diseases such as retinitis pigmentosa, glaucoma, and macular degeneration, or trauma such as caused by automobile accident or blast damage from explosions. Many of the blindness-causing diseases target the retina or other ocular structure. Often, despite the loss of sensitivity to light, the remainder of the visual pathway is still functional, enabling electrical devices to deliver effective and meaningful visual information to the brain via arrays of electrodes. These arrays can be placed in any part of the early visual pathway, such as the retina, optic nerve, lateral geniculate nucleus, or visual cortex. A camera or other imaging source is used to drive electrical stimulation of remaining healthy cells or structures to create artificial vision and provide restoration of function. In this review, each approach to visual prostheses is described, including advantages and disadvantages as well as assessments of the current state of the art. Most of the work to-date has been targeting stimulation of (a) the retina, with three devices approved for general use and two more in clinical testing; (b) the lateral geniculate nucleus, with efforts still in the pre-clinical stage; and (c) the cortex, with three devices in clinical testing and none currently approved for general use despite the longest history of investigation of the three major approaches. Each class of device has different medical indications, and different levels of invasiveness required for implantation. All contemporary devices deliver relatively poor vision. There has been remarkable progress since the first proof-of-concept demonstration that used stimulation of the primary visual cortex, with the field exploring all viable options for restoration of function. Much of the progress has been recent, driven by advances in microelectronics and biocompatibility. With three devices currently approved for general use in various parts of the world, and a handful of additional devices well along in the pipeline toward approval, prospects for wide deployment of a device-based therapy to treat acquired blindness are good.
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Prospective approaches such as gene and cell therapies or optogenetics only focus on the retina and are ineffective when pathologies irremediably damage the retina or the optic nerve.
“Prospective approaches, like gene and cell therapies or optogenetics, only focus on the retina [5,6], and they are ineffective when pathologies irremediably damage the retina or the optic nerve [7,8].”
From Advances in visual prostheses: engineering and biological challenges (2022) · cites this paper as [7]
The LGN is a stratified compact structure in the thalamus receiving input from the optic nerve and relaying information to the primary visual cortex.
“The LGN is a stratified compact structure in the thalamus receiving input from the optic nerve and relaying information to the primary visual cortex [7].”
From Advances in visual prostheses: engineering and biological challenges (2022) · cites this paper as [7]
A cortical prosthesis offers the advantage of artificial vision in most conditions of blindness, excluding traumatic brain injuries and stroke.
“A cortical prosthesis offers the advantage of artificial vision in most conditions of blindness, excluding traumatic brain injuries and stroke [7].”
From Advances in visual prostheses: engineering and biological challenges (2022) · cites this paper as [7]
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Self-citation
- Authors
- Mirochnik, R. M., & Pezaris, J. S.
- Affiliations
- Northeastern University (US)
- Harvard University (US)
- Corresponding author
- Pezaris, John S.
- ORCID
- Pezaris, John S.
- Venue
- Military Medical Research
- Publisher
- Elsevier BV
- Published
- 2019-06-05
- Volume
- 6
- Issue
- 1
- Pages
- 19-19
- ISSN
- 2054-9369 (ISSN-L)
- PMC
- PMC6549329
- OpenAlex
- W2948931117
- Cited by
- 58
- References
- 80
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 8 · 2023: 11 · 2022: 10 · 2021: 12 · 2020: 8
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Update notices
- correction (2019-08-07)
- Open access
- diamond
- doi.org
- Locations
- Military Medical Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- William M. Wood Foundation (Visual Prosthesis Laboratory)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Life Sciences › Neuroscience › Cognitive Neuroscience › Tactile and Sensory Interactions
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- retinal prosthesis, acquired blindness, visual cortex stimulation, electrode arrays, retinitis pigmentosa, glaucoma, macular degeneration, visual pathway, artificial vision, biocompatibility, biomedical implants
- MeSH terms
- Blindness, Clinical Trials as Topic, Electric Stimulation Therapy, Humans, Optic Nerve, Visual Cortex, Visual Prosthesis
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