A growing group of companies think their technology can give some patients the ability to see.
Neuralink, Elon Musk’s brain-computer venture, and rivals like Max Hodak’s Science, are chasing advances in technology that could treat patients with severe vision loss, pursuing sci-fi-like solutions to widespread maladies like macular degeneration.
In September, Neuralink Corp. received the Food and Drug Administration’s blessing to fast-track its vision technology, called Blindsight, through the regulatory process. And last month, Science Corp., the brain-machine interface startup run by former Neuralink President Hodak, announced the results of a clinical trial showing some restored vision to patients suffering from age-related macular degeneration.
These companies are joined by a handful of other startups and academic researchers trying to improve patients’ vision as the field of brain-computer technology gains traction, investors and more regulatory acceptance. So far, Science has raised US$150 million from investors and Neuralink has raised more than US$600 million.
“Restoring vision to patients will be the first killer app” for brain-computer interfaces, Hodak said in an interview. In Science’s case, 32 of its 38 patients in its study saw significant benefits, the company said. On a standard eye chart, patients could read smaller letters, an average of almost five lines lower. One patient saw improvement of almost 12 lines.
Researchers caution that recent advances don’t mean that an actual cure for blindness is imminent. “It’s really important that potential patients don’t get their hopes up and expectations,” said Xing Chen, an assistant professor of ophthalmology at the University of Pittsburgh and a co-founder of Phosphoenix BV, which is working on its own device. For most people, “they’re not going to be able to see again or even use implants on a daily basis for several years.”
But Chen also pointed to an “explosion of interest” in the potentially promising field.
The new momentum reflects advancements in several different technologies, said Yağmur Güçlütürk, an assistant professor at Radboud University the Netherlands. “Fields such as AI, materials science, surgical robotics, wireless communication technologies and microchip design have all made significant progress,” she said.
Other startups working on technology to mitigate blindness include ReVision, a Belgian company developing a system based on an implant and glasses with a built-in video camera. And in September, Spanish startup Inbrain said its graphene-based device had gone in human brains, at least temporarily, for the first time. Chief Scientific Officer Jose Antonio Garrido said that while Inbrain plans to work on devices to treat conditions such as Parkinson’s first, vision is on its roadmap.
Eye Tech
Startups aiming to restore sight have adopted a variety of strategies. At Science, researchers are developing an implant that sits directly in the eye, under the retina. That’s different than Science’s other planned devices, which will put electrodes in the brain — approaches that could eventually complement each other.
“One of the reasons we really like the retina, is the retina is easy to surgically access,” Hodak said, adding that the implantation can be done as an 80-minute outpatient procedure. It’s “a huge amount of benefit, with minimal risk.”
Science’s system, called Prima, won “breakthrough” status from the FDA last year, a designation aimed at shortening the regulatory timeline. That’s the same designation that Neuralink announced it has for Blindsight, and was also awarded in 2020 for its brain implants. Prima’s technology comes from a French startup called Pixium Vision, which Science bought earlier this year.
In the long term, researchers believe the best way to improve vision will be to work in the visual cortex rather than the retina, because the visual cortex is larger, allowing for the introduction of more electrodes and the possibility of improved resolution — though vision will still be blurry.
“At the visual cortex, you have more space,” said Inbrain’s Garrido. “The range of indications you could address is larger,” he added, referring to various types of blindness. Therapy based on visual cortex implants could also be applied to patients with severe degeneration of the retina or the optical nerve, which is not the case for retinal implants.
Retinal implant technology has seen big advances — and failures. One promising company, Second Sight Medical Products, ran out of funds in 2020, leaving its patients without replacement parts and software upgrades for its Argus product. It has since merged with another company, saying it would provide limited support for Argus users.
Meanwhile, other technologies, such as cell therapy for macular degeneration, are also making strides and could end up providing competition for vision implants. For example, a cell-therapy company called Cellino has raised almost $100 million from investors including Khosla Ventures, according to PitchBook data.
Big Ambition
Technology aimed at restoring sight has a long history, and efforts to improve vision using electrodes implanted on or in the visual cortex have been in development since the 1970s. Generally speaking, patients post-treatment can see blurred flashes rather than sharp images. Still, many say even those flashes provide an improvement to their quality of life.
“Most often, people describe the vision as being very different to nature, like fireworks or snowflakes,” said Michael Beyeler, an assistant professor at the University of California, Santa Barbara. Beyeler said that for many patients, seeing in that limited way represents “a great advancement.” Knowing the extent of the impact of the latest generation of electrodes in the visual cortex for treating blindness will take another three to five years, he estimated.
Little is known about Blindsight, the project underway at Musk’s Neuralink, but its technology promises to be among the most ambitious. Dan Adams, the company’s chief scientist, has said in academic preseontations that Neuralink would place electrodes on both sides of the visual cortex using the latest high-electrode generation of its device. The company, which first said it was tackling vision about two years ago, is recruiting patients, including those with vision loss, in the US, Canada and the UK.
In an interview earlier this year with podcaster Lex Fridman, Neuralink President DJ Seo discussed the potential of a glasses-and-electrodes system that could one day do more than treat blind people.
“We’re currently limited by our biology in terms of the wavelength that we can see,” he said. “But when you have an external camera with this BCI system, you’re not limited to that. You can have infrared, you can have UV, you can have whatever other spectrum that you want to see.” He added that he has such technology in mind when he talks about Neuralink’s goal of “going beyond the limits of our biology.”