It took nearly a year for Kulik’s private insurance to agree to cover the $150,000 device. Finally, in June of this year, Kulik went under the knife.
First, Olmos de Koo peeled back the outermost layer of the eye, the conjunctiva. Next she wrapped a silicon belt around the eye’s circumference, behind the eye muscles. To reach the back of the eye, she broke up the vitreous, the jelly-like substance that fills the eye, suctioned it out and replaced it with a saline solution. Then came the hard part: she had to place the electrode chip so that it fell squarely into the center of the retina. “You don’t get another chance,” Olmos de Koo says. She tacked the chip in place and hoped for the best.
A few days later, Kulik turned on the device. At first she could only see dramatic contrast: the edges of sidewalks, the steak on her plate at dinner (she still can’t make out rice). “A lot of people think I’m going to put it on and ‘Wow, you’re going to see again.’ It’s nothing like that,” she says. “The contrast is easy, but trying to figure out shapes and letters—I need to work on that more. It’s definitely a whole new way of learning how to see.”
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Humayun dreams of more than just 60 pixels. He wants to fine-tune the resolution of the device so that it can be used for those with macular degeneration, a far more common cause of blindness that affects more than 2 million Americans, according to Prevent Blindness America. That challenge will be “more than just going from two to eight megapixels,” he says. “It’s like going from a train to a plane.”
Yet no matter how much Humayun improves it, there are some things the Argus II will never achieve. For instance, color. That would require wiring each electrode to one of the eye’s matching colored cones—an impossible feat. And the device still requires a user to have an intact optic nerve and other structures of the eye to convey its messages to the brain, a caveat that rules out many other forms of blindness.
In other words, the very brilliance that makes the Argus II possible is also its limitation. The device is a “good stop-gap,” Robert Greenberg, founder and CEO of Second Sight, said in a 2013 interview. But “with these implants, we’re not fixing the disease, we’re bypassing the damaged part.”
Some put it more bluntly. “Right now, we’re just poking the retina,” says Dr. Theodore Leng, an eye surgeon at Stanford University who specializes in retinal surgery. To truly restore a natural sense of sight, Leng says, we will have to break the neural code, the way light is processed to become an image in the brain. If scientists could do that, they could skip the eye entirely and stimulate the brain directly to produce sight. “We’re only scratching the surface as far as trying to replicate visual function,” Leng says.
But between increasing the resolution and breaking neural code, it may be possible for those who were once blind to see faces, landscapes, animals and other objects in “the realm of normal image representation,” Sheila Nirenberg, a neuroscientist at Cornell University, wrote in a 2012 paper.
“Understanding the code is really, really important,” Nirenberg said in a 2011 TED Talk. “If we can understand the code, the language of the brain, things become possible that didn’t seem obviously possible before.”
Still, for some, 60 pixels is enough. This July 4, Kulik saw fireworks for the first time in more than a decade. Of course, they weren’t the same for her as they were for you or I; all she saw was thick and thin flashes of light against a black sky, “like dash-dash-dash,” as she puts it. “I knew what it was because it was flashing like crazy when I looked up.” But she wouldn’t soon forget the experience. “It was very, very exciting,” she says.
Kulik says that what she looks forward to most is regaining her sense of independence. “I know I’ll never drive again, but [I’ll] at least to get around to take a walk by myself, to get around by myself,” she says. And now, she can see her grandchildren.