The Guardian view on electronic implants: a new way of seeing, not of being | Editorial
IIn medical terms, the eye is not the window to the soul, but to the spirit. The retina and optic nerve are outgrowths of neural tissue, and the remarkable success of electronic implants in restoring sight shows how far brain-computer interfaces have come. These have not given rise to a science fiction vision of augmented humans with incredible new powers, but, perhaps more fortunately, significant progress has been made, restoring capacity and action to those who have suffered injury or illness.
People with age-related macular degeneration face a world in decline. The disease, which affects around 600,000 people in the UK, causes progressive loss of central vision. There is no cure, but new trials offer something else: a new way of seeing.
Patients at several trial sites across Europe, including Moorfields Eye Hospital in London, were fitted with a microchip surgically implanted in their retinas. Just 4 mm square and 30 micrometers thick, the chip functions as a pattern converter. Visual information recorded by a camera in a pair of glasses is transmitted to the chip via infrared light, which the chip converts into electrical signals detected by the retina, restoring the lost link between the eye and the brain. After one year, 84% of patients in the 38-person trial were able to read letters and numbers with the device, after losing their sight, with an average improvement equal to about five lines on a standard vision test chart.
The boundary between mind and machine is changing. Devices placed on the head to read brain waves have allowed paralyzed people to type. The prostheses currently being tested are controlled by sensors placed on the muscles and nerves remaining after amputation, and can also send back signals, restoring the sense of touch and proprioception. Last year, in typical fashion, Elon Musk’s Neuralink project implanted a chip directly into a volunteer’s brain, allowing them to send basic commands to a computer.
The dangers should be obvious. In the macular degeneration trial, there were 26 “adverse events,” including retinal damage requiring additional surgery. Go deeper into the brain and these risks multiply. Even then, the brain must be taught to read the signals – to remember that these chips do not yet speak body language. (An AI algorithm was used to more clearly distinguish text from visual signals, a simple example of how the unique data processing and pattern recognition power of AI really helps.)
With any new medical technology, cost and accessibility are an issue. The Prima device from the trial is under review by the U.S. Food and Drug Administration and EU regulators. A CE marking of the latter would allow Prima to be considered for supply to the NHS. As with most prosthetics, it is the result of partnerships between publicly funded medical researchers and a private biotechnology company, which handles any eventual large-scale manufacturing. In 2022, the NHS approved various multi-grip prosthetic hands, controlled by non-invasive electrodes that read muscle signals, for widespread use – and reported costs of around £13,000 to £37,000 per prosthesis, plus additional service costs over time. Prima and other devices being tested go even further: a direct fusion of advanced computer technology and the human nervous system. Few novels or films dwell on cyborgs who simply throw a ball or read a newspaper, but it seems to be our future, and it’s welcome.
