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Biotech Science

Eye Transplant Enables Blind Boy to See 309

Chris Gondek points to this story carried by the Sydney Morning Herald, excerpting: "A one-year-old Pakistani boy saw the world for the first time yesterday through an eye donated by an Indian. Mohammed Ahmed gained partial vision after a difficult operation at the Agarwal Eye Institute in the southern city of Madras. Doctors said Ahmed, who was born blind, would get near-normal sight by the time he heads back to Karachi next week."
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Eye Transplant Enables Blind Boy to See

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  • Careful... (Score:5, Informative)

    by BWJones ( 18351 ) * on Monday July 05, 2004 @03:42AM (#9611409) Homepage Journal
    The title is very misleading and is born of sloppy reporting. The whole eye was NOT transplanted, rather the cornea was what was transplanted. The cornea had adhered to the boys iris clouding his vision. Technically and surgically, this is nothing of note as corneal replacements have been happening now for years and years. Politically however stuff like this is good for Indian Pakistani relations.

    The title suggests that the whole eye was transplanted which would indeed be very exciting as I myself work in vision rescue focusing on diseases that cause blindness through degeneration of the retina. However, the concept of rescuing vision once we have lost it due to trauma to the retina or degenerative diseases is much more difficult than simply replacing the tissue with a healthy donor tissue. We are working with a number of folks on bionic and biological therapies and replacements for retinal vision loss, but it is a challenging prospect despite what some commercial organizations would have the media believe.

    In addition to the above mentioned corrections, there are other problems with this story. In particular, apparently the child was born blind from birth which would suggest that depending upon how old the child is, there will be problems due to vision being occluded during certain critical periods of vision pathway development. This means that there may be no vision in the eye that was clouded anyway, or that vision may not be fully "normal" and likely will never be.

    (yes, I am a vision scientist)

  • Comment removed (Score:2, Informative)

    by account_deleted ( 4530225 ) * on Monday July 05, 2004 @03:44AM (#9611418)
    Comment removed based on user account deletion
  • by BWJones ( 18351 ) * on Monday July 05, 2004 @04:01AM (#9611474) Homepage Journal
    You are not reading the article very carefully. Only the cornea or the transparent outer portion of the eye was transplanted in this case, NOT the whole eye. Furthermore, the two references you report are bad science. First off, let me ask you if organ rejection is something to be considered, would you trade a lifetime of immunosuppresants causing kidney damage and joint disease for vision? Next, the two references in Wired are missing the boat and were written by some very deceptive science. Dobelle is a bit of a crackpot who is using high current electrodes on the surface of the brain and is kindling those patients brains increasing the likelyhood of seizures. Indeed seizures have been reported in those patients. Furthermore, from a conceptual point of view, stimulating visual cortex with crude electrical stimulii will certainly make one see phosphenes, but you can also see them by getting punched in the head. In other words it is not vision and those that are suggesting it is are either deceived or worse. To make things even more dubious, Dobelle has yet to publish his work in a peer reviewed journal and has to perform it outside the US because nobody will let him do it here.

    The issue is much more complicated than these individuals would have you believe. There are a couple of corporations that have been started that are very good with media hype. They have good engineers, but the engineers are looking for a solution without understanding what the biology is.

  • Good news links (Score:5, Informative)

    by fleener ( 140714 ) on Monday July 05, 2004 @04:05AM (#9611490)
    Google News results [google.com] for those of us rejecting cookies and unable to bypass the Syndney Morning Herald's bogus "Register later and continue to your Article" link.
  • Re:One year old? (Score:2, Informative)

    by Anonymous Coward on Monday July 05, 2004 @04:05AM (#9611491)
    Well.. For one thing, he was not able to see earlier and now he is playing with toys and handling them well. I saw the report on TV. (I am from India)
  • Re:Careful... (Score:5, Informative)

    by OkiWanKenobi ( 688609 ) on Monday July 05, 2004 @04:22AM (#9611547)
    we are talking about rewiring about 1000000 nerves in a very tight bundle, each of which has a pair and is part of a patway binding your eyes with your brain, regardeless of your approach, i would be surprised if a complete and totally successful eye transplantation happens within the next 100 years, it is the 2. most complicated operation possible, comming behind brain tranplantation...
  • Re:Careful... (Score:5, Informative)

    by DrScott ( 4365 ) on Monday July 05, 2004 @04:35AM (#9611593)
    I agree. The title is completely misleading. There are one million retinal ganglion cell axons in the optic nerve that would be sectioned and need reconnection in an eye transplant, not to mention the reconnection of the short and long ciliary nerves to innervate the ciliary muscles, etc. Even with recent advances in nerve growth factor and other neuropeptides, this is still beyond current science and more in the realm of science fiction.

    (another vision scientist)
  • Well duh (Score:5, Informative)

    by SmallFurryCreature ( 593017 ) on Monday July 05, 2004 @04:50AM (#9611648) Journal
    It says the boy picked a ball of from the table in front of him. Doesn't exactly take a rocket scientist to tell is he is grabbing for it blindly or directly as a sighted person would.

    There are also simpler tests. wave a hand a quickly in front and note reaction, move a light and watch if the eye follows it.

    How much he sees and how well is of course another question. But if you had the choice between being completly blind and being able to see a ball on a table what would you choose?

  • Re:One year old? (Score:5, Informative)

    by bigsexyjoe ( 581721 ) on Monday July 05, 2004 @05:17AM (#9611715)
    Yes, there is an objective test. It uses a device that is a cylinder that can roll. It has pictures on it. You roll it and the patient's eyes will track the motion if he can see it. Interestingly enough, this is a good way to see if someone is faking vision loss. Because if you see the motion you can't help but to track the motion.
  • by just_gecko ( 794095 ) on Monday July 05, 2004 @07:02AM (#9611992)
    I totally agree. I've seen some tips in a yoga book and used them. Trust me, I spend ALOT of time in front of the computer and I (think :] ) I see perfectly. I found (some of) those tips in this article [omplace.com] (omplace.com). I am sure there are other articles about this on the web. Those exercises can actually help you start seeing normally (without your glasses) again.
  • by mz2 ( 770412 ) on Monday July 05, 2004 @07:26AM (#9612043)

    Making stem cells to specialize into kidney cells is not quite as hard as producing functional neurons and making their growth cones migrate exactly where wanted -- The "wires" aren't the biggest problem, it's the signaling that takes place to connect the wires into something that has a wanted physiological meaning.

    And there's very active research going into understanding nerve cell targeting. The problem is just that the successful process of nerve cell growth is a result of a fine balance of a huge number of extracellular signals -- different guidance cues, repelling signals, survival factors, cell-to-cell adherence molecules, etc, etc. The basis is known, but it also appears to be one huge area of intracellular signaling research to cover.

  • by Etosoerc ( 561629 ) on Monday July 05, 2004 @08:24AM (#9612250)
    Could it be Oliver Sacks' An antropologist on Mars [amazon.com]? His main problem was that all he saw was coloured blobbs moving about. He could not understand objects, and correlate them with his previous experiences. For example, when they removed his blindfold, he was just sitting there. Then the doctor asked 'well?' and only then did he realise that the blobb he saw was the doctor. He had pretty bad sight after the operation, and it was not made entierly clear if it was due to his eyes or his brain not making any sense of the input. Excelent book, for the rest too!
  • by Anonymous Coward on Monday July 05, 2004 @08:51AM (#9612355)

    You can grow a headless (or brainless) body in a vat. They've already grown headless mice:

    Time Magazine Summary on Headless Mice. [time.com]

    As well, I suppose, it might be easier just to transplant out all your organs. Do arm transplants, skin transplants, organ transplants, and build a new body around the old brain.

    Key areas of research I'd want is:

    • Artificial Intelligence (All these technologies will come online almost simultaneously if we developed artificial consciousness / intelligence)
    • Cryonics. The ability to freeze and unfreeze people at will be useful in expanding out beyond our solar system.
    • Environmental sciences. We need to be able to live with the planet in a sustainable manner. We might wipe ourselves by killing the planet before we develop technologies to prevent it from happening ;).
  • by DrYak ( 748999 ) on Monday July 05, 2004 @09:07AM (#9612416) Homepage
    The input really comes from external stimulis, but yes in a way, what we see is the brain's own interpretation of those stimulis.

    The information is never used as-is by the brain, but at each stage it processed, and information is extracted and spareted.

    The vision, for exemple, doesn't work at all like in a computer with a pixel grid.

    The input from the cones and the rods (the "pixels") is not sended as-is to the brain. Instead, in other layers of the retina, value from rods close to each other is compared (for : exemple you have "off-/ and on-centers", a signal is genrated only if surrounding cones are off and central cone are on, meaning there's something in the middle of that region).

    The information transmited in the optical nerve isn't "pixel at coordinate (150,175) is color rgb(126,129,32)" but "there a change between these points and their neighbours, so there must be something there".

    Further stages in the brain works the same way :
    point are compared together to extract edges (comparing point close together), or motion directions (comparing the timing between two near region).
    Then motion, shape, colour, etc... is processed independently in deffirent arrea of the brain.

    This analysis is also done at different frequencices : some region compare difference between point very close to eachother, where other regions compare global differences between the two half of your field-of-view.

    So : when you see a red pen falling, you're brain isn't processing the images at a whole (not like a sequences of pictures of the pen falling).
    But one region of your brain say it found a red object, another region of your brain tells there's an object that is long and thin, a third region see ther's motion going downward, etc...

    Also, it isn't possible to have a single nerve fiber for each "pixel" while keeping a high resolution. So there's some kind of information drop : only the center of the view has a high density of receptors (cones & rods), the rest of the field of view has much less receptors.
    Only the center of the view can see fine details.
    The rest cannot give details, but can still give an alrt if there's something, and you'll automatically point your eyes int that directions to bring the interesting objet in you "high resolution" zone.

    The whole scene is the kept reconstucted in some kinf of mental visual scratch pad.

    So when you look at a plant you can see it well with all details, leaves, etc...
    Then when you look at your computer screen, you can't see that plant that well, but even in your peripheral vision you can still a bullry green spot, and you remembre that you saw a plant there. Even if you can't see details anymore, your brain can still notice that the green spot has suddenly turned brown-orange. You turn your eyes and see that you can is trying to eat your plants....

    This also explains why we don't "see" our blind spot. (Due to some poor cabling, the optical nerve is running thru the retina, and there's no receptor in that place, to leave room for the nerve).
    It's like a grid with some pixels missing.
    The vision works by comparing points. It's just that in the blind spot, the brain is comparing receptors that are VERY far appart. So if something small is located just in the blind spot, we won't see it, but we won't even realise that we are missing it, because when the brain compare the points above, below and on the sides of this spot, it doesn't notice any change, so the brain thinks the background is continuous. (That's what some call 'filling the gaps').

  • by ONOIML8 ( 23262 ) on Monday July 05, 2004 @09:32AM (#9612517) Homepage
    The average /. reader can't see.

    If you had RTFA you would know that it wasn't about the technical details of some new surgery. Far from it.

    For those who wont RTFA, it was mostly about doctors in India helping children from Pakistan. And for thost who won't read anything but /. you might be interested to know that India and Pakistan aren't the most friendly of neighbors. So things like this are good for improving the way people in those two countries think about each other.

  • by ChrisMaple ( 607946 ) on Monday July 05, 2004 @10:58AM (#9613020)
    I think perhaps the vision defect he had would be much like holding a thin sheet of paper in front of the eye. Dimness, but not lack of light, would not entirely prevent development of the visual system. Resolution would be very poor, but I'd guess he could track a finger moving an inch from his eye. Once the mechanical problem is fixed, vision stands a good chance for substantial improvement. Even if vision is never good enough to allow safe car driving, it can still be very usable.

    Humans develop more slowly than cats and remain "plastic" in their mental abilities much longer. As long as the development of the visual system has not been prevented, there is reasonable hope.

  • by LurkerXXX ( 667952 ) on Monday July 05, 2004 @11:47AM (#9613346)
    All evidence? Really? Tell me more.

    As a neuroscientist, I can tell you that you are wrong. The brain does age along with the body, old brains do not look like young brains. Some do age much better than others, but the same is true of the rest of the body as well. Damage from oxygen radicals happens in neurons and glia, just as it does in every other type of cell in the body.

  • Re:Careful... (Score:3, Informative)

    by IdahoEv ( 195056 ) on Monday July 05, 2004 @03:13PM (#9614989) Homepage
    As another neuroscientist, I'm going to agree with Polkyb, here. I don't think precise rewiring of each of the optical nerve axons is necessary. We know, for example, that even normal humans whose vision is reversed vertically through prisms will learn to interpret the new visual information appropriately within a few days.

    We also know (or think we know) that much of the functionality within visual cortex is built through some self-organizational algorithm during early development. (Witness horrible experiments with kittens that show kittens deprived of normal visual stimuli for the first few months cannot see objects correctly in adulthood).

    So, especially if it were done very young, I suspect that any wiring of a transplant eye's optic nerve axons to the axons of the optic nerve in the patient would ultimately be configured more-or-less appropriately. The patient might not learn to see the way we do, but they would learn to interpret the optical signals in a useful way.

    However, this still begs the question: when will we be able to rewire nerves at all? Whether or not the brain can learn to interpret the new signals, transplanting a whole eye means cutting the optic nerve and reattaching 100,000 broken cell axons to 100,000 other broken cell axons, even if we don't care which one goes to which. Axons are about a micron in diameter; these aren't the kind of structures you can do surgery on.

    So far, we can't even reconnect a single axon, and I don't see any emerging technologies that show promise for making this possible. I suspect we'll have success by growing new retinal neurons from stem cells and teaching them to grow axons down a "scaffold" optic nerve before we can sever and reconnect a grown optic nerve. And I'd put that stem cell approach 25-50 years off.
  • by armando_wall ( 714879 ) on Monday July 05, 2004 @10:24PM (#9617703) Homepage

    I found your comment very interesting, especially the part with the guy with the goggles.

    However, let me clear things up a little bit. When you spin or walk and suddenly stop, and you feel your brain overcompensates is not due to sight but to the inner ear, where the "labyrinth", and its fluids that help us with orientation, resides.

Math is like love -- a simple idea but it can get complicated. -- R. Drabek

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