Eye Transplant Enables Blind Boy to See

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."

One year old?

[grondin]

How can they tell that it worked?? Did they ask him - or is it some sort of objective test??

-FP??

Re:Careful...

[ofdm]

depending upon how old the child is

From the herald article (first line), the child is one year old. So what are the chances given that age? (I recall from a friend doing a PhD torturing kittens that early visual development is critical, and one year sounds maybe a little late to start).

A very promising technique

[bobhagopian]

Though my understanding of the human eye is far from perfect, I believe this technique will work for patients who are born blind as well as those that become blind through trauma or degenerative disease. That is, this technique can, I suspect, be used on *anyone*. I am particularly fascinated by this approach. While it certainly has some drawbacks (e.g., imperfect donor eyes, organ rejection), it definitely gets around the technical issues that one reads about in the U.S. Most of the research I've read about in the past couple years (see, e.g., article 1 [wired.com] and article 2 [dobelle.com]) involves the use of electronic fixtures of some sort with electrodes connected to the optic nerve or onto the brain itself. It's interesting--though perhaps not entirely surprising--that the low-tech approach might, at present, be more successful than the high-tech one.

Which would you rather have? A human replacement eye, or a pinhole camera mounted behind a pair of sunglasses?

Re:Careful...

[selderrr]

Nice to hear an expert once on /.

What do you think are the chances of ever seeing a complete eye transplant ? In 10 years ? 50 ? 100 ? Or maybe never at all ?

Re:Careful...

[BWJones]

The implications would have been staggering if they had been able to transplant an entire eye

Thus my interest.

a "BladeRunner" level of futuristic technology. "I made your eyes", etc

I am working on it.... Seriously.....

It would presumably also be relatively easy to graft an artificial electronic "eye", to create vision enhanced cyborgs - or to plug a video feed straight into the optic nerve for the ultimate in immersive graphics.

There are folks that are working on these solutions as well. One guy has a good approach while the others are basing their solutions on flawed assumptions of the basic biology. We are working on correcting these flawed assumptions.

After the eye works, then what?

[phr2]

If the kid has been blind since birth, has his visual cortex developed properly? I seem to remember hearing about horrible experiments involving sewing shut the eyes of newborn kittens. When the kitten is a month or two old, the eyelids get unsewn and the eyes work completely normally, but the kitten never really learns to see.

I feel feel squicked just thinking about this, but I wonder if that kid will ever have really useable vision.

Re:Careful...

[BWJones]

What do you think are the chances of ever seeing a complete eye transplant ? In 10 years ? 50 ? 100 ? Or maybe never at all ?

I've thought about this a lot. There is some very promising research in the neuromuscular community that suggests that spinal motor neurons can rewire rather successfully. The problem is that the retina (and the "wires" (axons) that come off of it is a very complicated tissue and rewiring them might be too much to attempt even if you could 1) get the retinal neurons to survive and 2) get them to rewire properly and perform the precise pathfinding necessary. Immunological considerations are another issue, so the approaches I am interested in a other biological and possibly bionic approaches.

Re:Careful...

[Quirk]

Isn't the issue better viewed in regard to your statement: "depending upon how old the child is, there will be problems due to vision being occluded during certain critical periods of vision pathway development."

My limited understanding as a lay person is that vision is dependent upon unimpeded development during a critical period at a very young age.

Re:Careful...

[Polkyb]

Would re-wiring the nerves properly be THAT important in allowing the eye to send information to the Brain?

The brain has astounded scientists in it's ability to reconfigure itself so as to perform the same tasks, but using a different region

For example, I remember a story about a boy who had a hemisperectomy. Doctors expected him to wake up paralysed down one side of his body, but, when he did wake up, he could do everything he could before. Which, IMO, amazing.

Re:Anyone spare an eye for a computer nerd?

[bigsmelly]

You need to exercise you eyes.
Staring at a screen all day every day will cause your eyesight to get worse.

Put an eye chart on a wall 15 feet away, and look at it every 15 minutes. Your eyesight WILL improve.

Re:A very promising technique

[JPRelph]

"would you trade a lifetime of immunosuppresants causing kidney damage and joint disease for vision?"

To be honest, yes. To me being blind sounds like hell and I couldn't imagine a worse disability. Obviously that's because I've been able to see for the past 20 years, so it might be different for someone who was born blind, but if someone said "vision and kidney/joint problems or blindness" it wouldn't be a particularly hard decision for me to make.

Re:Careful...

[anubi]

BW:

You are hinting that it looks feasable to you for constructing interfaces to take a high-speed binary serial stream, using some sort of implantable serial to parallel converter, to generate a video signal which would be like that on the optic nerve and recognizible by the brain as video?

Bridging the gap between binary electronics and and the neurological networks of life has got to be the biggest "hack" of all time.

Although I feel I understand the former extremely intimately, I am absolutely in the cold about the data formats, even to the physical layer, in the latter. About the closest I can come to is its some sort of frequency modulated 70 millivolt pulses mimicing synaptic firings. But there are so many parallel channels! And I would take a very strong guess that a lot of information is located in relative timing of the firings.

Has your involvement in the neurological end of things given you any good leads on hacking the biological end of the interface?

I envy you guys.. as you are on the edge of unknown. The Frontier.

Re:A very promising technique

[Henry V .009]

Actually, it is doubtful that this technique will work on those who are born blind. Through a number of experiments with eye-patches, electrodes, and kittens (it's not the prettiest side of science) we have found that the nerve connections that are formed in the first few weeks after birth are necessary to vision. So much so that if a patch is put over a kitten's eye for those first few weeks, it will never be able to see out of that eye even once the patch is removed.

I suppose that it would be possible to make electronic connections deep into the brain (past the optic nerve) to get around this. But I would still be skeptical that the brain would ever be able to adjust to processing the new information.

State of Affairs !

[phreakv6]

Its really heartening to see the social ties the two countries still have inspite of the tussle at the top.I hope the recent talks [indiatimes.com] between the two countries gets more bonds between the two countries.

What about the psychological aspect?

[musicmaster]

I remember some pop psychology book (author forgotten) with a story about some blind person getting vision when he was an adult. The problem was that he couldn't cope with it and got psychological problems. When his vision started deteriorating again he felt relieved.

Will this boy have the same problems?

bad, but not terrible

[grepistan]

It's not that bad. I'm not blind, but I do know and work with quite a lot of people who are, and you would be amazed at their independence and their quality of life. Like you suggested, many people who have never been able to see are perfectly content with their 'disability', and indeed can't imagine anything else. One of my friends says that if sight-restoring operations were possible in an everyday sense (which they certainly aren't), he would probably not take it. I'm not sure how typical of the blind community this is though.

The people who do really have trouble, obviously, are people who go blind later in life. They suffer more because they obviously didn't grow up blind, and thus didn't develop braille skills and other blind-person tricks like click-navigation (Seriously, a few people I know can point unerringly at furniture, doors and windows after clicking their fingers a few times!) These things take time, and a lot of older people unfortunately believe too strongly in the 'old dogs can't learn new tricks' maxim. The shock of this and the isolation that can come with blindness sometimes cause as many problems for older blind people than their actual physical condition.

An "Ask Slashdot" for the vision scientist(s)

[The Famous Brett Wat]

In Cringely's latest "pulpit" column [pbs.org], he talks about a video compression technology which uses one aspect of human vision physiology -- namely losses in the path from retina to brain via optic nerve -- to compress video. Apparently the bandwidth of the optic nerve isn't all that high, and not all the data available at the retina is transmitted to the brain. The brain makes up for this by filling in the gaps. I'm rather interested in this from a philosophical standpoint, having touched upon philosophy of colour recently. Is it true that much of what we perceive visually is imagery generated by the brain rather than directly produced in us by external stimuli?

all those in favor say.....

[Justabit]

I could understand if the boy was made blind, or was blind in one eye, that he would be able to see after a transplant, but for boy to be able to see (with the transplant) having not seen befor? I just don't see it. His optic nerves and brain having not had the input would not be used to the signals he was recieving and would take alot longer to get used to them if they were recieved by the brain at all.
It could be a case of 'Blind' as in 'technically blind' such as light reception through the optic nerve but completely fuzzy due to interference? How about "There is a ball on the desk in front of you. Reach out and grab it if you can" ball being black on white table he could see it. Please post next article if there is full eyeball and op nerve transplant and subsequent vision recovery, thank you.

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Re:True...Need more Funding.

[filipncs]

Transplanting the brain wouldn't make you immortal no matter what, the brain would still be deteriorating. But what makes you think the brain isn't the whole person?

Somewhat of a personal experience

[Xanlexian]

My father had a cornea transplant in his left eye back in 1987.

They first had to do a plaster mold of his eye (the first one broke). And then he had to sit and wait for an acceptable donor.

When the cornea came in, they numbed his eye completely (locally) and all the surrounding area (he was fully awake when the procedure was done). And stitched in the new cornea.

Late one night, I was sitting in the hospital room with my dad -- this is late the very same day (mind you, I was only 14 when this was done) -- the nurse came in to change dad's eyepatch, reapply some goo, and just do a general check. Soon as the nurse walked out of the room, my dad grabbed me and said, "Holy shit, son. I JUST saw DEPTH! I can't f*ckin' believe it. I saw in three dimensions!!!!" -- I've never saw my dad so excited over something. I told him something to the affect of "welcome to the world of depth" or something stupid like that. He told me to wear one of his eyepatches for a day, then take it off and look at how different the world was.

Later on some months, I couldn't handle driving with him. "The TREES are coming AT ME!!!"

I guess we stereoptic folks take this stuff for granted sometimes.

--Xan

It depends also on the brain itself.

[DrYak]

The biggest factor that influence if one can have it's vision back or not is the age and the brain itself.

It is because the center of vision finish developping at a certain age.

In your exemple, if the person is a ful grown adult when he looses his eyes, he has an already functionnating center of vision. And when he has a new eye, he'll be able to use it again.

If he lost his eye when he was a baby, and he waits until he's 20 before gettint a new eye, the new eye won't work, because during the childhood, the brain has only learned to use 1 eye.
The person has developped what is called "amblyopia" (he has only monoscopic vision).

That's why the article mentions that the transplantation happened when the child was only 1 year old. That means the child is still young enough to learn using both his eyes.

Another exemple are retinoblastomas. They are a form of cancer that can happen inside the eyeball. If it happens to an adult, as soon as the cancer is removed, the adult can see again.
But if this happens to a baby, the doctors have to be quick, because if they wait too long before diagnosting it and removing it, the child will develop "amblyopia" and won't be able to use this eye, even after the removal of the cancer.

Re:True...Need more Funding.

[CaseyB]

I'm curious about a related issue: is it necessary to wire neurons a->a, b->b, c->c between the "brain" end of the bundle and the "eye end"? If you could establish any 1:1 connection set, could the brain learn to interpret the signal as vision, or does it have to be mapped in a certain way?

I'm just wondering how much precision is really required, and how much the brain can compensate for after the fact.

Does it even make sense to think of the optic nerve as a bundle of parallel wires?

Re:Man wtf Slashdot

[lxt]

"Here I thought a boys WHOLE eye was replaced! That would have been amazing and something for the whole world to rejoice for" ...but people aren't amazed by the fact we can already give permanently deaf people hearing again. Nobody seems to have noticed we've created bionic ears...in fact, the whole area of Cochlear implants seems to have gone rather unnoticed (being the insertion of electrodes into the cochlear to enable someone born deaf to hear again).

I want better eyes than human eyes

[Space_Soldier]

Human eye transplant sounds good. However I'd like to see a more useful eye transplant. I'd like to see a Borg style transplant; this will give you the ability to zoom, night vision, sun proctection, x-rays in one package.

Re:Careful...

[seafortn]

In short, yes.
There's a famous experiment where a frog eye was removed and reattached inverted 180 degrees, and the frog never compensated (it would shoot it's tongue out the wrong direction when trying to eat flies, and had to be fed by hand for the rest of it's life) (vision scientist types - do you know the name of the guy who did the experiment?)

Another piece of evidence is the development of ocular dominance columns, which were hinted at in an earlier post - essentially, if you occlude one eye of a developing monkey, after a certain point, it will be permanently blind in that eye, because the input from the other eye reconfigures the brain to process only input from that eye - it is irreversible - thus the need for very early cataract correction in children.

(IANAVS, but I did pass my Neural Science course...)

Re:True...Need more Funding.

[vinlud]

Although the thought of being immortal is pretty attractive, problems will skyrocket when this really is possible. Already Western countries are struggling with their aging populations while people want to stop working earlier and earlier. People should realize that at some point life has to end and that it comes with a certain cost (worklife). I think this will be one of the major issues in this century.

In a way its healthy for our population when individuals don't live too long.

exp

[Anonymous Coward]

My girlfriend had a problem very similar to this when she was born. A cataract clouded her eye, but none of the doctors (!) said it was anything to worry about. Finally after six or eight months her parents found a pediatrician who knew what he was doing. She had a surgery to correct the initial problem. She wore a patch over her good eye until she was five years old to try to train her brain to see correctly out of the bad eye. She has had around ten surgeries on her eye, but she continues to have problems simply because her brain did not develop correctly to support both eyes. For instance, she has no depth perception whatsoever, she describes her vision out of her afflicted eye as "a little blurry", her vision is always double and sometimes when she gets tired her eyes tend go crossed.

Read the article, hope his rehabilitation is not as painful as hers was.

Re:True...Need more Funding.

[protonman]

First: This has nothing to do with neuroscience:

Is the car the same car after fueling? After an oil change? After a new engine has been put in? After a paint job?

See, the same kinds of questions can be asked about something totally unrelated to neuroscience, and this is a huge clue.

And, don't make the mistake to presume these questions about cars can be answered by car mechanics. Where would they start? How would they determine what constitutes a car without engaging in reflection on concepts, viz. philosophy?

Second: I am not referring to the effects of hormones.

Third: I am only objecting to the "the brain is the person"-answer to the question on how personality is related to the body: the mind-body problem.

Clearly, I am a person, and I have a brain in my head. I don't think you can object to this.

But if you say a person is a brain (and, presumably, a brain is a person), you should believe all these sentences mean the exact same thing:

I am a person, and I have a brain in my head.
I am a brain, and I have a brain in my head.
I am a person, and I have a person in my head.
I am a brain, and I have a person in my head.

Mostly nonsense of course. So clearly, a brain IS NOT a person.

Nevertheless, if you ask me if personality is `stored' in the brain, or something analogous to that, I would probably agree. There has been ample evidence of the fact that brain damage can cause severe personality changes, the case of Phineas Gage comes -- obviously -- to mind.

But believing that "a brain is a person" is, as Hacker & Bennett argue, committing a mereological fallacy, that is, confusing wholes and parts of things.

I agree.

Re:True...Need more Funding.

[meringuoid]

Perhaps we're coming at this from different angles. You seem to define 'person' as the whole system: brain and body, while I'm considering 'person' to mean only the personality. I'd happily apply the word 'person' to a biologically normal human being, to a brain in a crippled body communicating by speech synthesiser, to a brain in a vat communicating only by computer, and to an artificial intelligence that passes the Turing test.

So, going by my meaning of 'person', I would say: 'I am a person, implemented as a brain, resident inside a head which I call mine'. Barring the possible changes produced by the different hormones, I'd still be me even if transplanted into a female body - and since you're communicating with me only by text, would you be able to tell the difference?

Re:Careful...

[Otto]

There's a famous experiment where a frog eye was removed and reattached inverted 180 degrees, and the frog never compensated (it would shoot it's tongue out the wrong direction when trying to eat flies, and had to be fed by hand for the rest of it's life) (vision scientist types - do you know the name of the guy who did the experiment?)

I'll be damned if I remember anything more than these few details about it, but I recall reading about an experiment where a college kid was given glasses that reversed his vision vertically.. Sky was down, ground was up. Naturally, he had a hard time for a few weeks, and had to have somebody lead him around and such, but his brain eventually did reconfigure to the changed situation and he was able to walk and function normally. Then he took off the glasses and was screwed up for another few weeks until it went and reconfigured back to normal.

Could there be some kind of difference between a frog's brain and a human brain, in its ability to change itself to changed inputs?

Re:True...Need more Funding.

[DMUTPeregrine]

Hmm. Interesting. I also thought of this. I know of someone did an experiment where he wore special goggles that turned the world upside down for a month. After a week everything seemed normal to him. Then, when he took them off, the world was disorienting: His brain had adjusted to it being upside down. Also, try walking or driving for a while. Stop suddenly. The scene around you will appear to keep moving somewhat, as your brain overcompensates. Or just spin around in circles, you get a similar effect when you get dizzy. So it may in fact be possible to transplant the eyes, since perfect connection may not be required. Someime I'll have to do an experiment with slicing a view up randomly and see if I can adapt. Would any of the vision scientists care to comment?

Re:True...Need more Funding.

[Anonymous Coward]

I remember a documentary i saw where these people
were given goggles that "inverted"
everything they saw. - their eyes were fed a picture that to them was upside-down.
Initally, all had severe nausea and difficulty navigating.
reaching for a glass was difficult, drinking almost impossible.
after two weeks, every test subject's brain had "rewired" so that the upside-down view of the world appeared "right-side-up" to them.

when the glasses were finally removed, they had to go through the same readjustment period again.

Re:True...Need more Funding.

[HuguesT]

After a certain age it is very likely that the type of connection you refer to would be necessary.

This is from experiments on cats who were forced to wear some kind of optical contraption in front of their eyes from birth that reversed the field of their vision (i.e: everything was upside down). The cats learned to use this type of input and developed normal vision. When the contraption was removed, all cats are very confused for a while, but if cats are young enough at the time of the removal their brain did adjust after a while and they recovered normal vision again. If the cats were too old they remained confused.

If the connections were rewired randomly you'd get basically undecipherable noise from someone who had normal vision before. It's not clear if anyone would adjust. The cat experiment was much simpler with a simple geometry transform rather than random rewiring.