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Bionic Eye : An Iconic Innovation

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Review Article

Bionic Eye: An Iconic Innovation

Tarun Kumar Suvvari, Mansi Thipani Madhu1, Sowmyashree Nagendra2
Rangaraya Medical College, Kakinada, Andhra Pradesh, 1Vydehi Institute of Medical Sciences and Research Centre,
2
Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Abstract
The bionic eye is a visual prosthesis that restores the vision fully or partly in blind people suffering from retinitis pigmentosa and macular
degenerations. Many bionic eyes have completed human clinical trials and become functional but still need newer technical approaches to
make it available to all people. A bionic eye illuminates the dark world of blind people. To date, many bionic eyes were developed like
Argus II Retinal Prosthesis System, Artificial silicon retina and many more, whereas Gennaris Bionic vision System is the recent advanced
bionic eye. In our paper, we have covered the basic structure and working of the bionic eye, projects on the bionic eye to date, vision
through the bionic eye, implants and restoration of sight, limitations, and the future of the bionic eye.

Keywords: Bionic eye, retina, vision, visual prostheses

INTRODUCTION for patients with defects in light processing functions

People having a near or distance vision impairment are (damage to the retina, macula, and optic nerve). But for
estimated to be at least 1 billion globally that could have patients who were born blind, it was not convenient to
been prevented or has yet to be addressed. Uncorrected implant a bionic eye them due to not well developed optic
refractive error, cataracts, and diabetic nephropathy are the nerve.[3]
major causes of vision impairment and blindness. The most
common age group suffering from vision impairment and OVERVIEW OF BASIC STRUCTURE AND WORKING OF THE
blindness is over 50 years.[1]
BIONIC EYE
The eye receives a light stimulus and transforms into a
The bionic eye is a visual prosthesis which helps to restore
nerve impulse, which runs along the optic nerve reaching
the vision fully or partly. Visual prostheses are implanted
the visual cortex and gives rise to visual sensation. The
based on neuronal electric stimulation at different locations
retina is the innermost membrane of the eye that contains
along the visual pathway, i.e., subretinal, epi-retinal, optic
photoreceptors (rods and cones), and the macula (fovea
nerve, and visual cortex.
centralis) is the most sensitive spot, and cones are
concentrated at that point. The retina transforms light energy The bionic eye consists of image sensors, radio transmitters,
into an electrical stimulus and transmits them to the brain microprocessors, receivers, and retinal chips. This electronic
through optic nerves to create vision.[2] system helps blind people to get back good vision. Bionic
eyes have a computer chip located at the back eye and
A bionic eye is a form of a neural prosthesis intended to linked to a small video camera built into glasses, which they
restore lost vision or partially amplify existing vision. The wear. The camera’s captured images are focused on the
bionic eye was developed in view of patients with vision chip, which converts it into an electronic signal and sends it
loss due to the degeneration of photoreceptors like retinitis to the brain. Electrodes on the implanted chip cover these
pigmentosa (RP), macular degeneration. Visual prosthetic signals into electrical impulses to stimulate cells in the
implants are suitable retina that connect
Address for correspondence: Mr. Tarun Kumar
Received: 12-11-2020 Revised: 22-12-2020 Suvvari, Rangaraya Medical College, Kakinada, Andhra
Accepted: 13-01-2021 Published: 27-03-2021 Pradesh, India. E-mail: tarunkumarsuvvari234@gmail.com

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DOI:
10.4103/tjosr.tjosr_168_20
How to cite this article: Suvvari TK, Madhu MT, Nagendra S. Bionic
eye: An iconic innovation. J Ophthalmic Sci Res 2021;59:52-5.
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Suvvari, et al.: Bionic eye

to the optic nerve. These impulses are then passed down information and power to the intraocular components
along the optic nerve to the brain’s visual cortex, where they through radiofrequency waves. The intraocular prosthesis
are interpreted as an image. The images produced by the will decode the signals and send electrical stimulus to retinal
bionic eye do not have high clarity, but they are good neurons through the electrodes, which visualize images
enough to recognize the things/places.[4,5] acquired by the CMOS camera. The MARC system has a
compact size of 6 mm × 6 mm, good diagnostic capability,
PROJECTS TILL DATE ON BIONIC EYE and low stress on the retina.[12]
Argus II retinal prosthesis There are many more similar projects mentioned above
Argus II Retinal Prosthesis System is also called an like Alpha IMS (subretinal visual implant), [13] holographic
“artificial retina” or “bionic eye.” It is the epi-renal implant technology (based on optogenetics),[14] microsystem-based
and approved by the US Food and Drug Administration on visual prosthesis, implantable miniature telescope,[15]
February 14, 2013. Argus II consists of a mini video camera, photovoltaic retinal prosthesis (PRIMA), intracortical visual
the transmitter set up into eyeglasses, a video processing unit prosthesis….etc.
(VPU), and implanted retinal prosthesis (array of
electrodes).[6] The video camera captures images and
transforms it into electronic data with the help of VPU,
RECENT ADVANCES IN BIONIC EYE
which sends signals to a wireless receiver (the retinal Gennaris bionic vision system
prosthesis electrodes). The electrodes sent the electronic Gennaris[16] is a project by the Monash Vision Group
signals to bypass the damaged retina and transmit directly to (MVG) of Monash University in collaboration with Alfred
the brain’s visual cortex and interpreted as visual images. Health, Grey Innovation, and MiniFAB. It is designed in a
The criteria to get implant Argus II are aged 25 or older, way where people with optic nerve damage can also get
aphakic or pseudophakic, having bare light or no light vision.
perception in both eyes, and previous history of good visual Gennaris consists of headgear with a camera, a vision
acuity.[7] processor unit and software, a wireless transmitter, and a
Artificial silicon retina series of 9 mm × 9 mm tiles for implanting into the brain.
Artificial silicon retina (ASR) is a subretinal implant, a silicon The video recorded by the camera will be sent to the vision
microchip of 2 mm diameter that contains approximately processor, where it will be processed to extract the required
5000 microelectrode-tipped micro photodiodes and is information. The data will be transmitted wirelessly to the
powered by incident light. It is a solid-state biocompatible circuitry within each implanted tile. The data will be
chip that contains an array of photoreceptors. It is implanted converted into electrical pulses, which will stimulate the brain
to replace the functionality of defective photoreceptors. [8] through the microelectrode array. The visual pattern will be
The need for external supply was eliminated in the ASR. created with combinations of up to 473 spots of light
The ASR was shown excellent vision restoration and did not (phosphenes), which will provide necessary information for
lead to any side effects like rejection, inflammation, the user regarding indoor and outdoor environments and
neovascularization…etc.[9] recognize the presence of people and objects around them.
The headgear of gennaris encases MVG’s wireless
Harvard/Massachusetts Institute of Technology Retinal transmission technology, sending data to up to 10 implants
Implant where each can stimulate 43 points of the human visual
It is an epi-retinal implant where a microelectrode array cortex. Because of direct involvement with the cortex,
replaces damaged photoreceptors. The image acquisition MVG’s technology has hopes to assist most people who
was using a charged couple device (CCD) camera. The have total blindness also.[16]
patient spectacle holds the power source and camera. The
subretinal stimulator (array of electrodes) is placed beneath Many projects related to the bionic eye are still under
the retina in the subretinal space, which receives image clinical trials. Approximately 1 million electrodes are
signals from the camera and the stimulator chip, decodes necessary for natural sight. Developers are currently
signals, and stimulates retinal ganglion cells. The secondary working on implants with 240 electrodes and peripheral
receiver coil was sutured around the iris.[10,11] electrodes to improve the size of the person’s visual field.

Multiple units of artificial retinal chipset system

Multiple units of artificial retinal chipset system (MARC) uses
VISION THROUGH THE BIONIC EYE
a CCD camera input and radio frequency signals to transmit The bionic eye technology is complex. It depends on the
the image into the microchip present in the retina. The specific eye or prototype, as well as the associated
image has a resolution of 100 pixels, which is achieved condition. The bionic eye architecture consists of both
using a 10 × 10 array. It contains a platinum/rubber silicon external and internal components.[17] The external
electrode array placed inside the eye, which stimulates the components include glasses with a video micro camera
cells. It also consists have a secondary receiving coil mounted in it and an external connection coil. The Visual
mounted near to the cornea. An external mini low-power Processing Unit (VPU), which is a portable computer
CMOS camera was attached to an eyeglass frame. It customized for the patient., the internal component is the
captures an image and transfers the visual implant, and it consists of the receiver’s coil, electronic case,
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microelectrode array.[17,18]

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Suvvari, et al.: Bionic eye

When the system is turned on, the micro-camera in the reasons include a patent for Argus II, higher per capita, and
glasses records and transmits the images to the VPU. The increased awareness. Following North America, Europe and Asia-
image is converted into electrical stimulations and sent to Pacific are leading. The Asia-Pacific market is filled and is
the external transmitter coil. These signals are then penetrated only to a limited extent. The market has been
transmitted to the receiver coil of the implant. The receiver
coil and electronics case are sutured to the sclera of the eye.
The received signals are decoded, and stimulation output is
generated, sent to the microelectrode array. Microelectrodes
deliver stimulation to the retina. The impulses are relayed to
the brain through the normal optic nerve tract, generating
vision.[18,19]

IMPLANTS AND RESTORATION OF SIGHT

The flickering light is designed to reflect an object’s
fundamental form in front of the camera, with its
approximate height, width, and position. The electrical
stimulation of the surviving neurons causes the person to
perceive tiny light spots called phosphenes. A phosphene is
a phenomenon of experiencing seeing light without light
actually entering the eye
- like the colours you may see when you close your eyes.
[20,21]

These phosphenes can be used to map out the visual scene

in bursts of light in anyone with a bionic eye. The vision
provided by a bionic eye, therefore, is not like a natural
vision. It is a set of flickering spots and shapes that the
individual uses to view the world. The vision created by the
system is distinct from the premorbid vision of the patient.
To process light patterns, patients must understand its
working. To interpret the camera image, recipients need to
use these irregular flashes. After postoperative care and
years of rehabilitation, several individuals who acquired the
implant were able to identify everyday objects, faces of
loved ones, even cross streets, and read large-print books
without aid.[20,21]

GLOBAL MARKETING ON BIONIC EYE

Bionics (a combination of biology and electronic
equipment) is gaining an increase in demand in India.
Bionics is still in its developing stages, but many hospitals
and medical institutes favor using bionics rather than organ
transplants or traditional methods such as a wooden
leg/marble/glass eye.
Bionic eye or retinal implant was co-invented by an Indian
origin Scientist, Dr. Rajat N Agrawal, an ophthalmologist
and retina surgeon, University of Southern California, USA.
He is currently working in collaboration with the All India
Institute of Medical Sciences, and IITs develop a cheaper
native variant of the bionic eye so that people in India can
afford it. The natively developed implant is assumed to be
Rs 5 lakhs, which is affordable and very less than Rs 45 lakhs’
present cost. He was the founder of a nongovernmental
group called “Retina India” to research retinal implants.[22]
North America currently dominates the global market; some

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growing since 2012 and is expected to surge in the of Argus II retinal stimulator is under design with 60
upcoming years. Unfortunately, the awareness about controllable electrodes, which can project high beam rays
the bionic eye is still less than the assumption.[23] and form high-resolution images. Technology is advancing
more and more every day, and with inventions like this, it is
Limitations
The ultimate aim of the invention is to reach
maximum people, so it is all about the cost for Bionic
eye, which is $30,000 approximately where many
people cannot afford it. The cost is the main factor of
the bionic eye; hopefully, the cost will decrease, and
these will become more common in the medical world
in the coming years. The bionic eye is not suitable for
all blind people (e.g., glaucoma); it is mainly for
people who have retinal damage due to RP …etc. The
percentage of restoration of vision is not high enough.
Unfortunately, the vision offered by a bionic eye is not
clear enough for recipients to rely on to navigate the
world since they generate streaky images and are too
slow to catch rapid movements. Overall, the vision still
falls short of a natural human eye. Researchers hope
potential bionic eye implants can generate higher
resolution vision, but this has inherent challenges. The
Argus system allows recipients to say the difference
between forms, motion, and light. However, since
only 60 electrodes are part of the system, it does not
allow us to see in the same way that healthy eyes
operate. In comparison, we will need around a million
electrodes to achieve the natural vision. However, the
Argus company plans to add more electrodes in future
models.
Another factor why the bionic eye cannot replicate
human eye vision is due to lack of perception of color
as the retina has many types of neurons, but the
electrodes are too large to target individual types
selectively. This long procedure is surely a very
expensive one and may not be covered by medical
insurance. Apart from that, recipients must learn the
working of the device and the interpretation of
flashes. The patient must use head motions to scan the
area, which is surely tedious. The long-term stability
and long-term impact of the system’s electronic
components on the retina are still not well established.
The future of bionic eye
Although the vision provided by the bionic eye is far
from that of a natural eye, this system has endless
opportunities for improvement. Many surgeons are
now becoming aware of the benefits of the bionic eye
over the traditional glass eye, but choosing these over
surgical and medical treatments is still a long way
down the road.
The major focus is to increase the number of
electrodes in the implants and decrease host immune
response, contact blood clotting, and device failures.
Future implants may enable people to see in color and
they could also be extended to a broader spectrum of
diseases causing blindness. We need to increase the
number of electrodes that can produce sharp, colorful,
and more functional vision. The upcoming generation

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Suvvari, et al.: Bionic eye

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