The vision researchers throughout the world have been working, since 1950, towards the ambitious goal of restoring a functional level of vision to the blind via electrical stimulation of the visual pathways. Groups based in Australia, USA, Germany, France and Japan report progress in the translation of retinal visual prosthetics from the experimental to clinical domains, with two retinal visual prostheses having recently received regulatory approval for clinical use. Regulatory approval for cortical visual prostheses is yet to be obtained; however, several groups report plans to conduct clinical trials in the near future, building upon the seminal clinical studies. An attempt has been made in this informative Booklet to discuss the general principles of visual prostheses employing electrical stimulation of the visual pathways, focusing on the retina and visual cortex as the two most extensively studied stimulation sites. Further to state that the surgical and functional outcomes reported to date for retinal and cortical prostheses, concluding with a brief discussion of novel developments in this field and an outlook for the future, has also been described precisely in this review for the enthusiastic Medicos. …..Dr.H.K.Saboowala. M.B.(Bom) M.R.S.H.(London)
This book describes advances in implantable neural stimulation technology to restore partial sight to people who are blind from retinal degnerative diseases such as age-related macular degeneration and retintis pigmentosa. Many scientific, engineering, and surgical challenges must be surmounted before widespread practical applications can be realized. The book summarizes the state of research and clinical practice in the field and reviews the current ideas and approaches of its leading researchers and practitioners.
This book presents and analyses the most recent research dedicated to restoring vision in individuals who are severely impaired or blind from retinal disease or injury. It is written by the leading groups worldwide who are at the forefront of developing artificial vision. The book begins by discussing the difficulties in comparing and interpreting functional results in the area of very low vision and the principal prospects and limitations of spatial resolution with artificial tools. Further on, chapters are included by researchers who stimulate the surface or the pigment epithelial side of the retina and by experts who work on stimulating the optic nerve, the lateral geniculate body and the superficial layers of the visual cortex. Artificial Vision: A Clinical Guide collates the most recent work of key artificial vision research groups to explain in a comparable and stringent order their varying approaches, the clinical or preclinical outcomes and their achievements during the last years. Senior ophthalmic fellows and academic practitioners will find this guide to be an indispensable resource for understanding the current status of artificial vision.
Intended as a useful and practical guide primarily oriented toward ophthalmic practitioners involved in retinal prosthesis implantation and post-operative visual rehabilitation, this book focuses on the Argus II Retinal Prosthesis and its revolutionary incorporation into the practice. The reader will get an update on patient selection, expected visual outcomes, surgical implantation techniques, and post-operative visual rehabilitation. Retinal Prosthesis - A Clinical Guide to Successful Implementation is written in a clear and concise manner and includes diagrams and high quality photographs to demonstrate best practices in surgical techniques and desired outcomes. Covering topics such as history of retinal prostheses, bioengineering considerations, clinical therapies, and other therapies and future directions, this book is written for practicing ophthalmologists, residents, and medical students interested in retinal implants.
Recent technological advances in the diagnosis of macular disorders have enhanced our understanding of these diseases. At the same time, advances in small-gauge vitrectomy instrumentation and techniques have improved the safety and efficiency of surgery, allowing macular conditions that would have otherwise resulted in blindness to be treated effectively, preserving patients’ sight. Macular surgery continues to evolve rapidly, thanks to exciting future technology trends. This book provides a detailed and up-to-date overview of the field. It begins with essential information on macular anatomy and pathophysiology, examination techniques, and surgical instrumentation. In turn, it discusses a broad range of disease processes, including macular holes, epiretinal membrane, vitreomacular traction and myopic maculopathy. The role and benefits of advanced vitrectomy techniques including submacular surgery, prosthetic vision, robotic surgery, and stem cell and gene therapy are addressed in detail. A review of perioperative care and potential complications rounds out the coverage.
This is a comprehensive, practical guidebook that provides a clear overview and update of current modern techniques of ocular surgery. The chapters will be of interest to a wide audience. The chapters are written by experts with special interest and extensive clinical experience in the topics.
This is the first textbook to offer a comprehensive account of ocular prosthetics and the evidence used to underpin and support this field of healthcare. It does so by bringing together information from ophthalmology, prosthetic eye and contact lens literature, and from experts actively engaged in these fields. The book describes the psychological, anatomical and physiological aspects of eye loss as well as surgical procedures for removing the eye, patient evaluation, constructing prosthetic eyes (including prosthetic and surgical techniques for dealing with socket complications), the socket’s response to prosthetic eyes, prosthetic eye maintenance and the history of prosthetic eyes. Though primarily intended for prosthetists, ophthalmologists, ophthalmic nurses, optometrists and students in the fields of ocular medicine, maxillofacial medicine and anaplastology, the book also offers a useful resource for other health workers and family members who care for prosthetic eye patients, and for those patients seeking a deeper understanding of the issues affecting them than they can find elsewhere.
Signi?cant progress has been made in the development of neural prostheses for restoration of human functions and improvement of the quality of life. Biomedical engineers and neuroscientists around the world are working to improve the design and performance of existing devices and to develop novel devices for arti?cial vision, arti?cial limbs, and brain-machine interfaces. This book, Implantable Neural Prostheses 2: Techniques and Engineering Approaches, is part two of a two-volume sequence that describes state-of-the-art advances in techniques associated with implantable neural prosthetic devices. The techniques covered include biocompatibility and biostability, hermetic packaging, electrochemical techniques for neural stimulation applications, novel electrode materials and testing, thin-?lm ?exible microelectrode arrays, in situ char- terization of microelectrode arrays, chip-size thin-?lm device encapsulation, microchip-embedded capacitors and microelectronics for recording, stimulation, and wireless telemetry. The design process in the development of medical devices is also discussed. Advances in biomedical engineering, microfabrication technology, and neu- science have led to improved medical-device designs and novel functions. However, many challenges remain. This book focuses on the engineering approaches, R&D advances, and technical challenges of medical implants from an engineering p- spective. We are grateful to leading researchers from academic institutes, national laboratories, as well as design engineers and professionals from the medical device industry who have contributed to the book. Part one of this series covers designs of implantable neural prosthetic devices and their clinical applications.
Jens Naumann, a typical energetic young man of 17 had just moved out of his parent's home in Northern British Columbia, moving into a railway camp as an employee with the British Columbia Railway. All goes well as Jens enjoys his new found freedom, treasuring his driver's license and its associated freedom of travel. Then on a wintry day in 1981, fate rears its ugly head and strikes him blind in his left eye. Jens quickly rearranges his life to accommodate his new found fear - that of losing his remaining eye now that the true vulnerability of his eyesight is revealed. As his life continues onwards despite the initial readjustment, he finds ultimate happiness in his new marriage to his young wife Lorri, and just when life stands at its threshold of paradise exploring fatherhood along with the beauty of travel and thrill, his worst nightmare becomes reality not once, but twice in the most bizarre series of unforeseen incidents of bad luck; as Jens is totally blinded with no foreseeable chance of seeing again according to the best medical experts. Jens tries his best to adjust to this unwanted situation, exploring conventional methods of rehabilitation to live with blindness, as well as using imaginative, totally unheard - of activities in order to pass his time in a hope of someday being able to see again despite all the odds stacked against him. Close to the turn of the century, Jens unexpectedly receives news of an American Medical Device Engineer, Dr. William H. Dobelle, inviting blind adults as patients for his newly developed artificial vision system designed to provide limited vision via visual cortex stimulation. Dr. Dobelle claims that his system has a good chance in functioning based on previous experimenting with volunteers, at the same time classifying the surgical procedure as minor. The system and its related components is complicated; consisting of not only the implants, but a series of "electrical sockets" protruding from the patients head to which an array of computer boxes and stimulator hardware is connected and worn by the patient. Jens is determined to be one of the patients, regardless of the remoteness of the chance of being one out of literally millions of blind people in the World possibly lining up to have this procedure in hopes of ending their blindness for once and for all. To his absolute surprise, Jens is accepted as the first patient for this procedure and slowly builds a relationship with Dr. Dobelle as Jens overcomes obvious barriers of raising enough money for the very expensive procedure, as well as fighting the challenges of relentless forces working against him for his involvement in the Dobelle vision project. Armed with preconceived ideas of how a research institute should be run, Jens travels overseas for the various stages of the procedure, only to find the most astonishing facts of what goes on in the heart of a renowned medical research institute. Not only is Jens looking at the workings of the Dobelle Institute from the view of a patient, but in short time Jens is hired by the firm as Patient Representative, providing further exploration yet on the inner most details concerning a research company and its treatment of the 15 additional implanted patients. Throughout the book, Jens describes the devastation, exhilaration, disappointment, elation, and confusion that attempts at sight recovery, medical intervention, media propaganda, and ethical boundaries conjure in the most illustrative intensity. The manner in which the book ends is most indescribable; one could view it as the final straw, the beginning of a new era, the curse of the unforgiven, the sadness of a crushing reality, the beginning of a good job left unfinished; or that of the birth of a new expert compelled to unleash the new found knowledge for the whole World to thrive. Just as many questions are answered, many more yet are opened and left so far undiscovered. Search for Paradise is ce
Over the last twenty years there has been an explosive growth in our understanding of the molecular, cellular, and anatomical changes that occur in the days and weeks following brain injury. It is now clear that training and exposure to certain environments can modify and shape neuronal plasticity in lower animals and humans. In humans, in particular, there are new ways of charting neuronal plasticity at the ensemble or regional level using functional neuroimaging techniques such as positron emission tomography and functional magnetic resonance imaging. Thus, the time seems right for transporting the laboratory results to the clinic so that experimental findings can be tested in the "field". This volume provides some impetus to moving the field of cognitive neuroscience a little further in its efforts to improve the lives of patients who have suffered a debilitating brain injury.
