Electronic Eye For Old Age Blindness

Electronic Eye For Old Age Blindness

A mass public agitation for the implementation of the Inner Line Permit system in Manipur is having its second innings. It’s a battle to turn back the tide caused by some bureaucrats in Manipur, who cannot see the central point of an argument straight, which is called ‘conclusion’ because of  wrinkles in thinking.

It’s like the ‘Battle of the Bulge’ of Nazi Germany’s last-ditch effort to drive back the Allied forces  through the snow- frozen Ardennes Forest in Belgium in December1944 and January 1945, when  19,000 American GIs lost their lives along with thousands of Allied and German soldiers.

The Bionic Eye

Now,  back in Manipur, there is a lull after a young 17 year old Meitei student Robinhood lost his life in the raging ‘Battle of the Permit’ of July-August 2015, between the Government of Manipur and the Meiteis, helped by the small but courageous non-Naga and non-Kuki tribes of Koireng and Uran Chiru from the flanks.

Sapam Robinhood and other 1,000 school-leaving students marched bravely forward through tear gas shells fired by Manipur police, exploding to the right, to the left and in front of them.

I feel this is a time for a breath of fresh air for the weary inhabitants of Manipur Valley. The fresh air is the knowledge that blindness due to old age, in spite of the increasing aging population does not occur in Manipur.

Old age blindness or senile macular degeneration, now refined to as Age-related macular degeneration (AMD) is the most common form of blindness in the UK and other European countries as well as among African Americans.  AMD was considered to be more common in the Caucasian  (white) population, though recent studies from (Mayang) India indicate that the prevalence in India may be almost equal to the western population (needs further confirmation).

“Life begins at forty” was a phrase popularised by the American psychologist Walter Pitkin in the beginning of the 20th century, in his book published  by that name in 1932 when the average life expectancy eg in Mediaeval England was 25 years and was just climbing up to 40. Now by the turn of the 21st century 40 becomes no age at all. It is more like 60 with comfortable pensioned age and women with freedom from looking after their children and grandchildren, though our body system continues to go downhill.

As a benchmark of old age our body structures degenerate, such as loss of muscle bulk due to disintegration of muscle fibres, loss of hair because of less productive hair follicles, wrinkling of skin due to lack of grease, needing reading glasses due to loss of elasticity of the lenses – all after the age of 40. So are the development of eye cataracts (Ngoudong in Manipuri) and the so called old-age blindness  – all after the age of 40.

AMD is by far the commonest cause of blindness in Britain, followed by cataract, glaucoma and diabetic retinopathy. While hypertensive retinopathy is the major cause of blindness in North America, mature cataract is the overwhelming cause of blindness in Mayang India but not in Manipur.

My parents and two older brothers who all lived over 80 years of age did not have them though only one of my older sisters had it, needing cataract extraction. While I also do not have it, all my medical class fellows from the UP, living in the UK, have their cataracts removed.

The macula is the most light-sensitive small spot at the centre of the retina – the light sensitive innermost screen of the eyeball. The retina converts the light rays coming through our cornea, pupil and lens into electrical impulses that travel through the optic nerve to our brain, where they are interpreted as the images we see.

The macula is made up of millions of light-sensing cells, which allows the eyes to have a sharp, central vision and lets people see objects that are straight ahead. It is oval shaped and 5.5 mm in size and is situated between the optic disc ( the head of the optic nerve) and the nose.

When the macula degenerates the centre of your field of  view may appear blurry and distorted to begin with, and later the sufferer cannot see in the centre of the field of vision, making it difficult to read or recognise faces, but the peripheral vision like arms and legs remains intact. The causes of AMD are old age, smoking and certain races.

As shown on British TV on  July  21 2015, the vision of Ray Flynn – an 80 year old Englishman who has been unable to recognise faces since he developed AMD eight years ago, was restored when he was fitted with this electronic implant. Not only can he see with his open eyes but also with closed eyes. This has given hope to 5,000,000 British people with AMD, for which there is currently no treatment.

Ray was the first person in the world to be fitted with a bionic eye on June 16 2015 and the system was switched on 2 weeks later, at Manchester Royal Eye Hospital, in June 2015. Bionic eye is an electrical implant which sends a video feed to the undamaged cells in his retina from a tiny camera attached to his eyeglasses. He is the first person in the world to have both artificial vision and natural vision.

It works like this. A tiny video camera attached on a pair of clear glasses captures what the subject is seeing. Video is sent to the video processing unit which he hold in the palm of his hand or puts in his pocket. This unit formats the information, which is then sent back to the glasses and transmitted wirelessly to the implant in the eye. Inside the eye pulses of electricity pass through electrodes that sit on the retina, stimulating the healthy cells capable of sending the correct signals to the brain. The signals are  transmitted to the brain via the optic nerve enabling the subject to “see” the image.

Age-related macular degeneration is of  two types – (1)  dry – 9 out of 10 cases;  and (2) wet – 1 out of 10 cases. Dry AMD develops when the cells of the macula become damaged as a result of a build-up of waste products called drusen  –  fatty yellow protein deposits behind the macula. It is the most common and least serious type of AMD.

Wet or neovascular (new vessels) AMD is generally caused by abnormal blood vessels that the body is growing because of dead cells in the macula. They often leak fluid or blood into the region underneath the macula. It is a more serious disease but can be diagnosed early and treated with injection of a drug into the eyeball. One in ten people with dry AMD will then go on to develop wet AMD.

AMD is the seventh leading cause of “legal blindness” in the UK. To a layperson blindness indicates complete loss of sight, but legal definition for social security benefits to which a ‘blind’ person is entitled is different.

In the UK, doctors certify people with ‘legal blindness’  and ‘impaired vision’ for social security benefits,  when a person has central visual acuity (vision that allows a person to see straight ahead of them) that cannot be corrected or improved with regular eyeglasses and make the person dangerous to work for a living.

The majority of people with impaired vision are in the developing world and are over the age of 50 years. While white cane is an international symbol of blindness,’ Guide dogs’ or assistance dogs trained to lead blind and visually impaired people around obstacles have given many blind people a good measure of independence.

A Guide dog is a specially trained dog for visually impaired person. The dog will guide the blind person while walking along familiar streets or country lanes and stop him at road pedestrian crossings. However, the dog does not know when it is safe to cross the road and the blind owner has to make the decision. It will open the door by turning the handle with its foot or pick up the telephone in its mouth when ringing and bring it to the person.

In the UK and other European countries there are yellow paving stones known as Tactile paving or Tactile Ground Surface indicators, which are a system of textured ground surface indicators found on the pavement of many pedestrian crossings while approaching the streets, and hazardous drop-offs like stairs and train station platforms, to alert people with visual impairments. These are detectable by a long cane or underfoot.

This bionic eye called The Argus II retinal implant has already been successfully used worldwide on more than 130 patients with the rare eye disease that causes total blindness, known as retinitis pigmentosa.

One day, as the cost of The Argus II becomes affordable, 20-25 million people worldwide, suffering from AMD will be able to see again properly.

Website: drimsingh.com
Image Credit: pixabay.com

Dr IM Singh

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