[Although we rarely think of them that way, common eye glasses are a presence-evoking technology because they mediate our experience of the world and we quickly forget their role in changing how we see. As a person with a non-correctable vision impairment (due to congenital nystagmus) I especially appreciate the value of the more advanced presence-evoking technologies to improve vision described in this New York Times story (see the original for two more pictures). –Matthew]
[Image: Ammad Khan, chief executive of IrisVision, with the company’s device to help those with low vision see better. It uses a smartphone, virtual reality headset and algorithms. Credit: Cayce Clifford for The New York Times]
Technology Bridges the Gap to Better Sight
More than 6 million Americans have vision problems that cannot be corrected by glasses or contact lenses. Companies like IrisVision are creating headsets to help them see better.
By Janet Morrissey
Published July 7, 2020; Updated July 14, 2020
This article is part of our continuing Fast Forward series, which examines technological, economic, social and cultural shifts that happen as businesses evolve.
When Jimmy Blakley signed up to serve his country during the Vietnam War, his health and vision were pristine. But shortly after finishing his service in 1971, Mr. Blakley’s vision began to sharply deteriorate.
He said doctors discovered signs of Agent Orange, the toxic herbicide used during the war, in his blood, and told him it was likely the cause of his vision loss. Over the years he had surgery and eye injections, but became legally blind in 1999. He used magnifiers on top of glasses to read and needed to sit two feet away to watch his 65-inch TV. He was frustrated.
Then Mr. Blakley, now 72 and living in College Station, Tex., learned about IrisVision, a device that uses a smartphone, virtual reality headset and algorithms to help people with poor vision see and read clearly. For Mr. Blakley, it was life-changing.
“I was amazed,” he said. “I was seeing the bottom of the eye chart; it was like being 19 again.”
Among companies using technology to address vision problems, IrisVision is working to go a step further: Its device, in addition to improving sight, is expected to be able to diagnose conditions and test and even treat patients remotely within the next two years.
“It’s not aesthetically pleasing but it does something that really provides a useful function for people,” said Jerome Wujek, program director and research resources officer at the National Eye Institute, part of the National Institutes of Health. “We are visual animals. If you lose your vision, you lose a big chunk of your life.” He said devices that used artificial intelligence to test, diagnose and treat remotely were the future as they would allow ophthalmologists, optometrists and others to treat people in rural and underserved areas.
The market for this technology could be huge. About 6.4 million Americans have low vision that cannot be corrected by glasses or contact lenses, according to a 2016 National Academy of Sciences report. Of those, 4.2 million are older than 40. And as the “silver tsunami” of aging baby boomers sweeps the nation, age-related eye diseases and conditions, like macular degeneration, glaucoma and diabetic retinopathy, are expected to surge.
The coronavirus outbreak has made it particularly challenging for the visually impaired. People with low vision rely heavily on touch and sound to identify objects and people, and this can be tough while following hand sanitizing and social distancing practices, and listening to people through masks, said Dr. L. Penny Rosenblum, director of research at the American Foundation for the Blind, who has congenital cataracts and glaucoma. Those with low vision can also find themselves even more isolated if they are unable to use Zoom and other technology to stay connected, Dr. Rosenblum added.
Frank Werblin, co-founder and chief scientist at IrisVision and a professor of neuroscience at the University of California, Berkeley, for more than 40 years, came up with the idea for IrisVision in 2014. While speaking at a Foundation Fighting Blindness conference, a board trustee, J. Lynn Dougan, approached him, offering to provide funding if Dr. Werblin could invent a wearable device that could help his vision-impaired daughter. Dr. Werblin said he had been fascinated by the relationship between brain neurons, the retina and vision, and eagerly accepted the challenge.
Along the way, Dr. Werblin brought in a tech-savvy mobile app developer, Ammad Khan, as a partner. “Imagining a concept that would transform somebody’s life was very compelling for me,” Mr. Khan said.
With $1.5 million from Mr. Dougan, a $1.5 million grant from the National Eye Institute, and about $4 million from angel investors and venture capitalists, the co-founders got to work. They collaborated with experts from Stanford and Johns Hopkins universities, and partnered with Samsung, which provided the smartphone, the augmented, virtual and mixed reality technologies, and the mobile artificial intelligence platform. By 2017, the device was ready.
IrisVision helps restore visual function to people with such conditions as macular degeneration, diabetic retinopathy, retinitis pigmentosa, Stargardt disease, glaucoma and optic atrophy — but not cataracts. It can help someone with visual acuity as low as 20/1000. (Acuity measures sharpness: A 20/200 acuity, for example, means a person can make out an object at a distance of 20 feet that a normal vision person could see from 200 feet.)
So how does it work?
IrisVision helps the brain use parts of the eyes that still function properly. The smartphone’s camera captures an image, and then the virtual reality, or V.R., headset and algorithms enhance the image by providing enough information to fill in the gaps and remap the scene to provide a complete picture.
The company recently added voice control, video streaming, Alexa and other interactive features that give those with low vision easy access to news, weather updates, YouTube videos and TV shows viewed within the headset. The person can adjust the headset, by voice command or button, to zoom in or adjust the color, contrast or brightness.
Still, the device has its shortcomings: It is large and clunky, and the user needs to be stationary — not walking around — to use it. In addition, at $2,950, it is expensive. And unless you are a veteran, health insurers do not cover the cost.
IrisVision has seen an increase in sales during the pandemic, rising 50 percent in June from the same month a year ago, according to Mr. Khan. He said most of the devices were now being sold directly to consumers, as clinics where people often purchased them had shut down during the outbreak. IrisVision ships the devices to homes and then helps buyers set up the technology remotely.
A number of other companies are also working to address issues with low vision, like NuEyes, eSight, Patriot Vision, OrCam, Vispero and Aira. Patriot’s ViewPoint, Vispero’s Compact 6 HD Wear, and NuEyes e2 all offer V.R. headsets similar to IrisVision’s, although magnification, field of view and other features vary among models. Some devices, like e2 and Compact Wear, are less expensive but offer fewer features.
They also vary in size and weight. NuEyes Pro, eSight, and Vispero’s Jordy resemble oversized sunglasses or ski goggles and are designed for walking down the street, visiting museums or shopping, which IrisVision is not.
“We’re still in the very, very early days,” said Kjell Carlsson, a senior analyst at Forrester Research. He said the size and price would need to come down before the devices became mainstream.
The differences in devices mean that one may suit a person or a condition better than another.
“The IrisVision was too pixilated and the image ‘too big’ for me,” Dr. Rosenblum said, adding that her friend’s 91-year old mother, who had macular degeneration, loved IrisVision. “One device doesn’t fit all.”
IrisVision has the backing of Brook Byers, who invested in 2017 and has since pumped more than $3 million into the company. Mr. Byers, a senior partner and a co-founder at Kleiner Perkins, a venture capital firm that invested early in Amazon, Google and Twitter, has retinal issues in one eye stemming from an accident when he was 11.
“I tried it on in my office. I have a really, really bad eye, and wow, I could see with it,” he said. “There was an aha moment.”
Mr. Byers said he was particularly excited about the company’s next steps. IrisVision’s updated model, expected later this year, will be able to test and diagnose eye conditions remotely. And, Mr. Khan said, the treatment component should be added within two years.
“The great value of this device isn’t that it simply restores vision,” Dr. Werblin said. “But it brings people back to life.”