On Tech & Vision With Dr. Cal Roberts

This podcast is about big ideas on how technology is making life better for people with vision loss.

In 2012, Christine Ha won the third season of Masterchef, after having lost her vision in her twenties. Since her win, she has opened two restaurants in Houston, adapting to the challenges the pandemic still poses to restaurateurs in order to meet the needs of her community. In a similarly innovative way, Max Ostermeier, CEO and Founder of Implandata Ophthalmic Products out of Hannover Germany, has reimagined the remote management and care of patients with glaucoma. Max and his team developed the EyeMate system, a microscopic implantable device and microsensor that measures intraocular pressure throughout the day. The EyeMate sends eye pressure data to an external device and uploads it to their eye doctor's office for analysis. This game-changing technology allows people with glaucoma to bypass regular trips to the ophthalmologist's office to measure their eye pressure, key data in maintaining their eye health. We revisit a conversation with Sherrill Jones, who lost her sight due to glaucoma, in which she shares how difficult it was to adhere to compliance protocols. Max believes the EyeMate will evolve to be part of a closed loop drug delivery system; that is, when the EyeMate registers a high pressure, medications could automatically be released into the patient's eye, which could improve outcomes significantly. We dig into issues of compliance and closed-loop systems by considering diabetes. We talk to occupational therapist Christina Senechal who has managed her diabetes for 27 years, and Dr. Carmen Pal, who specializes in internal medicine, endocrinology, diabetes, and metabolism in Lighthouse Guild's Maxine and John M. Bendheim Center for Diabetes Care.

The Big Takeaways:

• Innovation and adaptability have been key as Christine Ha, who won Masterchef in 2012 despite being blind, keeps the doors open on two Houston restaurants during the pandemic. In order to find opportunities through the pandemic, Christine has had to discover new needs that have to be met.
• The pandemic has made it harder for patients with glaucoma, many of whom are older, to get to the eye doctor.
• Dr. Max Ostermeier and his team have invented a microscopic implantable device, the EyeMate, that measures intraocular pressure throughout the day and then sends the data to a patient's handheld device and their eye doctor's office for analysis, saving patients a trip.
• Since it can take many readings throughout the day, this system is better than relying on a doctor's visit. The abundance of data can help patients use their medication more reliably, but can also be optimized in the future by algorithms.
• In the future, Max envisions that the EyeMate could be paired with a drug delivery implant to close the loop between monitoring and drug delivery, as with diabetes. This would make it easier for patients to stay in compliance with glaucoma protocols.
• We speak with Sherrill Jones, a patient with glaucoma, on why compliance for glaucoma was a challenge for her.
• We hear from Christina Senechal about her journey with diabetes and how hard compliance can be and how new technologies can help, and from Dr. Carmen Pal about how closed-loop drug delivery systems that pair glucose monitoring with insulin delivery help patients stay in compliance.

Tweetables:

• There is opportunity and you just have to kind of think outside of the box and figure out what new ways … to think or do things, and what new needs are that need to be met. And that's how you survive. — Christine Ha, chef and restaurateur, Xin Chao and The Blind Goat, Houston
• "Glaucoma patients … are among the most vulnerable. … They have been asked to stay out of the doctor's office. … But … they have an eye disease, which, if the pressure is too high, can damage the optic nerve. —Max Ostermeier, CEO and Founder of Implandata Ophthalmic Products
• Right now, ... a patient sees his eye doctor, maybe every few weeks or every few months and in between the office visits, the doctor has no understanding at all, what's going on with the patient. —Max Ostermeier, CEO and Founder of Implandata Ophthalmic Products
• I knew I had glaucoma, but the rapidness of it attacked me really fast. … and … I didn't faithfully use the drops in the beginning because I thought other remedies could help.—Sherrill Jones, patient with glaucoma
• I'm pretty sure in 10 years from now, we will see something like that, you know. A device, which … is releasing active ingredients … every time the pressure's too high. —Max Ostermeier, CEO and Founder of Implandata Ophthalmic Products
• I'm a mom, … and … it's … 10 o'clock. … I'm exhausted. I've had a full day … and my insulin pump starts beeping. … I just wanna go to bed! I'm so tired, but … I don't have that luxury of saying no. — Christina Senechal, occupational therapist and patient with diabetes
• It is quite beneficial … that … the patient does not … have to … fill the role of the pancreas, which is a little bit of an … unfair … task to ask of them. — Dr. Carmen Pal, diabetes specialist in Lighthouse Guild's Maxine and John M. Bendheim Center for Diabetes Care.

Contact Us:

• Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

• Lighthouse Guild
• Max Ostermeier
• Christine Ha
• Dr. Carmen Pal

This podcast is about big ideas on how technology is making life better for people with vision loss.

The Enigma machines that Germany used to encode messages during World War II were notorious for their complexity. Two Enigma experts — Dr. Tom Perera, a retired neuroscientist, and founder of EnigmaMuseum.com, and Dr. Mark Baldwin, an expert on the story of Enigma machines — tell us how the Allies were able to crack the code, by using input-output mapping.

The human brain is similarly complex. Until recently, no one knew the code the retina used to communicate with the brain to create sight. Our guest, Dr. Sheila Nirenberg, a neuroscientist at Weill Cornell, and Principal and Founder of Bionic Sight has — using input-output mapping — cracked the retina's neural code, enabling her to recreate the electric signals to the brain that could restore sight in people with retinal degeneration. She has created a set of goggles that convert a camera's images into the code, via pulses of light. And she relies on optogenetics, a relatively new procedure in neuroscience that helps neurons become responsive to light. In her clinical trial, Dr. Nirenberg injects the optogenetic vector into the eye, and trial participants who are completely blind, like Barry Honig, who we speak with on this program, report being able to see light. In early studies, coupling the effects of the optogenetics with the code-enabled goggles has an even more impressive effect on patients' vision. Dr. Nirenberg is also using her knowledge of the visual neural code to inform machine learning applications that could also be further used to support people who are blind or visually impaired. Clinical trial participants are important partners in the journey of discovery, Dr. Nirenberg says. Barry Honig agrees. He was happy to participate to help ease the burden on future children diagnosed with eye diseases that would otherwise result in blindness, but thanks to these advancements, someday may not.

The Big Takeaways:

• Dr. Tom Perera and Dr. Mark Baldwin describe the history and workings of the Enigma machine, the complex encoding device that allowed Germany to take the upper hand at the beginning of World War II, a war in which communication was sent wirelessly, elevating the need for encryption. They then describe the Polish and British efforts to break Enigma, including standard decryption and Alan Turing's Bombe machine.
• Similar to the Enigma, the human brain is incredibly complex, and much of the codes that make it run have not yet been deciphered, until now.
• Our guest, Dr. Sheila Nirenberg, conducted extensive input-output mapping on live human retinas. She was able to keep them alive in a dish outside the body for a few hours, during which time she'd show them videos. As the retina perceived the films, Dr. Nirenberg mapped the electrical current that would pulse through the ganglion nerve. In this way, she was able to learn how the human eye sees and to decipher the code that allows our brains to perceive images. This code has been honed via evolution over millennia.
• Having cracked the retinal neural code, Dr. Nirengberg held the key to restoring vision in people who are blind from retinal degeneration. She developed goggles embedded with a camera to convert the visual world into the retina's neural code using pulses of light, but she still had to get these pulses of light into an unseeing eye.
• Optogenetics is the key to creating light perception. Optogenetics is a relatively new procedure in neuroscience, by which researchers have created a genetically modified virus based on light-responsive algae, which when injected into live human cells, recombines its DNA with the DNA of host cells. In Dr. Nirenberg's case, she injects the optogenetic vector into the patient's retina. Most patients report the restoration of light perception to varying degrees, with just the optogenetics alone. Coupled with the goggles, and with Dr. Nirenberg's visual neural code, this system could restore some vision in people who are blind. The trial is still in its early stages.
• Dr. Nirenberg also uses the retinal neural code to improve how computers see. Computer vision experts are teaching computers to "see" more like humans. Still, if they can equip algorithms with humanity's neural code, the goal of human-like vision becomes more easily achievable.
• Barry Honig is a participant in the clinical trial. After his optogenetic injection, he was able to perceive the menorah at Hanukkah. From different perspectives, Barry and Dr. Nirenberg agree on the importance of trial participants.

Tweetables:

• "The analogy between the Enigma and the human brain is rather interesting. The brain has … 10 billion brain cells, … the Enigma machine has 10 to the 114th power possible internal connections. And that is actually a lot more."
• — Tom Perera, neuroscientist and founder of EnigmaMuseum.com
• "Millions of years of evolution honed the retina into pulling out … the right features. And then it converts those features into electrical pulses and sends them up to the brain. That's what a normal retina does."
• — Dr. Sheila Nirenberg, neuroscientist at Weill Cornell, and Principal and Founder of Bionic Sight.
• "And so … you're watching the retina watch a movie. And … you're seeing what it would be sending … to your brain."
• — Dr. Sheila Nirenberg, neuroscientist at Weill Cornell, and Principal and Founder of Bionic Sight."So I went from … sort of bare light perception to … this recent past Hanukkah, I … said to my … wife, the menorah — I think it was the eighth day and … the whole menorah was lit!"
• — Barry Honig, clinical trial participant and founder of Honig International
• "Whether or not that's perfect, you know, time will tell, but … to be able to spare kids that, and equally as importantly, to spare their parents that, you know, if I could … just take an injection and be a part of it, then, … that's a lot of reward.
• — Barry Honig, clinical trial participant and founder of Honig International

Contact Us:

• Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

• Lighthouse Guild
• Dr. Sheila Nirenberg
• Dr. Tom Perera
• Dr. Mark Baldwin
• Barry Honig

This podcast is about big ideas on how technology is making life better for people with vision loss.

Every day, people who are blind or visually impaired use their hearing to compensate for vision loss. But when we lose our vision, can we access our visual cortex via other senses? We call this ability for the brain to change its activity "plasticity," and brain plasticity is an area of active research. In this episode, we'll explore how, through sensory substitution, audio feedback can, in some cases, stimulate a user's visual cortex, allowing a user to — without sight — achieve something close to visual perception.

Erik Weihenmayer — world-class mountain climber, kayaker, and founder of No Barriers who lost his vision as a teenager due to retinoschisis — brings us to the summit of Everest by describing what it sounds like. He explains how his hearing helps him navigate his amazing outdoor adventures safely. We also speak with Peter Meijer, the creator of The vOICe, an experimental technology that converts visual information into sound, and has been shown to activate users' visual cortices, especially as users train on the technology, and master how to interpret the audio feedback. We hear an example of what users of The vOICe hear when it translates a visual image of scissors into audio. Erik Weihenmayer shares his experience with Brainport, a similar sensory substitution technology featured in our episode "Training the Brain: Sensory Substitution. While research is ongoing in the areas of sensory substitution and brain plasticity, it's encouraging that some users of The vOICe report that the experience is like seeing. In the spirit of Erik Weihenmayer, one user even uses it to surf.

The Big Takeaways:

• Erik Weihenmayer, despite having lost his vision as a teenager, has become a world-class adventurer. He summited Everest in 2001 and then summitted the highest peaks on each continent. He has also kayaked 277 miles of whitewater rapids in the Colorado River through the Grand Canyon. He explains how his sense of hearing, in addition to his other senses, and technologies, teams, and systems, helps him achieve his goal to live a life with no barriers.
• Dutch Inventor Peter Meijer developed a technology called The vOICe, which converts a two-dimensional image from a camera into audio feedback. Dr. Roberts interviews Dr. Meijer about this technology and gives listeners a chance to hear what The vOICe sounds like. Users who train on this system interpret the sounds to make sense of the original visual image. Research on The vOICe shows that this happens in the brain's visual cortex. While some users say the experience is more auditory than visual, others report the experience as akin to sight.
• The vOICe relies on the principles of sensory substitution established by the founder of sensory substitution Paul Bach-y-Rita. We discussed sensory substitution in our episode "Training the Brain: Sensory Substitution," which featured the Brainport device by WICAB. Erik has used Brainport, and in this episode, he describes how the Brainport allowed him to catch a ball rolling across a table, an exciting feat for someone who is blind. He adds that sensory substitution takes serious practice to master.
• The vOICe is still in the experimental stage, and more research has to be done on sensory substitution. However, neuroscientists studying The vOICe have shown that it stimulates the visual cortex, and some users report visual results.
• One user of The vOICe recently reported using the technology to surf.

Tweetables:

• "When there's a lack of things that the sound bounces off of, like on a summit, the sound vibrations just move out through space infinitely and that's a really beautiful awe-inspiring sound." — Erik Weihenmayer, No Barriers.
• "She rolled this white tennis ball across. It lit up perfectly. [...] I'm like, 'Holy cow, that is a tennis ball rolling towards me.' And I just naturally reached out and I grabbed this tennis ball." — Erik Weihenmayer, No Barriers (on using the Brainport device by WICAB)
• "They applied transcranial magnetic stimulation to ... temporarily disrupt the processing and the visual cortex of a user of The vOICe. ... So this showed that apparently, the visual cortex was doing visual things again." — Dr. Peter Meijer, Seeing with Sound, The vOICe.
• "Some ... insist that the sensation of working with the soundscape of The vOICe is truly visual. ... But .... most ... users of The vOICe .... say, "It's ... auditory but I can use it to visually interpret things." — Dr. Peter Meijer, Seeing with Sound, The vOICe.
• "Yeah, sure, if you want a really really safe life, you can hang out on the couch and you can watch Netflix. But I think most people want to be out there in the thick of things. They want to be in the food fight." — Erik Weihenmayer, No Barriers.

Contact Us:

• Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

• Lighthouse Guild
• Peter Meijer
• Erik Weihenmayer
• No Barriers

This podcast is about big ideas on how technology is making life better for people with vision loss.

Today's big idea is about exciting and emerging technologies that will someday allow people who are blind or visually impaired to navigate fully autonomously. In this episode, you will meet Jason Eichenholz, the Co-Founder and CTO of Luminar, and his manufacturing engineer, Nico Gentry. Luminar's LIDAR technology is instrumental to the development of self-driving cars, but this same technology could be useful for people who are blind or visually impaired, who also have to navigate autonomously. You'll hear from Thomas Panek, the President and CEO of Guiding Eyes for the Blind, an avid runner who dreamed of running on his own. He took this unmet need to a Google Hackathon and Ryan Burke, the Creative Producer at Google Creative Lab put together a team to develop a solution that turned into Project Guideline. Kevin Yoo, Co-Founder of WearWorks Technology is using inclusive design to develop Wayband, a navigation wristband that communicates directions with users via haptics.

The Big Takeaways:

• Since LIDAR uses a shorter wavelength of light than other sensing technologies it creates the most nuanced image, but unlike a camera, LIDAR also measures the distance to each element in the landscape, making it perfect for self-driving cars. And the fact that LIDAR sensors have gotten better and cheaper for self-driving cars has made them available as well for technologies that help people who are blind and visually impaired. LIDAR's Jason Eichenholz and his engineer, Nico Gentry; who is visually impaired; dive deep into the broad benefits of LIDAR for self-driving cars and for autonomously navigating people.
• As an avid runner who is visually impaired, Thomas Panek, President and CEO of Guiding Eyes for the Blind, decided to take matters into his own hands, and enlist Google to help build him a tool that would allow him to run without a guide — human or canine. Ryan Burke weighs in on how his prototype, Project Guideline, helps people like Thomas run safely.
• We can't talk about running safely without talking about GPS. Kevin Yoo of WearWorks Technology has developed a wearable band called Wayband to help pedestrians navigate different paths and terrain more accurately by connecting to GPS maps. And he's developing a haptic language that will allow users to understand nuanced directions without the need for visual or audio feedback.

Tweetables:

• "The big difference of LIDAR technology over sonar or radar is the wavelength of light. So because the wavelength of light is so much shorter, you're able to get much higher spatial resolution. [...] So what you're able to do is to have [....] camera-like spatial resolution with radar-like range, you're getting the best of both worlds." — Jason Eichenholz, of LIDAR technology.
• "The learning curve to be able to run as fast as my legs could carry was being able to train to those beeping sounds and fine-tuning those sounds with the Google engineering team." — Thomas Panek
• "It's a compass; it's a vibration compass. And literally, as you rotate, [...] we can literally guide you down the line of a curvy road by creating this Pac-Man-like effect. So what we call these dew points. So as soon as you collect the dew point, it will guide you to the next one." — Kevin Yoo

Contact Us:

• Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

• Lighthouse Guild
• Jason Eichenholz
• Thomas Panek
• Ryan Burke
• Kevin Yoo

This podcast is about big ideas on how technology is making life better for people with vision loss.

Today's big idea is Sonar and a somewhat similar technology called LiDAR! Can we use the latest sonar technology for obstacle detection the way bats and other nocturnal creatures do? There have been many exciting advances happening in sonar sensors that now make this possible for people who are blind. However, unlike bats, we won't need to receive feedback signals through our ears. Advances in haptic technologies and languages make communication through touch possible. Dr. Cal Roberts talks with Dr. Matina Kalcounis-Rueppell from the College of Natural and Applied Science at the University of Alberta, Ben Eynon, and Diego Roel from Strap Technologies, Marco Trujillo of Sunu, and Sam Seavey of The Blind Life YouTube Channel to find out more.

The Big Takeaways:

• How does a bat see what it sees? Dr. Kalcounis-Rueppell studies bats and how they use sound to thrive in their nighttime world. Bats use a series of echoes to see a 3D view of their environment, but their world isn't always so simple. There's rain, there are leaves, and other creatures flying that bats need to detect with their sonar. Similarly, people with vision impairment have to use their hearing to navigate complex auditory environments.
• Strap Technologies uses Sonar and LiDAR sensors that can be strapped across the chest, which helps people who are blind detect obstacles. These kinds of sensors have been used to park spacecraft, but with recent developments, they're finally small enough that a human can wear them in a compact way. Ben and Diego share how it works.
• Unlike Sonor, LiDAR technology uses pulsed laser light instead of sound waves.
• Though bats have been honing their echolocation skills for millennia, interpreting information haptically, rather than sonically, is an adaptation that humans, using technologies like Strap, can make. Haptic information can help us navigate without sight through the use of vibrations, which is great news because it means we can leave our ears open to process our active world. More specifically, Ben and Diego suggest that people may no longer need to use a cane to detect obstacles.
• Ben and Diego are excited about the future. With their technology, they hope to create quick-reacting haptic technology so people who are blind can one day ride a bike or run a race. Infrared or radiation sensors could be added in the future to detect other hazards in the environment. The more user feedback they receive, the easier it will be to add on these product enhancements.
• Another way we can approximate sight is through echolocation. However, how easy is it for us to hear echoes, really? For Marco at Sunu, it's actually a natural skill we can learn to develop. Similar to Strap Technologies, the process of learning echolocation could be improved if you're wearing a Sunu Band.
• Sam Seavey was diagnosed at age 11 with Stargardt's Disease. He decided to use his voice and video skills to create a YouTube review channel for those who need to use assistive tech. The positive feedback from the community keeps him going. Sam has personally reviewed the Sunu Band, and you can check out the link to his review in the show notes!

Tweetables:

"They parked spacecraft with these same sensors, and recent developments have really pushed the miniaturization of the components, such that a human being can now wear them in a very compact form factor." — Ben Eynon

"He said, 'I'm walking faster than I have in a long, long time,' because he started to trust that the haptic vibrations were telling him every obstacle in the way." — Ben Eynon shares the reaction from a user who is visually impaired testing Strap

"We're changing our environment around us in ways that also change the acoustic environment." — Dr. Matina Kalcounis-Rueppell

"How is it that we have self-driving cars, we have rockets that land themselves like, we have a better iPhone every year, but we don't have something better than a stick? How can this happen? We still have people moving around and having issues every day." — Marco Trujillo

Contact Us:

Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

• Lighthouse Guild
• Dr. Matina Kalcounis-Rueppell
• Ben Eynon & Diego Roel
• Marco Trujillo
• Sam Seavey — Sunu Band Review

This podcast is about big ideas on how technology is making life better for people with vision loss.

Close your eyes. Raise your hands. Reach out and touch the nearest surface. What are you touching? A desktop, a leather steering wheel cover, a porcelain cup, a plastic keyboard? Our sense of touch and the way in which we interpret the materials in our environment are fundamental to our experience of the world.

This episode's big idea is the new developments in tactile technologies. You're probably familiar with one of the oldest technologies, Braille, which was invented in 1824 by Louis Braille, a Frenchman who was blind by the age of three. Braille, which has undergone numerous refinements since its invention, has led the way in helping people who are blind read, write, and interact with the world around them. But as useful as Braille is, it has its limits: Braille is used for text; it can't convey images. Two individuals who are working to develop technologies that will one day help people with vision impairment to experience images and graphics are material scientist Dr. Julia R. Greer from Caltech and physicist Dr. John Gardner from Oregon State University.

The Big Takeaways:

• Did you know most people who are blind still don't have access to good graphic descriptions? When Dr. John Gardner suddenly and unexpectedly lost his eyesight, he realized he could not see wave graphs in his research. He was unable to teach the concepts in the lectures to his students because they were too inexperienced to know how to interpret the graphs. He had to fax his research to a select number of experts to help him interpret the graphical data accurately. Eventually, Dr. Gardner came to develop a product called Tiger Software that, working with an embosser, enabled him to read with his hands — and ultimately carry on his work.
• Braille books are expensive and they take up large amounts of space. A normal algebra book could be 50 volumes in Braille. Dr. Gardner's software has been life-changing for many students who are blind and eager to learn. It produces tactile graphics that can be perceived by touch. So instead of students relying only on Braille text or audio descriptions of images, they can use this technology as a complement to those tools by using special printers that create graphics, charts, and images that can be "read" by touch.
• There are a few tactical tools people who are blind can use: Braille books (which take up too much space), Braille embossers (which offer dynamic printing of Braille but not a complete experience), Braille and tactile embossers (like Dr. Gardner's program), and refreshable Braille displays (downloadable content like ebooks in braille, but which are expensive).
• Promising research is coming out of the lab of Dr. Gardner's colleague, Dr. Julia Greer. Her team discovered and is now developing a special electroactive polymer, a substance that exhibits a change in size or shape when stimulated by an electric field. They hope to use it to create raised tactile images on a plane. It has potential beyond Braille displays and could one day be used for students, architects, artists, scientists, engineers, or anyone who needs tactile representations of visual data.

Tweetables:

• "We went back to Braille embossing and we had to develop a much higher resolution embossing format, and one of my students and I invented a new technology.." — Dr. John Gardner
• "I need to touch it. Touching is like seeing it. Hearing about a complicated diagram is not the same as seeing it with my fingers." — Audrey Schading
• "It seems to be a natural connection to have this polyelectrolyte gel that swells in response to an applied field. Now that we have it, we can shape it into a 3D shape of some kind." — Dr. Julia R. Greer

Contact Us:

• Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

• Lighthouse Guild
• Dr. Julia R. Greer
• Dr. John Gardner
• Tiger Software Suite
• Audrey Schading

This podcast is about big ideas on how technology is making life better for people with vision loss.

Today's big idea highlights how innovations don't happen in a vacuum, but rather a long chain of science and research and developments that build on each other. Dr. Shelley Fried's work exemplifies this process. It took him a career's worth of experiments and adjustments to enable his cortical brain implants to bypass the eye and restore the patient's ability to perceive light. He had a lot of obstacles to overcome, everything from circumventing the brain's natural inflammatory response to getting the research published. One thing is clear, breakthroughs take time and you cannot give up in the process. Your work often becomes an iteration of an iteration. Dr. Fried took inspiration from the artificial retina, which was prototyped from a cochlear implant. Dr. Fried's revolutionary technology is another step towards a world in which no person is limited by their visual capacity.

The Big Takeaways:

• A cochlear implant is a neuroprosthetic device surgically implanted in the cochlea, the inner part of the ear that is responsible for the transmission of nerve impulses in to the auditory cortex of the brain. Originally developed in 1950, the modern form was honed in the 1970s with help from NASA engineer.
• Dr. Mark Humanyan took design cues from the cochlear when he was developing the Argus II retinal implant. What is a retinal prosthesis and how does it work? The simplest way to explain it is that it's an array of electrodes that stimulates the retina and it helps restore vision loss. They work for some blindness cases but not all. For example, this treatment is not recommended for people with advanced glaucoma.
• Dr. Fried took inspiration from retinal prostheses to build upon the cortical brain implant. The implants are revolutionary because it means they go directly to the source (the brain).
• The cortical brain implant works by gathering information externally and it converts that data to stimulate the brain so the patient can perceive it. However, vision science doesn't end there! Vision science keeps building on itself. In this case, the cortical implant technology was inspired by artificial retinas, which took their inspiration from the cochlear implant.
• How do you target a single neuron? Dr. Fried's innovative solution was the use of coils, which are smaller than a human hair, to help specify which neurons need activation. When you go directly to the brain, there are some complications that occur. The brain sees the implant as a threat and creates an inflammatory response, which blocks the electrodes from communicating with one another. By using these coils, it bypasses the body's natural inflammatory response and keeps the lines of communication open.
• This innovation in technology did not happen overnight. It took over a year and a half to get the coil experiments to work alone, and that doesn't include all the other methods Dr. Fried experimented with that didn't succeed. Science is about building upon prior research, and it takes time and a lot of experimentation before a solution will work.

Tweetables:

"Cochlear implants had taught us that if you even put some of a rudimentary signal in the ear, that the brain can start to use it….. So we want of reconfigured a cochlear implant and used it to stimulate the retina". — Dr. Mark Humayun

"In its simplest form, a retina prosthesis is an array of electrodes. The common one is 6x10 electrodes and each electrode is designed to stimulate a small portion of the retina." — Dr. Shelley Fried

"We run into additional problems when we go into the brain that don't exist in the retina. One of them is the brain has a huge inflammatory response to the implant." — Dr. Shelley Fried

"Coils are not only more stable over time, but they're more selective. They're able to create a smaller region of activation. And so we think we can get much higher acuity with coils than we can with conventional electrodes." – Dr. Shelley Fried

"Our advance was that we showed that we could really shrink down coils to the sub millimeter size and that they would still be effective, that they can still induce neural activation. – Dr. Shelley Fried

"I was fortunate that I certainly was not one of the pioneers in terms of being one of the first people to be implanted. [B]eing able to rely on other people's experiences and being able to trust the process was really helpful." – Rebecca Alexander, cochlear implant recipient

Contact Us:

Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

Lighthouse Guild

Rebalexander.com

Dr. Shelley Fried

Guest Bios:

Dr. Shelley Fried

Shelley I. Fried, PhD, is an Associate Professor of Neurosurgery, Harvard Medical School and an Associate Professor for Massachusetts General Hospital, Department of Neurosurgery. He is the developer of cortical brain implants. Dr. Fried was inspired to do this work after reading a New York Times article on the in-depth work that went behind trying to restore vision to returning blind Vietnam vets.

Dr. Mark Humayun

Mark S. Humayun, MD, PhD, is Director, USC Ginsburg Institute for Biomedical Therapeutics and Co-Director, USC Roski Eye Institute. Dr. Humayun has devoted much of his career to clinical and scientific research in ophthalmology and bioengineering, becoming both a biomedical engineer and professor of ophthalmology. You can hear more about him and his work in Episode 4 — The Development of Artificial Vision.

Rebecca Alexander

Rebecca Alexander is an author, psychotherapist, group fitness instructor, advocate, and extreme athlete who is almost completely blind and deaf. Born and raised in the San Francisco Bay Area, she currently lives in New York City.

Host Bio:

Dr. Calvin W. Roberts

Calvin W. Roberts, MD, is President and Chief Executive Officer of Lighthouse Guild, the leading organization dedicated to providing exceptional services that inspire people who are visually impaired to attain their goals. Dr. Roberts has a unique blend of academic, clinical, business, and hands-on product development experience. Dr. Roberts is a Clinical Professor of Ophthalmology at Weill Cornell Medical College. He was formerly Senior Vice President and Chief Medical Officer, Eye Care, at Bausch Health Companies where he coordinated global development and research efforts across their vision care, pharmaceutical, and surgical business units. As a practicing ophthalmologist from 1982 to 2008, he performed more than 10,000 cataract surgeries as well as 5,000 refractive and other corneal surgeries. He is credited with developing surgical therapies, over-the-counter products for vision care, prescription ocular therapeutics, and innovative treatment regimens. He also holds patents on the wide-field specular microscope and has done extensive research on ophthalmic non-steroidals and postoperative cystoid macular edema. Dr. Roberts has co-founded a specialty pharmaceutical company and is a frequent industry lecturer and author. He currently serves as an Independent Director on multiple corporate boards and has served as a consultant to Allergan, Johnson & Johnson, and Novartis. A graduate of Princeton University and the College of Physicians and Surgeons of Columbia University, Dr. Roberts completed his internship and ophthalmology residency at New York-Presbyterian Hospital/Columbia University Medical Center in New York. He also completed cornea fellowships at Massachusetts Eye and Ear Infirmary and the Schepens Eye Research Institute in Boston.

This podcast is about big ideas on how technology is making life better for people with vision loss.

Today's big idea is: How will remote diagnostic tests change ophthalmology and vision care? It might be a foreign concept for some, but the specialists in today's episode, Dr. Peter Pham and Dr. Sean Ianchulev, founders of (Keep Your Sight, a nonprofit focused on remote diagnostic vision tests) share how they can conduct more reliable perimetry tests that help detect macular degeneration, glaucoma, and other conditions that lead to vision loss and eventually blindness — remotely, while patients stay home. Developments like these in remote diagnostics are a stepping stone for the ways machine learning will impact the field of ophthalmology in the future. This episode also features Dr. Einar Stefansson and Dr. Arna Gudmundsdottir, developers of the app, Retina Risk, which helps with remote risk assessment of diabetic eye disease for people with diabetes, as well as Sherrill Jones, who lost her vision due to glaucoma.

The Big Takeaways:

• Retina Risk was created to help people with diabetes assess in real-time their individualized risk for sight-threatening diabetic retinopathy. The app was created back in 2009 and the concept of using technology and algorithms to calculate risk was still quite foreign to most people.
• What goes into taking a regular perimetry test today? Patients have to come into the office, wait, register, wait some more, get taken to a dark room to be positioned correctly, and after 20-30 minutes, you get a result. Now, there's an easier way: patients can take these tests at home.
• Why is telescreening so important? Dr. Pham and Dr. Ianchulev noticed it could take months for patients to be scheduled in for routine visual field tests. By that time, the glaucoma may have advanced, and in some cases, rapidly. There was an unmet need here and there was a better way to serve people quicker and more efficiently, especially people from rural communities who did not have readily available access to healthcare.
• Medicare did not allow for doctors to reimburse their services unless it was conducted within the physician's office. This led to a lot of roadblocks in telemedicine, despite the technology being available for the last 15-plus years. Thankfully, in December of 2020, policies were changed so that doctors would be reimbursed for remote patient monitoring.

Tweetables:

"We know that our blindspot is 15 degrees away from fixation and, with simple trigonometry, you can now use that blindspot to help position patients correctly in front of the computer monitor. We can now use online technology to perform visual field tests." — Dr. Peter Pham

"It was our goal to do a hardware-free digital/virtual device. We felt in ophthalmology, we're kind of lucky. We are looking at a visual function. So perimetry lends itself to a fully virtual software as a service device." — Dr. Sean Ianchulev

"I think technology will help us get to the next level. Technology has been around for this, but it hasn't been applied for this." — Dr. Sean Ianchulev

Contact Us:

Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

Lighthouse Guild

Retina Risk

Keep Your Sight.org

Guest Bios:

Dr. Peter Pham & Dr. Sean Ianchulev are both the Co-Founders of Keep Your Sight. Dr. Pham is a boarded certified ophthalmologist who has devoted his professional life to restoring sight and helping patients keep their vision. As a surgeon and clinician, Dr. Pham treats conditions such as glaucoma, cataract, and macular degeneration, all of which can cause blindness. As a researcher, he worked on the development of a novel delivery system for introducing large-sized molecular compounds into thousands of living cells simultaneously. Realizing the importance of technology and innovation for screening and prevention, Dr. Pham teamed up with Dr. Ianchulev to develop the KYS telemedicine system for vision health.

Dr. Ianchulev has been on the cutting edge of innovation, making an impact in the treatment of major eye diseases such as macular degeneration and glaucoma. He was instrumental in the development of many new therapies and advances, such as Lucentis for AMD and Diabetic Retinopathy, intraoperative aberrometry for high-precision cataract surgery, micro-stent technology for glaucoma, the miLOOP interventional technology for cataract surgery, and others.

Dr. Einar Stefansson & Dr. Arna Gudmundsdottir are both the Co-Founders of Retina Risk. Dr. Stefansson is a leader in the field of diabetic eye disease and diabetic screening and head supervisor for product development and clinical science. Dr. Stefansson graduated from the University of Iceland Medical School in 1978 with honors. He received a PhD degree in physiology from Duke University in 1981 followed by a residency at Duke.

Dr. Gudmundsdottir takes an active role in all product development and clinical testing. Her expertise gives valuable insight into practical usage of products and medical approaches. Dr. Gudmundsdottir graduated from the University of Iceland Medical School in '92. She undertook a fellowship program in endocrinology at the University of Iowa Hospital and Clinics.

Sherrill Jones lives in New York City and volunteers administrative services in Lighthouse Guild's Volunteer Services department.

Host Bio:

Dr. Calvin W. Roberts

Calvin W. Roberts, MD, is President and Chief Executive Officer of Lighthouse Guild, the leading organization dedicated to providing exceptional services that inspire people who are visually impaired to attain their goals. Dr. Roberts has a unique blend of academic, clinical, business, and hands-on product development experience. Dr. Roberts is a Clinical Professor of Ophthalmology at Weill Cornell Medical College. He was formerly Senior Vice President and Chief Medical Officer, Eye Care, at Bausch Health Companies where he coordinated global development and research efforts across their vision care, pharmaceutical, and surgical business units. As a practicing ophthalmologist from 1982 to 2008, he performed more than 10,000 cataract surgeries as well as 5,000 refractive and other corneal surgeries. He is credited with developing surgical therapies, over-the-counter products for vision care, prescription ocular therapeutics, and innovative treatment regimens. He also holds patents on the wide-field specular microscope and has done extensive research on ophthalmic non-steroidals and postoperative cystoid macular edema. Dr. Roberts has co-founded a specialty pharmaceutical company and is a frequent industry lecturer and author. He currently serves as an Independent Director on multiple corporate boards and has served as a consultant to Allergan, Johnson & Johnson, and Novartis. A graduate of Princeton University and the College of Physicians and Surgeons of Columbia University, Dr. Roberts completed his internship and ophthalmology residency at New York-Presbyterian Hospital/Columbia University Medical Center in New York. He also completed cornea fellowships at Massachusetts Eye and Ear Infirmary and the Schepens Eye Research Institute in Boston.

This podcast is about big ideas on how technology is making life better for people with vision loss.

This episode's big idea is navigation and how to implement a navigation solution that enables people with vision impairment to broadly travel cities — how and when they want to, independently. Dr. Roberts talks with Javier Pita, the creator of such a technology called NaviLens, which marries location finding with information. Dr. Roberts also talks with representatives of New York City's Metropolitan Transit Authority — one of the biggest transportation hubs in the world. They discuss the importance of accessible public transportation for people who are visually impaired and how NaviLens technology can help make independent navigation a reality.

The Big Takeaways:

• NaviLens system uses improved QR technology with a new type of code made up of four colors that enables it to store more information than a black and white QR code.
• Using a smartphone, the NaviLens app scans the area. Once it picks up the unique NaviLens code, the app provides the embedded information audibly to the user along with their distance/directionality from the code.
• As long as the code appears anywhere in the field of view of the smartphone camera, the code is detected and information is delivered.
• NaviLens is more accurate than GPS technology because it takes into account smaller distances that are crucial to navigation for people who are visually impaired. NaviLens codes can be read up to 12 times farther away than QR or bar codes as well as at 160-degree angle.
• Future advances to the NaviLens technology include a 360-degree technology that will register and retain the user's location so the system can still tell where they are, and guide them to the destination even if they lose contact with the code. In addition, the NaviLens GO app uses advanced technology to help users navigate indoor spaces such as stores and to locate items in the store.
• This technology is elegant, inexpensive, flexible, easy to use, and fits seamlessly into a user's life. While already part of public transportation in Barcelona, cities like New York City are testing it and hope to make this technology a more integral part of their public transportation system.

Tweetables

"Public transportation is the answer to so much inequity across all urban areas, and nonurban areas. If we can work to make the system as safe as possible for any range of abilities, that would be an enormous win, and huge piece making public transit truly public transit." – Mira Philipson, Systemwide Accessibility Analyst, Metropolitan Transportation Authority New York City Transit

"I could walk down the hallway and it's telling me when I've arrived at this department and the door is right in front of me — it really gives me that autonomy that I really crave." - Ed Plumacher, Adaptive Technology Specialist, Lighthouse Guild

"We began in public transportation because for us and the users on our team, it is super important to make public transportation more accessible." - Javier Pita, Founder and CEO NaviLens

"Accessibility needs to be built into products, websites, software, whatever it is, from the ground up, because it will just lead to a better product overall." Gian Carlo Pedulla, Supervisor, NYC Department of Education and Member, Advisory Committee for Transit Accessibility, Metropolitan Transportation Authority New York City Transit

Contact Us:

Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

Lighthouse Guild

NaviLens

NaviLens GO

Guest Bios:

Javier Pita Lozano, Founder and CEO, NaviLens

• Javier is the CEO of NaviLens, a solution whose objective is to increase autonomy, social inclusion and quality of life of the visually impaired. Any place can adopt the NaviLens technology in an easy way to improve the space's accessibility through the use of a new patented cutting-edge technology artificial markers called ddTags. Entrepreneur with more than 15 years of experience in launching disruptive technologic companies. Javier and his team are working hard to make this world more accessible for the visually impaired people.

Mira Philipson, Analyst, Systemwide Accessibility, Office ofthe President, Metropolitan Transportation Authority New York City Transit

Gian Carlo Pedulla, Supervisor, NYC Department of Education and Member, Advisory Committee for Transit Accessibility, Metropolitan Transportation Authority New York City Transit

• Gian Carlo Pedulla was born and raised in Bensonhurst, Brooklyn. Legally blind due to Leber's Congenital Amaurosis, he has persevered to overcome his blindness as well as all related obstacles to meet both personal and professional goals. Raised in an Italian American home, he learned the importance of a good meal, being fastidious, having a strong work ethic, and to be as independent as possible despite his blindness. After 15 years of teaching, Mr. Pedulla is now an administrator for Educational Vision Services within the New York City Department of Education. Besides his passion for Mathematics, Physics, and being a Teacher of the Visually Impaired, Mr. Pedulla enjoys music and has been successful as a professional Disk Jockey performing at numerous private and corporate functions throughout the tri-state area over the last 25 years. Mr. Pedulla has been able to adapt and integrate himself to the different school environments and to utilize his strong interpersonal skills to interact with a variety of individuals and personalities, disabled and non-disabled alike. Assistive Technology has been an integral part of his ability to access an array of materials and complete a variety of assignments to achieve goals, both in academia and the workplace.

Edward Plumacher, Adaptive Technology Specialist, Lighthouse Guild Adaptive Technology Specialist for Lighthouse Guild since 2016

• Founder of a tech company that created products and services for domestic and international professional sports leagues and their television broadcast rights holders, providing advanced optical imaging systems for quantifying and measuring live action recreated in real-time 3-D computer generated video replays. Also produced scoring and measurement systems for teams, coaches, managers and league governing bodies. His world changed when he lost his vision — including his career — though it still involved technology. Purchased first iPhone after first orientation and mobility training. Self-taught how to use voiceover over a weekend, and went from having difficulty trying to email on his computer with a magnifying glass and mouse to texting for the first time, easily accessing email calendars, and the internet. Was very active with the Foundation Fighting Blindness (FFB) and became President of the Long Island chapter. Began making presentations on smartphones and smart tablets for FFB just after he lost his sight. Created audio tutorials, ran workshops and networking groups on adaptive technology. Puts together curriculums on teaching people with vision loss about using technology. Worked with New York State Commission for the Blind (NYSCB) to develop a curriculum for providing services on iOS devices and became one of the first people in NY State authorized to conduct iPhone and iPad training. Experienced in podcasting and media, facilitates a peer-to-peer support group at NY Public Library's Andrew Heiskell Library, and is also very active in sports such as running, skiing, beat baseball, tandem cycling and outrigger canoeing.

Host Bio:

Dr. Calvin W. Roberts

Calvin W. Roberts, MD, is President and Chief Executive Officer of Lighthouse Guild, the leading organization dedicated to providing exceptional services that inspire people who are visually impaired to attain their goals. Dr. Roberts has a unique blend of academic, clinical, business, and hands-on product development experience. Dr. Roberts is a Clinical Professor of Ophthalmology at Weill Cornell Medical College. He was formerly Senior Vice President and Chief Medical Officer, Eye Care, at Bausch Health Companies where he coordinated global development and research efforts across their vision care, pharmaceutical, and surgical business units. As a practicing ophthalmologist from 1982 to 2008, he performed more than 10,000 cataract surgeries as well as 5,000 refractive and other corneal surgeries. He is credited with developing surgical therapies, over-the-counter products for vision care, prescription ocular therapeutics, and innovative treatment regimens. He also holds patents on the wide-field specular microscope and has done extensive research on ophthalmic non-steroidals and postoperative cystoid macular edema. Dr. Roberts has co-founded a specialty pharmaceutical company and is a frequent industry lecturer and author. He currently serves as an Independent Director on multiple corporate boards and has served as a consultant to Allergan, Johnson & Johnson, and Novartis. A graduate of Princeton University and the College of Physicians and Surgeons of Columbia University, Dr. Roberts completed his internship and ophthalmology residency at New York-Presbyterian Hospital/Columbia University Medical Center in New York. He also completed cornea fellowships at Massachusetts Eye and Ear Infirmary and the Schepens Eye Research Institute in Boston.

This podcast is about big ideas on how technology is making life better for people with vision loss.

Today's big idea centers on the place where big ideas get born — the human brain. In today's episode, Dr. Roberts and his guests explore theories of brain plasticity, sensory substitution, and sensory augmentation. Dr. Patricia Grant discusses the BrainPort, which uses sensory substitution in this case, the nerve fibers in the tongue, to send information to the brain instead of the optic nerve. Dr. John-Ross Rizzo is developing a device to be called the Sensory Halo, which is supported by sensory augmentation. Both guests share what is being learned about sensory substitution and augmentation through these technologies and how this understanding will help perfect future devices to enable people with vision impairment to see better.

The Big Takeaways:

• The BrainPort is a headset device with a camera that picks up visual input as the eyes would. It uses the theory of sensory substitution by sending stimulation to the nerve fibers on the tongue. The device picks up visual formation in grayscale imagery: lighter areas of the images produce high stimulation on the tongue, while dark areas produce none. This contrast allows users to identify objects in their environment.
• The BrainPort device is meant for people who are blind so it's not crowding out a person's residual vision. And surprisingly, both users who are congenitally blind and users who have seen before and have a visual memory — have performed the same in clinical trials. This shows that users are not experiencing a memory of sight. They are learning to interpret the camera's image through stimulating the nerve fibers on their tongue.
• In the future, there are opportunities for collaboration between BrainPort and other technologies to continue to enhance the user experience to create more autonomy.
• Another device being developed that draws on some aspects of sensory augmentation is the Sensory Halo. Using a device with sensory augmentation is more intuitive to use than a device that uses sensory substitution. The Sensory Halo is designed to empower the wearer by delivering key pieces of information to safely and independently navigate their environment.

Tweetables:

• "We put the brain port on him and started training him, and we were doing some mobility tasks...And I was walking around the room and he would just scan the room. Then all of a sudden, I could feel when he perceived me." — Dr. Patricia Grant
• "The great thing about the BrainPort is that it gives a person their own sense. It's something that they can experience on their own, and that is of great value to a person who is blind." — Dr. Patricia Grant
• "Simply put, I just want to amplify your existing senses and augment what I can give to you right now so that you can have a richer experience." — Dr. John-Ross Rizzo

Contact Us:

• Contact us at [email protected] with your innovative new technology ideas for people with vision loss.

Pertinent Links:

• Lighthouse Guild
• BrainPort
• Assistive Technology & Advanced Wearables by John-Ross Rizzo, MD, MSCI

Guest Bios:

Patricia Grant, PhD, Director of Clinical Research, Wicab, Inc.

• Dr. Grant joined Wicab, Inc. as Director of Clinical Research in February 2014. She previously served as Co-Investigator for Wicab's FDA clinical trial and currently serves as the Principal Investigator of a clinical trial, funded by the US Department of Defense, investigating the safety and efficacy of the BrainPort for people who have been blinded by traumatic injury. Her future research goals include demonstrating the value of the BrainPort in the workplace, in addition to teaching spatial concepts to children.
• Prior to joining Wicab, Dr. Grant was the Director of Research at the Chicago Lighthouse for People Who Are Blind and Visually Impaired and a Research Specialist in the Low Vision Research and the Applied Physics laboratories in the Department of Ophthalmology & Visual Sciences at the University of Illinois at Chicago. In addition to her work at Wicab, Dr. Grant has contributed to research in the areas of methods for assessing loss of vision due to retinal disease, treatments to optimize remaining vision, the psychological effects of vision loss, and the measurement of retinal image quality and ocular aberration. She earned a BA in Psychology, an MS in Public Health Sciences, and PhD from the School of Public Health at the University of Illinois at Chicago, with a concentration in behavioral science and eye health promotion.

John-Ross (JR) Rizzo, MD, MSCI, Director of Innovation and Technology, Assistant Professor Department of Rehabilitation Medicine and Department of Neurology, NYU Langone Medical Center

• John-Ross (JR) Rizzo, MD, MSCI, is a physician-scientist at NYU Langone Medical Center. He is serving as the Director of Innovation and Technology for the Department of Physical medicine and rehabilitation at Rusk Institute of Rehabilitation Medicine, with cross-appointments in the Department of Neurology and the Departments of Biomedical & Mechanical and Aerospace Engineering New York University Tandon School of Engineering. He is also the Associate Director of Healthcare for the NYU Wireless Laboratory in the Department of Electrical and Computer Engineering at New York University Tandon School of Engineering. He leads the Visuomotor Integration Laboratory (VMIL), where his team focuses on eye-hand coordination, as it relates to acquired brain injury, and the REACTIV Laboratory (Rehabilitation Engineering Alliance and Center Transforming Low Vision), where his team focuses on advanced wearables for the sensory deprived and benefits from his own personal experiences with vision loss.
• He is also the Founder and Chief Medical Advisor of Tactile Navigation Tools, LLC, where he and his team work to disrupt the assistive technology space for those with visual impairments of all kinds, enhancing human capabilities. He partners with a number of industrial sponsors and laboratories throughout the country to help breakthrough new barriers in disability research and/or motor control.

Host Bio:

Dr. Calvin W. Roberts

• Calvin W. Roberts, MD, is President and Chief Executive Officer of Lighthouse Guild, the leading organization dedicated to providing exceptional services that inspire people who are visually impaired to attain their goals. Dr. Roberts has a unique blend of academic, clinical, business, and hands-on product development experience. Dr. Roberts is a Clinical Professor of Ophthalmology at Weill Cornell Medical College. He was formerly Senior Vice President and Chief Medical Officer, Eye Care, at Bausch Health Companies where he coordinated global development and research efforts across their vision care, pharmaceutical, and surgical business units. As a practicing ophthalmologist from 1982 to 2008, he performed more than 10,000 cataract surgeries as well as 5,000 refractive and other corneal surgeries. He is credited with developing surgical therapies, over-the-counter products for vision care, prescription ocular therapeutics, and innovative treatment regimens. He also holds patents on the wide-field specular microscope and has done extensive research on ophthalmic non-steroidals and postoperative cystoid macular edema. Dr. Roberts has co-founded a specialty pharmaceutical company and is a frequent industry lecturer and author. He currently serves as an Independent Director on multiple corporate boards and has served as a consultant to Allergan, Johnson & Johnson, and Novartis. A graduate of Princeton University and the College of Physicians and Surgeons of Columbia University, Dr. Roberts completed his internship and ophthalmology residency at New York-Presbyterian Hospital/Columbia University Medical Center in New York. He also completed cornea fellowships at Massachusetts Eye and Ear Infirmary and the Schepens Eye Research Institute in Boston.