For people with impaired eyesight or no sight at all, the world is an enormous obstacle course. Professor Gregg Suaning is pushing vision capture and nerve stimulation technologies beyond their limits to help clear a path.
As research goals go, it is bold聽with perhaps a touch of the聽miraculous. For more than聽twenty years, Professor Gregg聽Suaning has been working to聽bring sight to the blind. Though聽in the early days, the idea was聽almost all he had.
鈥淲e were dismantling radios聽and car electricals to make the equipment聽we needed,鈥 Suaning says, obviously聽enjoying the memory. 鈥淥ne time we were making bespoke electrodes and we聽ended up using a capacitor out of a big,聽old鈥憇tyle television.鈥
Those early hurdles have long聽been cleared and today, Suaning鈥檚聽work is at a point where the broad聽technology of delivering a sense of聽sight exists. In principle, it鈥檚 not unlike聽the cochlear implant and related聽technologies which now help millions of聽hearing鈥慽mpaired people.
A camera on a pair of glasses collects聽the visual information which is then sent聽to a mobile phone and processed. The聽result is sent wirelessly to a microchip聽implanted in the retina which decodes聽the wireless signal and sends electrical聽impulses to the part of the brain that聽produces vision: the visual cortex.
While the technology might be聽cochlear-like, the degree of difficulty is聽many times greater because vision is so聽much more information dense than sound.
Where hearing technologies can deliver聽a more than acceptable result using 14聽channels of information, Suaning鈥檚 work聽currently uses 100 channels with more聽limits in the process of being pushed.
Still, the challenge plays to Suaning鈥檚聽natural impulses since he grew up聽wanting to be a motor mechanic before聽discovering mechanical engineering then聽biomedical engineering. In fact, he was an聽engineer at Cochlear in its very early days,聽and it was there that he set himself the聽goal of helping blind people see.
鈥淚t hasn鈥檛 been easy,鈥 says Suaning in聽his Australian-inflected San Franciscan聽accent, having met his Australian wife in a聽Jerusalem Youth Hostel.
鈥淜eeping in mind聽that full vision is like a million channels of聽information, it really helps that the brain聽can also make a lot out of very little.鈥
This was demonstrated in 2014聽when the sight technology was still聽cumbersome, and lab bound. As part of聽national project where researchers were聽developing an Australian bionic eye, three聽blind volunteers came to a Melbourne聽University lab, and were implanted聽with a rudimentary electrode array and聽connected to laboratory-based electronics.
鈥淭wo didn鈥檛 get much of a reaction, but聽one of them did really well,鈥 remembers聽Suaning. 鈥淕oing through an obstacle聽course she avoided and even identified聽obstacles, including a chair. Though it聽wouldn鈥檛 have been a fully realised chair,聽just a few dots. But her brain filled in聽enough of the gaps.鈥
This represents a key challenge for the聽research: making the visual information聽captured and communicated actually meaningful for the blind person,聽meaningful being a key term here.
鈥淲e鈥檙e working towards something聽so blind people can navigate the world,鈥澛燬uaning says. 鈥淭o help them recognise聽objects, avoid obstacles and move about聽more confidently. Will it ever be the聽full visual experience sighted people聽have? Thinking about the huge advances聽there鈥檝e been in video game technology, it聽might be possible, but we鈥檙e not there yet.鈥
Still, over the years people have been聽inspired by the huge promise of the聽technology and even offered much needed聽financial support (鈥淥ne blind聽person called me wanting to donate to聽the work - though I think he was deaf as聽well. He was absolutely screaming into聽the phone because he was so excited鈥.)
But recent support from the Neil and聽Norma Hill Foundation has sent Suaning聽and the technology down a new path.
Where the research focus for Suaning聽has always been on a rare, blindness inducing聽condition called retina聽pigmentosa, which can strike people聽in their 30s and 40s, causing initial聽tunnel vision that later narrows to full聽vision loss, the Foundation gift brought聽macular degeneration into the frame.
As the Trustee for the Foundation says, 鈥淲hen we heard about聽Professor Suaning's work we felt聽compelled to help. We are so pleased聽that our philanthropy could help to ease聽the burden in some way for people with聽macular degeneration and their families."
In some ways, MD is like the reverse聽of retina pigmentosa since the damage聽starts in the middle of the field of vision聽and works outward. Certainly, it鈥檚 much聽more common than retina pigmentosa,聽with one in seven Australians over聽50 having some age-related macular聽degeneration (MD), and about 17% of聽those going on to suffer vision loss.
That being the case, the reason聽Suaning didn鈥檛 focus on MD in the early聽days of his research was out of concern聽for his volunteers. People with severe聽retina pigmentosa can suffer full vision聽loss, whereas people with MD usually聽retain some sight around the central聽area of retinal damage. Suaning didn鈥檛聽want to risk whatever sight was still聽retained by MD volunteers.
Allowing that significant advances聽have been made since those early days,聽Suaning is now preparing for the first聽human trials where the volunteers will use聽wearable equipment that they can take聽home. To even contemplate using human聽volunteers in this way, Suaning has had to聽demonstrate the safety of what he鈥檚 doing聽to the highest possible standards.
This he has done, and in the process聽seen for himself that the newest聽expression of the technology would聽present a minimal threat to any聽volunteer participating, including聽someone with macular degeneration.
This has also seen him looking聽differently at the technology itself. For聽retina pigmentosa, the in-eye electrode聽array is arranged for the outside-to-inside聽progress of the condition, whereas聽the new MD array must work inside-to-outside.
Having to do this thinking has聽fed new and useful ideas into the process.
Another thing that has helped聽Suaning鈥檚 work is his move to the聽University of Sydney, 鈥淭here鈥檚 so much聽multidisciplinary stuff that happens聽here,鈥 he says. 鈥淎s part of one ecosystem聽there鈥檚 the technical side, medical,聽business, even the psychological aspects.
鈥淭hat makes every advancement even聽more immediate. You can see the effect聽it could have, maybe not tomorrow, but聽you can see it; something is emerging聽that will help people.鈥