Treating Blindness Takes More Than Meets The Eye Advances in medicine are making it increasingly possible to replace or regrow parts of the eye. But restoring sight may require changes in the brain as well -- and that's much harder to achieve.
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Treating Blindness Takes More Than Meets The Eye

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Treating Blindness Takes More Than Meets The Eye

Treating Blindness Takes More Than Meets The Eye

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It's MORNING EDITION, from NPR News. I'm Steve Inskeep.


And I'm Linda Wertheimer.

INSKEEP: a tiny, implantable telescope. This is one of several innovations that target the mechanics of the eye itself. But as researchers are learning, that may not be enough. From member station KQED in San Francisco, Amy Standen has our story.

AMY STANDEN: On the day that Mike May's bandages came off in March 2000, TV cameras were there to capture the drama. Scientists, the story went, may have finally found a way to cure at least some kinds of blindness.


STONE PHILLIPS: It is the moment of truth for Mike May and his eye surgeon. Less than 24 hours after an operation that could restore his sight, the bandages are about to come off. What will he see?

STANDEN: This comes from the NBC show "Dateline."


WERTHEIMER: Holy smokes.


U: Can you see a little bit?

WERTHEIMER: I sure can.

STANDEN: Mike went blind when he was just 3 years old, when a jar of chemicals exploded in his face. The accident destroyed one of his eyes entirely, and it badly scarred the other. But now, 43 years later, two surgeries were intended to bring that vision back. In the first, doctors used stem cells to repair the surface of Mike's surviving eye. Once that healed, they attached a transplanted cornea. Mike now had what should have been a perfectly functioning eye.


U: And then Mike sees his wife Jennifer's face for the first time.

STANDEN: Well, sort of. Mike could see the basic outlines of his wife Jennifer's face. But he says it was frustrating, because he couldn't really recognize what it was he was seeing.

WERTHEIMER: I didn't see any details about her face.

STANDEN: Ten years later, Mike still can't see much. He can make out vague shapes and movement, but very little detail. And he has a hard time identifying what it is that he does see. Mostly, he functions like a blind person, with a cane and a guide dog named Miguel.

WERTHEIMER: I've learned to use my blindness when it's more appropriate, use the sight, use them together. And I don't think about it. So people say, well, how is the vision going? And I think, oh, yeah. How is it going? It's just another tool, like my dog, like my GPS. That's just part of the way I operate in the world.

STANDEN: But to scientists who study vision, Mike's case has posed a powerful question: Why can't he see better?

Among the first people to study Mike after his surgery was Ione Fine. She's an assistant professor of psychology at the University of Washington. She says it was clear immediately that the problem wasn't in Mike's eye. It was in his brain.

INSKEEP: It's this fact that his brain hasn't received input for 40 years that's stopping Mike from seeing.

STANDEN: But Mike had been able to see, once upon a time. So now that he had a good eye, why couldn't his brain just pick up where it left off? That's the subject of a paper published earlier this year in the journal Neuron.

INSKEEP: At the age of 3, kids' vision is pretty good.

STANDEN: Author Brian Wandell teaches in the psychology department at Stanford University.

INSKEEP: They do funny stuff, but they can see a lot of things.

STANDEN: Wandell says that even though a 3-year-old can see OK, his visual system is still taking shape. It hasn't really, as Wandell puts it, locked down yet.

INSKEEP: What's happened at the age of 3 is that a certain class of cells that are cells that really help you see fine detail - things like, you know, that you might use for reading or seeing fine pattern or textures - those cells are just stabilizing. At 18 months, they're probably really not in place. But at 3, they seem like they're just getting there.

STANDEN: Now, we know that the brains of young children are especially plastic, or malleable. That's why kids pick up language more easily than older people. Wandell says it's a case of brain cells adjusting to meet new demands.

INSKEEP: So all the cells in your brain as you're developing are in kind of competition with one another for more space, you know - who gets a little more territory, who gets a little less.

STANDEN: But after 3-year-old Mike had his accident, that jostling for space took a different turn.

INSKEEP: In Mike's case, the cells that were his visual cells were disadvantaged because they weren't being driven by the environment. So the other cells said, well, listen. I'm doing a lot more business than you're doing, and I'm going to take up the space that you would've had, because I'm just getting a lot more activity.

STANDEN: Those visual cells that are devoted to fine detail eventually deteriorated. But the damage didn't stop there. Instead, it set off a chain reaction throughout Mike's brain as other parts, which had also depended on that visual information, suddenly weren't getting it.

INSKEEP: We were worried that when Mike's eye wasn't producing any signals - that literally, the big cables that would carry the information between parts of his eye and his brain and different parts of his brain - would have withered away.

STANDEN: Wandell believes that's exactly what happened. Cut off from a steady stream of images, Mike's ability to - for instance - recognize faces, disappeared. But at the same time, those cells were being repurposed to do other things, things that are useful to a blind person. Here's Ione Fine.

INSKEEP: The back of the brain starts doing things, like Braille. It starts doing things like listening for the tap of a cane. It starts developing the ability to process these other skills that blind people have and we don't.

STANDEN: And that's why, at the end of the day, having very limited vision isn't such a big deal to Mike. He still runs the GPS business he founded, still competes in downhill skiing races.

As for Brian Wandell, he says the lesson here isn't that doctors should stop trying to cure blindness. It's that for some patients, the cure will have to include the brain as well as the eye. And that may take a bit more doing.

For NPR, I'm Amy Standen.

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