Open Dialogue

Seeing the Light: A Patient’s Story of Regaining Sight through a New ‘Bionic Eye’

Orly Shamir speaks to the Catalyst about last spring’s life-changing surgery, undertaken at the Krembil Neuroscience Centre, in which a retinal implant in her left eye partially restored her sight after a decade of advancing blindness. She is the first patient in Canada to receive this new ‘bionic eye.’

On June 5, 2014 46-year-old Orly Shamir’s life changed. Born with a rare inherited eye disease that affects around 1 in 80,000 people and leads to blindness, the married mother of three boys partially regained her sight through an implanted retinal prosthesis on her left eye. When the technology is turned on, it stimulates the eye and restores functional vision in patients.

The three-hour surgery was undertaken by Dr. Robert Devenyi at the Donald K. Johnson Eye Centre of the Krembil Neuroscience Centre, Toronto Western Hospital/University Health Network (UHN), as part of an observational study to see how the Argus Retinal II Prosthesis System affects patients’ vision and to collect information about the safety of the new tool ‒ a device that Devenyi referred to as “the most amazing development in medicine in our lifetime.”

Shamir, the first of two patients to receive the ‘bionic eye’ in Canada, sat down with the Catalyst to tell her remarkable story.

Bionic eye patient Orly Shamir cropped
Orly Shamir, first recipient in Canada of the new bionic eye. Photograph courtesy of Orly Shamir.

Let’s go back to the beginning: You had limited vision as a child. In your 20s to mid-30s, you could no longer make out signs or facial details. Eight years ago you got a guide dog, and for the last decade your eyesight has been severely limited. Could you describe your vision before and after turning on the new bionic eye?

The vision that I have is blurred light perception. It’s not that I see darkness, but whatever I do see, there’s no definition. It’s just very light and blurred. The vision that I am able to gain through using the Argus II, the retinal microchip implant, is still at the beginning stages, but now I am able to see a bit more definition when it comes to contrast – an object that’s light on a dark surface or vice versa. So there has to be contrast for me to pick it up when I have the technology turned on.

There are several components to the Argus II, including special glasses wired to a computer worn by the patient. The glasses have a mini camera that converts the video images from the microchip into a series of small electrical pulses that are then transmitted wirelessly to electrodes. The pulses from the electrodes stimulate the retina’s remaining cells, which transmit the visual information along the optic nerve to the brain. This technology is rapidly evolving, isn’t it?

There’s so much happening in technology. They’re working on all kinds of different updates. I know, in time, there’s going to be a lot more that the technology can offer. For example, Argus III has more electrodes that would be placed onto the retina [compared to Argus II].

Although Argus III would involve another operation to implant a new microchip, there are upgrades that could be made to the existing system, the actual computer, such as colour and facial recognition.

Extensive rehabilitation is necessary to train the brain to recognize light and interpret the visual information captured by the device. Can you tell us a bit about rehab at the hospital, your homework identifying shapes on an easel, and what it’s like learning to navigate around your environment on a day-to-day basis?

I went to Toronto Western and met with a rehabilitation low vision worker, and we started from the beginning. I was given an easel and different shapes to place on it. The easel had two sides – one was black, one was white. I would place the opposite contrast shape [on the appropriate board]. Black on white board; white on black board. With time and practice, I started being able to detect not only the perimeter of the board itself but also the outline of the shapes. Soon I was able to figure out what shape I was looking at. Every time I was able to do this, I would take off the glasses, turn off the technology… and of course with my own vision, I was not even able to see the shapes. So, there is improvement.

Now, I have two workers with different areas of expertise. One is a mobility instructor. I am learning how to navigate outside and to recognize what I’m seeing through this technology. At this stage, it’s still being worked on, and eventually, from what I hear, I’ll be able to see the contrast between the sidewalk and the grass, or the sidewalk and the road. I can start navigating a little more independently.

I have another worker whose area of expertise is in the home. So I’ll start figuring out how to recognize different things in this context ‒ more practical uses of this new technology.

With more rehabilitation, I’ll gain more useable vision in time.

What are your impressions of Dr. Devenyi and his team at the Donald K. Johnson Eye Centre of the Krembil Neuroscience Centre?

Dr. Devenyi is fantastic. He’s an amazing surgeon and also a great person. He took on this project and went to Europe and the U.S. to learn how to implant the device. He sat in on surgeries done by professionals in other countries in order to bring this new technology to Canada.

Dr. Devenyi
Dr. Robert Devenyi, University Health Network (UHN) performing the surgery, implanting the Argus II
Retinal Prosthesis System. Photograph courtesy of UHN.

What makes me feel very good is that whenever I went for any of my follow-up checkups, the California-based company that manufactures this microchip and technology, Second Sight, was present. The company sent a few of their representatives, every time. And they were so impressed by the way Dr. Devenyi placed the microchip on my retina, which is a very delicate operation. He placed it so exactly, so precisely. The reps had not seen another surgeon place the microchip as well as he had. It made me feel really good.

Secondly, Dr. Devenyi’s team, every team member at the hospital that was involved in this clinical trial, was eager to learn, fantastic, doing such a great job. They’ve taken on something and they’re really doing it well.

How has this changed your life? – An admittedly big question, but do you have any examples of a pivotal moment that really hit home?

Every time I turn on the technology, try to do something and see that it’s making a difference… this is exciting each and every time. The fact that I am able to detect shapes and see a board with black and white stripes… that’s huge.

I’m so glad that I’m part of helping this project move forward. And knowing what’s to come is very exciting. I have no doubt that there are going to be huge technological advances in a few years.

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Shamir realizes the importance of her role as participant. She is planning to start a blog to chronicle her experience, having already launched a website: www.orlymylight.com. This url has special meaning: As if her path in this journey were somehow destined, the name Orly means “my light” in Hebrew.

To read more about the science, technology and the surgical team behind Canada’s first bionic eye, go here: http://bit.ly/1zOcKbP.