The 50 Million Dollar Bionic Eye

Last year, in March, mivision featured an interview with the new Federal Health Minister, the Hon. Nicola Roxon about the Minister’s vision for Australian eye care. In this article, the Minister stated: “Eye health will feature prominently in the preventative health care agenda of the Rudd Government. Many eye diseases are preventable and, if not preventable, are treatable.”

In the following issue, mivision’s cover line proclaimed: ‘Bionic Eye: An Aussie World First’. This feature story revealed the decade-long, and greatly advanced research, of an indigenous bionic eye being developed in Sydney, under the watchful eye of Professor Minas Coroneo, Head of Ophthalmology at Sydney’s Prince of Wales Hospital.

In mid-April, the bionic eye then became one of the main ideas and the talk of the Rudd Government’s 2020 Summit. In part, our April feature story said: “Preliminary studies have already been cleared by the Medical Ethics Committee for a bionic eye to be permanently implanted into a patient. This amazing quantum leap is the culmination of almost a decade of research by a group called the Australian Bionic Eye Foundation and is expected to take place before the end of the year.

Given that the approaches the two groups are taking are quite different and that we’re both quite developed in both the approach and the technology we are using, I can’t see the groups combining

“And unlike other bionic eye research in the United States, the Sydney team, in a world first, has developed a device implanted on the outer surface – the sclera of the globe of the eye, rather than needing to be placed inside the eye, which requires more invasive surgery.”

Prof. Coroneo also pointed out that the research, under the umbrella of the Bionic Eye Foundation, had been done despite major underfunding (just a few hundred thousand dollars) and that his team, which includes Dr. Vivek Chowdhury, was now ready to implant its device into a human.

The 2020 Summit

In the lead-up to the 2020 Summit, more than 900 ideas were generated. Out of those ideas, nine were pursued by the Federal Government. One of the ideas chosen to be implemented was to provide AUD$50 million in funding for the development of a bionic eye.

The Federal Government’s Summit Response Paper detailed its commitment, as part of its ‘Long Term National Health Strategy’, to bionic eye research. The Paper states: “The Government is committed to supporting research where Australia is on the leading edge of innovation as a crucial investment in our nation’s future. One such area is research into the bionic eye, which is a critical advancement for millions of vision impaired Australians and promises the development of technologies to translate into other areas of need. Australia is already a world leader in bionics based on our expertise in the bionic ear. The Government is committed to conducting a competitive grants process to fund this important work.”

The Bionic Eye Groups

There are currently a number of groups in Australia developing a bionic eye. Apart from Prof. Coroneo’s research with the Bionic Eye Foundation, there is a second group based in Melbourne. This group is known as Bionic Vision Australia, and has also been involved in the development of a bionic eye under the directorship of Dr. Anthony Burkitt, Professor of Engineering at the University of Melbourne. This group is only now testing a device and carrying out the safety and bio-compatibility studies. “We are in the early stages of doing efficacy studies.

We are doing animal and laboratory experiments,” Dr. Burkitt says.Explaining his group, Dr Burkitt adds: “We are Bionic Vision Australia and there are five partners. There’s the University of Melbourne, University of NSW, the National Information Technology Centre (ITC) of Australia Centre for Eye Research Australia and the Bionic Ear Institute.

“Different partners have been working on this for many years. Our colleagues at the University of NSW are Nigel Lovell, Professor at the Graduate School of Biomedical Engineering at UNSW. His expertise ranges from biomedical instrumentation, biological signal processing, neurophysiology and physiological modelling … and Gregg Suaning, Associate Professor with the Graduate School of Biomedical Engineering at the UNSW, Co-Director of the Centre for Implantable Bionics and the Australian Vision Prosthesis Group.

“They have been working on a retinal implant for well over ten years and have a well established international record in this field. Our device would be implanted. We are looking at a supra choroidal approach bringing us much closer to the neurons that need to be stimulated. The choroid are the layers of blood vessels just inside from the sclera. It is surgically implanted and we would hope to do human trials within two years of getting some funding.” Dr Burkitt explains.

Who Gets the Funding?

Although rivals for funding, the two groups have welcomed the Federal Government’s funding package, but make it clear that each will be applying for funding. Dr. Burkitt says it is pleasing to see the Federal Government has maintained a long-sighted view in these economically uncertain times, and is investing in future technological development, which will place Australia at the forefront of development in the bionic eye.

Professor Coroneo agrees. “Look, it’s good news and everyone who has an interest in this can now apply for money … targeted money … and we will hopefully stand on our track record and get some money,” he says.

Although friendly rivals, the two groups are rivals nevertheless … and it just might be that the funding will be split between the two leading groups in a race to be the first to develop a working bionic eye in Australia.

Dr. Burkitt says: “I think the funding is a matter for the Australian Research Council now. We actually don’t know what the process is. I imagine they will hold a competitive peer review process to apply for this funding. I think one of the possibilities is that the funding may be split.

” Asked if he could imagine the two groups combining their resources, Dr. Burkitt says: “Given that the approaches the two groups are taking are quite different and that we’re both quite developed in both the approach and technology we are using, I can’t see the groups combining.

” Richard Grills, from the Bionic Eye Foundation, says: “We are hopeful that our project will be selected for funding. I do think we will. All the indicators are there, but there is another group in Melbourne that is going for it.”

“They are nowhere near as advanced as we are and they don’t have the backing of the CSIRO or Cochlear. I am very hopeful we achieve funding from the Government from that grant.

” The concepts the two bionic eye groups are working on are completely different. The Melbourne group involves a device implanted inside the eye, while the Sydney group’s device is not. It uses existing electrodes from Cochlear, existing surgical procedures used in retinal detachment surgery, existing implants that are used in retinal detachment surgery.

“So it’s not new. All these surgical components are not new and it appears to work. The single electrodes have already been tested on humans and they’ve had a number of really good responses from a number of patients,” says Mr. Grills.

Prof. Coroneo says: “Clearly, we have a track record in this area and they have a track record, and in the end I have no idea what criteria they are going to use to judge these things on. They (the Australian Research Council) will ask for submissions for funding and we will make a submission. They want someone to develop and commercialise a bionic eye device. We’ve been well down the track for a while.”

“Before Christmas we were asked to put together information for the Chief Scientist of Australia by the Prime Minister’s office. We were hopeful that we will get a decision of some sort. I’m delighted that the Government has done this because it means we will apply for another grant, but at least this one is targeted and obviously we hope to get some of the money,” says Prof. Coroneo.

As yet, neither party has any details on how the funding will be made available, but the Government will do so through the Australian Research Council (ARC). It is likely that the ARC will ask for submissions and make a decision from there.

International Competition

Prof. Coroneo points out that there are currently 23 groups around the world doing bionic eye research and some have been at it for more than ten years.

“Some of those groups have been incredibly well funded. The German government has been funding one body for this type of research for a long period of time.

“Australia comes along a decade later and puts AUD$50 million into this area. Either they know something that no one else knows or they are being terribly optimistic. Australians tend to punch above their weight. We do all sorts of things because we don’t have big markets or research dollars etc. That forces many Australian groups to be innovative in whatever you like.

” Addressing his overseas competitors in bionic eye research, Dr. Burkitt says: “International competition is a good thing and it keeps us on our toes. It also shows that the bionic eye is regarded as viable by a number of leading groups.

“The most advanced of those is a company called Second Sight in California and they have commenced clinical trial in a number of patients. Their success has only been modest. They still have a long way to go and I don’t think that is because they are in advance of us. I don’t see a disaster because when you look at the history of Cochlear implants, they have 70 per cent of the world market now, but were not the first company to commercialise such a device. 3M had the entire market before Cochlea. It’s the quality of the technology that’s the key here and that’s still open. We’re still in a race to find the best implant…the one that works best.

“What we’re aiming for with the first device is to be an aid to navigation… to be able give people the ability to move around and enable them to live independently… to be able to make out doorways and large objects and further down the line we want to increase the spatial resolution of the vision that they’re perceiving to do things such as read large print or identify faces. We’re looking at that within a decade and we will see a gradual improvement of these implants over the years just as we did see in the Cochlear implant.

“I think this funding really places us well to play a leading role internationally. I think it’s healthy to have the different approaches and it’s up to us to prove the superiority both of our approach and the team we put together that covers all different aspects of the technology that’s required.

” Touting his team’s advanced research, Prof. Coroneo says although the Melbourne group does have “a lot of money behind it”, his group’s collaboration includes the CSIRO in Queensland, a group at Harvard University, U.S., a group in London and Cochlear.

In the mivision feature last year, Prof. Coroneo explained: “The major advantage of the device we are developing is that it does not require highly invasive intraocular retinal surgery (which is the approach being pursued by most of the groups overseas) – which risks damage to whatever remaining visual function an otherwise blind patient may retain. Implanting the device is no more difficult than the sorts of operations we are already doing.

“The difference between overseas groups and us is that we have worked out that you can put the electrodes on the external surface of the eye, overlying the retina, but not directly in contact with it and that it’s safer and more stable”.

Where to Now?

“In overseas experiments there have not been any breakthroughs and won’t be anytime soon. Clearly, there have been problems with their whole approach. We have tried something different and we live in the hope we will get something out of it. We will stand on our record and we think our approach is more than just hopeful. We think it will fast track the development of this device,” says Prof. Coroneo.

And he issues a warning if his group fails to get funding for its research by saying: “Now, if we don’t (get funding), that’s fine as well. The next thing that will happen with this, one way or another, is that we would then probably take it off shore.

“In the end, there is not so much money available in Australia that you can commercialise a lot of things. I’ve got a track record in commercialisation, and I have contacts in the area, and we have some European and Australian patents soon to be awarded in a particular area.

“I could be misguided or I might even be wrong, but we’ve been at it for a long time with very few resources and we differ from most of the other overseas groups which we think is a good sign. We’re not re-inventing the wheel. We are using proven technology.”

Dr. Burkitt says: “We have the team of experts to compete with anyone in the world.”

“One of those experts is Head of the Macular Research Unit at the Centre for Eye Research Australia, Professor Robyn Guymer, who says the boost in funding will increase chances of delivering a bionic eye with such high resolution that it does more than simply differentiate between shadows and large objects, as current bionic eyes enable.

“We are hopeful that with this funding we could provide a much higher quality of life to people with severe visual loss.”

Despite the healthy rivalry between these two major research groups, according to the experts and various insiders, it is highly likely that the Australian Research Council will do what King Solomon threatened… “split the baby” between them.