Visual prostheses for the blind

• Visual prostheses are designed to provide artificial vision to blind patients by electrically stimulating localized neural populations in the retina or visual cortex.
• Significant technological challenges required solutions during development of these devices including surgical access and mechanical stability, hardware miniaturization, hermetic encapsulation, electrode development, and signal processing.
• After >40 years of research visual prostheses are moving from the laboratory into the clinic.
• Positive clinical outcomes with visual prostheses will be dependent on appropriate training and brain plasticity in addition to these advances in technology.

After more than 40 years of research, visual prostheses are moving from the laboratory into the clinic. These devices are designed to provide prosthetic vision to the blind by stimulating localized neural populations in one of the retinotopically organized structures of the visual pathway – typically the retina or visual cortex. The long gestation of this research reflects the many significant technical challenges encountered including surgical access, mechanical stability, hardware miniaturization, hermetic encapsulation, high-density electrode arrays, and signal processing. This review provides an introduction to the pathophysiology of blindness; an overview of existing visual prostheses, their advantages and drawbacks; the perceptual effects evoked by electrical stimulation; as well as the role played by plasticity and training in clinical outcomes.