After three decades of blindness, Larry Hester sat down Monday morning, switched on his new left eye and started his first lesson in seeing as much with his mind as with what is left of his old eye.
Several weeks ago, Duke surgeon Paul Hahn implanted a “bionic eye” in Hester, a 66-year-old retired Raleigh tire dealer. It was the first such implant in the state and just the seventh in the United States.
With the surgery site healed, the team at Duke switched on the $145,000 device Wednesday and sent Hester home to begin getting comfortable with it. Called the Argus II, it uses a small, belt-mounted computer and a tiny video camera mounted on sporty Oakley eyeglasses to beam a kind of rudimentary vision through a chip implanted in his left eyeball.
Now, though, it was time to learn how to properly use it.
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For his first lesson, occupational therapist Fay Tripp set up a board about the size of a dinner tray – one side white, the other black – on a table in front of Hester.
The implant turns the signals into pulses of electricity that stimulate the optic nerve, which the brain then perceives as a basic form of vision.
Hester, a soft-spoken, perpetually cheerful man, said Monday that he sees images as flashes of light. When he turns his head toward something that transmits light, or is light in color, there are flashes. Things that are dark don’t flash.
Tripp draped a white cloth over the black background, obscuring one side of it, and, once he had located the change in color, asked Hester to scan vertically. He locked on the edge of the cloth, and his head followed it up and down, just as if he was looking at it.
“Very good,” Tripp said.
“You go!” said Hester’s wife, Jerry, who was standing behind him, clapping him on the back.
Then Tripp put a white square on the black background and asked Hester to point at it.
He turned his head slightly from one side to the other, back and forth, a scanning motion that helps people who use the device locate the edges of things, then pointed directly at the center of the square.
Jerry laughed, her face flushing with happiness.
Then Tripp flipped the board to the trickier white background and attached a white rectangle.
“Flashing, flashing,” Hester said, leaning intently toward the board.
“Do you see an object?” Tripp said.
Again, Hester pointed precisely at the center of the shape.
Tripp worked with Hester to improve his scanning technique, broader sweeps for large objects and “microscanning” in tiny sweeps that are little more than vibrations to give sharper definition to the edges of an object once he locates it.
She said that it will be easier to find vertical objects such as doorways by scanning back and forth horizontally. Also, she noted that among other differences with natural sight, Hester would have to get used to moving his head more. When people look down at an object, for example, they usually lower their head for part of the required angle, and rotate their eyes the rest of the way.
After about 30 minutes, Hester began struggling to pick out shapes and edges.
That’s called saturation, and it’s normal, Tripp said. The mind and body get overloaded from working so intently on something as new as this. But if he breaks up his training sessions at home into short stints, he can do a few every day and make solid progress between his weekly visits with her.
That makes sense, Hester said, but it was hard to stop after just a few minutes when he’s hungry to learn all there is to know about using the device.
Tripp handed a kit of different shapes in black and white, and told him it would be best to work down to the smaller ones. Jerry laughed and said their granddaughters had already made him giant flash cards with high contrast shapes.
Hester was diagnosed 33 years ago with retinitis pigmentosa, a rare disease that destroys the special cells in the retina that collect light for the brain to translate into vision. There is no cure, and after a few years of seeing progressively worse, he lost his vision entirely.
Early last year, he heard that the so-called bionic eye had been approved for use in the United States and immediately called the company to say he was interested in becoming one of the first to try it.
Hester said that he knew the version of sight he would experience would be rudimentary. But bionic eyes are in their infancy, Hester said, and the company needs pioneers to help build up data to improve the equipment and software and perhaps eventually extend their use to people with more common causes of blindness.
He signed an agreement to work with the company for five years.
“It’s so incredibly overwhelming that you can see flashing lights and a contrast and know that there is at least some vision,” he said Monday.
Last month, just before Hahn inserted the chip in his eye, Hester said the thing he really wanted to see was Jerry’s beautiful blue eyes, though he knew the new type of vision he was about to experience would be far too basic for that. He said he would be elated just to be able to make out the shapes of the grandchildren he has never seen, and the flash of fireworks on July 4 at the traditional family trip to Manteo.
He is already enjoying a kind of visual alchemy, his new electronic eye turning one everyday sight after another into a personal miracle: the white duck he picked out from a flock of darker companions at Duke Gardens; the flash of streetlights as his wife drove him down a dark stretch of road; the bright yellow chrysanthemums in dark mulch outside his kitchen door that flashed so much they sparkled; the change in light when a television broadcast of a football game jumped to a closeup.
And then, Jerry said, he turned away from the game and saw the flashes that let him locate her.
He reached over and, without hesitating or fumbling, gently put his hand right on her cheek.