The Cutting Edge: COMPUTING / TECHNOLOGY / INNOVATION : LVES Sighting : ‘Space Glasses’ Help Those With Low Vision See

With his wrap-around goggles and a one-pound belt pack, Tom Cleary looks as if he’s about to play the latest virtual reality game. But the 73-year-old executive is doing something far more complicated: reading.

Cleary suffers from macular degeneration, a condition in which fluid leaks into part of the eye, resulting in distorted vision and large blind spots. Although he can see well enough to maneuver around his office, his 20/400 vision classifies him as legally blind.

Until earlier this year, Cleary relied on oversized type and a cumbersome reading machine to keep up with the paperwork at G&H; Technologies, the aerospace electronics company he runs in Camarillo. Now he is one of a few hundred low-vision patients around the country using NASA technology to see details such as printed words and facial expressions.

“Our management system requires lots of charts and plans, and now I can read them,” said Cleary, who has been using the Low-Vision Enhancement System, or LVES (pronounced “Elvis”), since October. “It makes life a lot easier for me.”

Of the 20 million Americans who suffer from visual impairments that cannot be corrected with glasses, 99% have some usable eyesight, according to Jeanine Toussaint, West Coast program director of the National Assn. for the Visually Handicapped in San Francisco. For those people, the goal is to use their residual eyesight to its maximum advantage.

That’s what Robert Massof had in mind in 1985 when he embarked on a scavenger hunt through the National Aeronautics and Space Administration in search of potentially suitable technologies. The next year, Massof--an ophthalmologist and professor at Johns Hopkins University in Baltimore--came upon a group at the agency’s Ames Research Center south of San Francisco that was building the first virtual reality system as part of a space station project.

NASA engineers had developed a head-mounted device that they hoped would eventually obviate the need for lifting bulky control panels into space. It wasn’t light enough, inexpensive enough or portable enough to use for low-vision patients, but “we could see how to get there based on what they’d done already,” said Massof, who also runs the low-vision section of the Wilmer Eye Institute at Johns Hopkins.

With more than $4 million in seed money, researchers from Johns Hopkins, NASA and Polaroid Corp. set out to build “space glasses,” as they were quickly dubbed.

LVES helps low-vision patients see better by magnifying objects to as much as 10 times their original size. It makes images brighter and forces the iris and pupil to open wider to take in more light. The system also increases contrast by forcing shades of gray to move closer to either black or white.

LVES users can adjust the contrast, magnification and focus of an image by turning knobs on the battery-powered belt pack, which is connected to the headset by a cable. For close-range reading tasks, a camera at the top center of the unit can be tilted down toward a book and fitted with an additional magnifier.

In a healthy eye, the lens and cornea focus on an object and project its image onto the retina, which lines the back of the eye. The image is then transmitted as electrical signals through the optic nerve to the brain.

People who suffer from vision ailments--including macular degeneration, cataracts, glaucoma and diabetic retinopathy--experience blurry or spotty vision and sometimes lose the ability to see things on the periphery. LVES helps some of them use their remaining vision to the best advantage.

Low-vision patients at the Center for the Partially Sighted in Santa Monica use LVES to watch television, write letters and maintain financial records on a computer, said Trang Nguyen, the doctor of optometry in charge of the LVES program there. The device allows one patient to read “stories to her son without holding the book so close to her face that he can’t see the pictures,” Nguyen said.

Here’s how it works: Tiny eye-level cameras film the outside world and send pictures to the belt pack. The images are manipulated to increase their contrast so they are easier to see. Then the images are sent to a pair of black-and-white cathode ray tubes at either end of the headset.

From there, the image is beamed through three lenses spaced to magnify the image and make it less fuzzy. A fourth custom-made lens can be added to account for a patient’s eyeglass prescription.

Then the image bounces off a series of mirrors to align it in front of the eyes. One of the mirrors is curved to further magnify and sharpen the image, the way a shaving mirror makes one’s face appear larger and more sharply focused.

The result: “It’s like watching a 60-inch television screen from four feet away,” Nguyen said.

The technology has proven promising enough that a Minneapolis firm called Visionics has spent $2.6 million to purchase the rights to the LVES technology and take over research and development and manufacturing responsibilities.

Brad Blankenship, the company’s chairman, thinks LVES can be useful for the 1.8 million Americans whose vision is between 20/100 and 20/800 but who have enough usable eyesight to recognize objects by their general shape. But users must have patience, strong necks and a willingness to learn how to use the system, he said.

So far, Visionics has sold about 250 LVES units, which cost $5,200 each, plus $1,200 for extensive training sessions at which patients learn to use the zoom, focus and contrast features on the belt pack without becoming seasick. Although most low-vision aids--mainly magnifiers of various sorts--cost several hundred dollars, LVES is cheaper than sophisticated devices such as reading machines, which can cost as much as $13,000.

On average, people wear the device--which weighs slightly more than two pounds--between two and four hours a day, although some say they wear it as many as 16.

The previous major breakthrough in low-vision aids came in the early 1970s, when electronic closed-circuit television systems were employed to help patients read, said Curtis Keswick, chief optometrist at the Veterans Administration hospital in Palo Alto, where 30 patients are using LVES. “This could be the next big break,” he said.

Comparing LVES to traditional types of low-vision aids is “like comparing a crutch to a motorized wheelchair,” Massof said.

Future versions of LVES will have automatic focus and weigh 20% less, Blankenship said.

Visionics expects to sell LVES to 5% of low-vision patients in markets where the device is being distributed--an estimated 90,000 people in all, Blankenship said. As insurance companies begin to cover the cost of LVES, the market will expand enough to drive the price down into the more affordable several-hundred-dollar range, he said.

“The ultimate goal is for every low-vision patient to get one of these,” Blankenship said, “just like you get a pair of glasses to improve refractive error.”

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Sight for the Blind

The Low-Vision Enhancement System (LVES) manipulates a normal beam of light to make images visible to a legally blind person. The goal is to magnify the image and increase its contrast to help low-vision patients make out details such as words and facial expressions. With LVES, vision is equivalent to viewing a five-foot-wide TV screen from only four feet away.

1. Light enters a head-mounted device through three frontal cameras and travels down a cable into a portable battery box. There, the signal is manipulated to increase the picture’s contrast. The image is sent to two cathode ray tubes, one in each of the temple arms. The tubes, which are three inches long and less than an inch across, act like tiny black-and-white televisions.

2. The image shoots out of the cathode ray tube and passes through a series of lenses. Three of them are standard, and another custom-made lens can be added to account for the user’s eyeglass prescription. By adjusting the spacing of these lenses, the image is magnified and made less fuzzy.

3. The light bounces off three mirrors designed to align the image so it travels directly into the user’s eye. One of the mirrors is curved to further magnify the image and bring it into focus, the way a shaving mirror makes your face look bigger and clearer.

Source: Visionics Corp.