James Kelm’s blindness has made many things tougher — the ability to walk into a bank, greet members of the Duluth church where he is a pastor, or watch favorite movies such as “Psycho” and “Driving Miss Daisy” with his wife.
But finally his degenerative vision, which he describes as a “persistent, medium gray,” made something easier. It was so bad that he was a shoo-in choice to be one of the world’s first recipients of a bionic eye implant.
After Kelm’s surgery this month, caregivers at the University of Minnesota Medical Center activated the device attached to his left eye this week to check what he could see.
“Rarely do we have the opportunity to really be a part of something that will change the world,” Kelm said Wednesday as he settled into an exam room chair to test the device for the first time.
Kelm, 53, has been legally blind for more than two decades, even though as a teen he was clearsighted enough to ride motorcycles.
A condition called retinitis pigmentosa eroded the retinal cells that produce contrast and color until, by age 30, he had no useful vision left. About 100,000 people in the U.S. have the degenerative eye disease — some suffering tunnel or limited vision, others complete blindness over time.
Kelm had given up on improvement until his sister read a year ago about the bionic eye made by California-based Second Sight. The device sends images from a camera bridged on the nose to a wireless transmitter surgically fitted around the eye. The transmitter sends images to an array of 60 contacts inside the retina, and they communicate corresponding amounts of light along the optic nerve to the brain.
The bionic eye isn’t restoring vision or repairing damaged cells. With the camera feeding images to the implant, it gives people sight whether their eyes are open or shut.
The implant is nonetheless a milestone, said Dr. Sandra Montezuma, the U ophthalmologist who operated on Kelm. “This is the first time ever where completely blind patients can see something.”
Kelm was skeptical at first. A martial arts instructor in Michigan at the time his sight was fully lost, Kelm said he stayed optimistic by being pessimistic about treatment. Assuming blindness for life, he learned to fight without sight — a strategy aided by making the first move so he could anticipate the countermove.
After moving to Duluth, Kelm, met a woman named Kimberly, whom he married seven years ago. On their first date, Kim drove from the Twin Cities to pick him up, only to have her car towed.
“Never trust a blind man to tell you where to park,” she quipped.
Now Kelm preaches at True Hope Church and is finishing a master’s degree in theology.
“I really had no expectation of anything ever changing,” he said, “because it was not part of my reality.”
Roughly 100 people have received bionic eye implants, including about 20 in the U.S. and patients at both the university and Mayo Clinic. The Food and Drug Administration approved a humanitarian exemption for the device in 2013, meaning it had been deemed reasonably safe to implant but that its effectiveness had yet to be proven.
The resulting vision is far from normal eyesight, giving patients such as Kelm the ability to contrast between objects of different colors or depths. Kelm’s hand in front of his face will appear as a bright geometric object.
“He could see a sidewalk on a green path or a silver handle on a blue door,” said Brad Kennedy, a clinical specialist for Second Sight.
With time and practice, patients such as Kelm learn to differentiate those objects, Kennedy said. “They have to train their brain about what they’re looking at.”
A long wait
Kelm had questions on Wednesday before Kennedy activated the implant, but no expectations of regaining the sight of his youth.
Just enough vision to increase the safety of his largely independent lifestyle would help, he said. “There are a lot of things that are not really accessible to the blind, so there’s a danger factor.”
On Wednesday, Kelm put on the frames — converted Oakley sunglasses — that placed the camera on his nose.
Kim squeezed her husband’s hand in anticipation as Kennedy prepared to test all 60 of the contacts, one at a time, to see if they produced bursts of light. Kelm’s sister closed in with a camera.
“I’ve waited a long time for this,” she said.
The first tests were of contacts at the periphery of vision, and at low strengths. There was prolonged silence.
“See anything there?” Kennedy asked.
“Uh, I don’t think so,” Kelm replied.
Minutes passed with similar indecisiveness until Kennedy activated a central contact.
“Whoa, I actually saw something there!” Kelm exclaimed. “That resembled light. That last one looked like a sparkler.”
Montezuma smiled at the progress. Someday, a better option might come along for Kelm. Research has already found evidence that Vitamin A and fatty fish oils can slow the progression of the incurable disease, but now scientists are examining whether stem cell transplants or gene cell therapy could heal damaged retinal cells.
“In the future, we could do those things for him,” she said.
The current bionic eye is crude — like the first cochlear implant compared with today’s sophisticated devices to restore hearing. But that didn’t diminish the excitement Friday — after two days of testing — when they switched on all 60 of the contacts in Kelm’s bionic eye at once.
Montezuma even brought her camera, wanting to document what happened.
Instead of one sparkler, Kelm was overwhelmed by a flashing movie marquee.
“Oh, boy, yup!” he exclaimed. “Whoa, that’s ... that’s startling.”
“All those lights are the people in the room,” Kennedy later explained.
“Holy …” Kelm said, then summed it up. “I feel like I’m outside of a strip joint or something.”
Kelm has a lot of learning to do. Certain movements like nodding create a nauseating cascade of swimming lights. Making sense of the obscure images he now sees will take training and practice. But Friday won’t be forgotten.
“Can you see me?” his wife asked, stepping in front of him.
“Yup, there you are right there,” Kelm replied.
Kim started crying and fell into the arms of a husband who saw her — even as a clump of lights and shapes — for the very first time.