PRIMA Chip Offers Stargardt Disease Patients New Hope for Restoring Sight

Imagine losing the ability to read a word or recognize the face in front of you, then regaining part of it thanks to a chip no larger than two millimeters. That is what happened to the first Stargardt disease patient to receive the PRIMA chip developed by Science Corporation. The news was announced by the company's CEO, Max Hodak, co-founder and former president of Neuralink, at TechCrunch Disrupt. The announcement is more than a medical milestone. It is part of a broader vision for the future of brain-computer interfaces.

What Is Stargardt Disease?

Stargardt disease is an inherited eye disorder that gradually destroys central vision. It targets the outer layer of the retina, where light-sensing photoreceptor cells die off over time, while the inner layer responsible for relaying visual signals to the brain may remain intact. Patients develop a blind spot at the center of their visual field that grows larger over time. An estimated 150,000 people worldwide have lost their sight to the disease, and there is currently no cure.

How Does the PRIMA Chip Work?

The idea is to replace damaged photoreceptor cells rather than attempt to repair them. The process involves two stages:

• Surgical implantation: A procedure lasting about an hour in which a tiny chip is placed at the back of the eye, where the photoreceptors have been damaged.
• Smart glasses: The patient wears glasses equipped with a camera that captures the surrounding scene and transmits it to the chip.

The chip acts as an artificial photoreceptor, converting the incoming image into electrical signals that pass through the healthy retinal cells to the optic nerve and on to the brain. Hodak sums up the principle this way: to the brain, vision is nothing more than electrical activity traveling along the optic nerve. If you can stimulate that nerve to send the right signals, you can give the brain the ability to see.

Early Results: A Letter, Then a Word

The patient received the chip in May as part of an ongoing clinical trial at Sydney Eye Hospital in Australia. In the first rehabilitation session, the patient was able to see a letter. By the second session, they could read an entire word.

That vision, however, is limited. The current chip measures just two millimeters by two millimeters, and Hodak likens the experience to looking through a straw. The image is black and white and covers only a small patch at the center of the visual field, but it is sharp and high-contrast, allowing the patient to read a few letters at a time.

Notably, PRIMA is already commercially available in Europe for patients with geographic atrophy, an advanced stage of age-related macular degeneration. The company believes the same technology can be applied to other conditions, starting with Stargardt disease.

Next Steps: A Wider Field of View and Higher Resolution

The company is working to overcome current limitations along two fronts:

• Enlarging the chip to widen the field of view, while accounting for the curvature of the eyeball, a complex engineering challenge.
• Shrinking the electrodes to approach the level of detail provided by a natural eye.

Hodak expects the next generation of the chip to enter human trials within the next year, and visual acuity to approach normal levels within five years.

The Retina as a Gateway to Brain-Computer Interfaces

The company views the retina as part of the central nervous system, which is why it considers cochlear implants, motor prosthetics, and retinal prostheses to be different types of brain-computer interfaces. Hodak's vision extends beyond controlling computers to a wide range of medical applications.

Hodak founded the company in 2021 after leaving Neuralink, with the goal of developing advanced neural engineering technologies. He chose to start with vision restoration to prove the effectiveness of the company's approaches and build a sustainable business model before expanding.

On the brain front, the company is developing a sensor implanted inside the skull that rests on the surface of the brain, unlike Neuralink's device, which is inserted directly into brain tissue. Potential applications include:

• Treating a widely known neurodegenerative disease that the company has not yet named.
• Compensating for brain regions damaged by stroke by connecting deep areas of the brain in ways that conventional electrodes cannot.
• Monitoring neural activity in patients with brain tumors.

Toward Longer, Healthier Lives

Hodak believes many people will eventually need some form of brain-computer interface, not at 40 while in good health, but when they reach 60 or 70. He describes his company's goal as extending healthy years of life, not simply extending lifespan. Its long-term mission is to understand how the brain produces the mind and to learn how to build engineered brains.

These ambitions remain long-term, but a patient who had lost central vision reading an entire word after just two rehabilitation sessions is a tangible step worth following in the evolution of neurotechnology.

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