Tech & Science Maybe We Shouldn't Go Bananas Over Smart Contacts Just Yet

03:55  17 january  2020
03:55  17 january  2020 Source:   gizmodo.com.au

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a close up of a hand: Image: Mojo Vision© Image: Mojo Vision Image: Mojo Vision

Imagine plopping a contact lens in your eye, and instead of just seeing better, you could see an enhanced view of your environment. That’s what Mojo Vision is saying their new prototype smart contact lens could do. Eventually. It sounds like a concept straight out of a sci-fi movie. But whereas anything is possible in fiction, real life has very real limitations—and there’s a lot of questions Mojo Vision has to answer before anyone should get excited over smart contacts.

Mojo Vision’s aim is noble. Its first prototype is designed to help people with low vision via a teeny, tiny, 14,000 ppi display. It also includes sensors to help detect motion, as well as a radio to interact with a wearable device or smartphone. Write-ups of demos shown at CES note that a fully working product might help someone with low vision see in the dark. But helping to solve a medical necessity isn’t the only thing that has tech media hyped about this particular product and smart contacts in general. It’s the idea of an invisible computer that you plop into your eye that could act like a pair of smart glasses.

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We’ve gone into great detail about the hurdles facing smart eyewear at Gizmodo, and many of those same problems apply to smart contact lenses. That said, there’s another element to contact lenses that deserves much more scrutiny: the fact that contacts have to sit directly on your eyeball. That has major health implications. Ask any friend who uses contact lenses, and you probably know someone who isn’t the best at taking them out every night or making sure they’re properly disinfected. Hygiene aside, there’s a lot of questions in the wearables space right now as to how effective these gadgets are as medical devices.

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Mojo Vision’s prototype is a hard scleral lens, which is not the same as the soft lenses you’re more likely to be familiar with. It’s a special type of contact lens that rests on the sclera or the white part of your eye, and is used to treat various eye conditions. Mojo Vision told Gizmodo via email that one reason they picked a scleral lens is it “touches fewer nerves and is very comfortable because it is custom-fitted to the shape of your eye.” It also provides stability that a soft lens doesn’t. Another benefit: Hard lenses aren’t disposable in the way soft lenses are, which is a good thing if you’re going to shell out for expensive technology.

This is well and good if you’re someone with low vision. But for the average, healthy person it’s not quite as simple, convenient, or easy as you’d imagine for a futuristic Google Glass replacement.

“Scleral lenses are incredible medical devices that are used for patients who have corneal disease, irregular astigmatism, or severe dry eye,” Dr. Suzanne Sherman, assistant professor of optometric sciences at Columbia University Medical Centre, told Gizmodo over the phone. “While they are incredible devices, they can be cumbersome. You need a certain solution—saline—to be put into the bowl of the lens. You need certain care products to take care of it. It’s more challenging to insert.”

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Dr. Sherman went on to explain that scleral lenses are a valuable medical tool, but the average person wouldn’t be likely to prefer them. In addition to requiring a certain level of skill to insert or remove, they must also be properly fitted or a patient could experience some serious problems. If you were a tech-savvy first adopter, you might assume you could just pop out to a Duane Reade and buy some multipurpose solution for your smart contacts. But the reality is using the wrong solution could result in a toxic reaction.

Furthermore, scleral lenses need to be handled delicately. Patients can only wear them for a limited number of hours per day. The lenses also need to have the highest level of oxygen permeability, and shouldn’t complicate previous surgeries. You’d also have to visit your eye doctor regularly to ensure that everything was going well and nothing was worsening. That’s a big ask for consumers who, by and large, have told tech companies with their wallets that they don’t need something like smart glasses just yet.

There are other concerns with smart contacts. In the case of Mojo Lens, is it really wise to have a device projecting light directly into your eye for extended periods of time? It’s hard to say because Mojo doesn’t yet have a working prototype. It’s likely a factor the startup is considering as it develops its product. Dr. Sherman noted that there are precautions about how much direct light should be shone into an eye. For instance, you have to take precautions with tools such as lasers, but also natural light and artificial light from screens. Even the sun can cause permanent damage if you stare at it too long. Have there been rigorous studies done on how AR projections from smart glasses and smart contact lenses may impact eyesight over time? Probably not, considering how nascent the technology is. (But there absolutely should be before a consumer sticks one in their eye.)

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The issue of heat also raises some questions. Mojo Lens clearly has a battery component—after all, the company says you have to charge and disinfect the lenses every night. Batteries mean heat. The lenses will also charge via wireless induction, and if you’ve ever used wireless induction chargers...you know products can get hot. On that front, Mojo Vision says its target power for the lens is 1 milliwatt and that heating or thermal impact should be minimal. The company also says it’s aiming to work within FDA guidelines to ensure the device meets thermal limits for implantable or near-body devices.

But that doesn’t answer the hygiene aspect of contact lenses. Most friends I know, and some Gizmodo staffers I’ve polled, are an eye doctor’s worst nightmare when it comes to contact lens care. And while it’s really up to an individual to be diligent about how they treat their eyes, it’s also easy to get addicted to technology and the never-ending stream of information. It’s also easy to take shortcuts when it comes to properly disinfecting contact lenses the way your eye doctor would recommend. And because you can sleep in soft contacts and get away with it for a long stretch of time, many—though not all—of us have been lulled into a false sense of complacency. Part of that problem is that it’s easy to forget your eye is an actual organ.

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“You wouldn’t have a device for sale on the market to wrap around your liver, your heart, or your other organs just for fun,” Sherman said. “We often forget sight is an incredible thing, but we have to be careful. We forget that contacts are a medical device. If your heart doctor says, ‘Wear this device for 12 hours max, no more,’ you wouldn’t wear it for 15 hours. But with eyes, people do.”

While smart glasses present a unique cultural issue with regard to privacy, the fact that they are quite visible and easily removed might be a reason why they’re preferable to smart contacts. “This [Mojo Lens] sounds like a pretty incredible product, and if there were no risk—like with the Google Glass where you put it on and it wouldn’t actually touch your eye—it would be awesome, “ Sherman said. “It’s just there’s a lot more risk and more to wearing contact lenses than most people realise or even want to acknowledge.”

That’s not to say there is absolutely no use case for a smart contact lens. Mojo Vision is right to try and figure out a way that technology could help low vision patients. But that’s again, a medical necessity. In that case, the benefits are clear. But for mass-market consumers?

Ideally, Mojo Vision—and similarly minded companies—will invest in conducting rigorous clinical studies with the FDA, regulatory bodies, and the medical community. In an email, Mojo Vision noted it has three optometrists on staff and is partnering with industry experts in optometry, ophthalmology, low-vision science, medical software, clinical testing, and regulatory approval. However, the company noted that right now it is too early to comment or provide any information on a timeframe for feasibility studies and trials—something that feels like a red flag, given multiple reports stating Mojo Vision hopes to have something ready in the next two years.

Otherwise, this may yet be another case of technology moving fast, and medicine moving slow—a problem that plagues much of wearable tech that hopes to serve as medical devices (see also: the Withings Move ECG). Technological hurdles aside, however, it might do healthy consumers some good to really think whether the promise of smart contacts is worth the potential risks and uncertainties.

“The benefits have to outweigh the risks,” Sherman said. “For the average healthy person, I don’t think the benefits outweigh the risks.”

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