Lieutenant Commander Geordi La Forge, chief engineer of Star Trek’s USS Enterprise-D and -E, was born blind and famously wore a visual instrument and sight organ replacement (VISOR) device in the science fiction television and movie series set in the 2350s. According to the Wikipedia page for Geordi La Forge, the VISOR scans the electromagnetic spectrum, creating visual input, and transmits the input to the brain via the optic nerves. The sensors are located on the front and attach to small input jacks implanted in the temples. It doesn’t produce normal vision, but instead allows the wearer to see energy phenomena invisible to the naked eye, including being able to see one’s heart rate, temperature, and monitor moods. This is impressive technology for just 3 centuries from now. But we already have the Argus retinal prothesis and even better iterations that are in clinical trials as we speak that approximate the capabilities of the VISOR, except for reading mood and heartbeat. So, what could be coming in 2020?

In Star Trek, during the Ba’ku incident, Dr. Beverly Crusher removes the VISOR to find that Geordi’s optic nerves had regenerated and he had gained normal sight due to the healing properties of the Ba’ku. That certainly would be nice, but I am not here to announce a research laboratory has cracked that riddle. However, in this issue, we do look at something that seems like science fiction — optogenetics.

Using viral gene therapy, genes encoding for light-sensitive ion channels (channelrhodopsins and other mammalian rhodopsins) are transfected into retinal cells, enabling the cells to respond to light in hereditary retinal degenerations. In preclinical models, blind animals respond to light stimuli and perform visual behaviors. In 2016, the first person with retinitis pigmentosa was injected with an AAV2 vector containing a gene encoding channelrhodopsin-2 (ChR2) by RetroSense. ChR2 is activated by blue light, meaning any infected retinal cells would respond to a particular wavelength of light. In 2018, GenSight Biologics injected GS030 using a modified AAV2.7m8 vector with a gene encoding for channelrhodopsin that responds to red light combined with a optronic visual stimulation device that captures visual information and amplifies the signals to the appropriate wavelength. Other companies are using optogenetics to treat pain, deafness, bladder control, and many other applications. There are doubtless many issues with these approaches, and I am sure we will learn all of them shortly, but the idea is amazing.

Interestingly, LeVar Burton, the actor who played Geordi La Forge, famously noted that he could see nothing with the VISOR on; so, a blind man in the Star Trek universe could see amazing things with the VISOR, but the actor was tripping over light stands, props, and cables on set. Whether optogenetics will allow a blind man to see, or simply fall flat, remains to be seen. RP