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From AR to Night Vision: What does the future of contact lenses look like?

In the not-so-distant future, the eyesight superpowers once confined to Marvel Universe characters could be available to us mere mortals. And it could all be as simple as wearing your daily contact lenses. We dive deep into the future of contact lenses—some of which are already ready for prime time.

The functionality of contact lenses is transcending imagination, with several companies making leaps and bounds with some seriously spylevel innovations on the horizon! Technology giants such as Samsung and Sony have investigated contact lenses that have their own cameras and can record video. Researchers from the University of California have even developed robotic contact lenses that can be commanded by blinking to zoom in up to 32%!

And how about ditching the night vision goggles for thermal-sensing or graphene night-vision contact lenses? The University of Michigan is studying this technology, which has useful applications in the military, as well as wildlife and conservation.

Beyond smart contact lenses

With the release of smart glasses, people had access to a world of information right in front of their eyes. But with smart contact lenses, they bring all of this information directly into the wearer’s visual field.

In addition to enhancing the sense of sight, smart contact lenses can also tell you, or your healthcare provider, all about your eye health! Upcoming technologies utilize an array of sensors, accelerometers and displays as part of the experience, and apply the technology to assess key features of your tears, providing real-time monitoring of salts, proteins, metabolites and enzymes. A big draw to this sort of healthcare is the prospect of continuous glucose monitoring and the impact this could have on a large portion of the population.

Dr. Yangzhi Zhu, an assistant professor at the Terasaki Institute for Biomedical Innovation in Los Angeles, California, whose work focuses on soft materials and wearable bioelectronics for diagnostic and therapeutic applications, has been watching the promises and pitfalls of contact lens technology over the years.

“Smart contact lens has evolved to serve as a wearable intelligent ocular prosthetic device capable of noninvasive and continuous monitoring of essential physiological and chemical biomarkers and therapeutic delivery for personalized ocular and systemic healthcare management,” Dr. Zhu shared.

However, before we all rush in to our optometrists demanding our superpowers, Dr. Zhu recognizes that from a practical standpoint, there are development hurdles that still need to be cleared before this technology can go mainstream.

“There still is a long way to go to achieve better practicability and even final commercialization,” he said. “For example, contact lens-induced dry eye and other symptoms are still a primary reason that stops users from using them.”

It would be a big step forward in healthcare if wearable technology could reliably monitor multiple aspects of patient health. But we need to make sure the results we receive are accurate.

While Dr. Zhu recognizes the potential benefits of smart contacts, he still has certain concerns regarding their biomedical applications. “For the contact lens biosensing system, we agree that it would create a huge success if we could use wearable tear tests to replace blood tests, because wearable tear analysis with smart contact lenses can achieve continuous and non-invasive monitoring of multiple essential biomarkers from the tear,” he explained. “However, the question is whether there is a robust correlation between biomarkers in the tear and biomarkers in the blood.”

He shared the example of Google’s smart contact lens project in 2014. “This project aimed to assist people with diabetes by constantly measuring the glucose levels in their tears. Later, Verily terminated this project because of the lack of correlation between tear glucose and blood glucose,” he said.

Such a lack of correlation could have severe consequences, especially for patients whose treatments would be based on levels indicated by their contact lenses instead of what their body truly required.

From AR to Night Vision: What does the future of contact lenses look like?

Are we ready for AR lenses?

Another avenue of research is augmented reality (AR) contact lenses, which promise to deliver a more immersive experience for the user without the need for glasses or cumbersome virtual reality headsets. These lenses overlay what you already see with messages, directions or other helpful details, eliminating the need to continuously check a smartphone or other device.

“AR, or human-machine interface, lenses have also received much attention in this field. Mojo was a new startup pioneering this technology due to their expertise in advanced micro-LED and macro fabrications,” Dr. Zhu shared, describing one company working with AR technology within a contact lens.

The prototype Mojo Lens (Mojo Vision, California, USA) included a 4,000-pixel-per-inch “screen” with onboard power and communications. Dr. Zhu noted some of the challenges companies like Mojo have encountered: “Integrating electronic components, user comfort, functional stability, transparency, biosafety, breathability, flexibility, and the cost of the lens, could be critical concerns,” he said.

Bear in mind that we are talking about a foreign body that users will need to insert into their eye. So understandably, they won’t pay thousands of dollars if it isn’t comfortable, or even worse, if it could be potentially harmful to the eye.

Although Mojo Vision’s Mojo Lens was thought to be near-ready for the real world in early 2022, the company has since pivoted, focusing more heavily on its micro- LED technology instead—putting lens development on the back burner (for now).

Drug-eluting contact lenses are here!

Patient compliance has consistently posed a challenge for optometrists. Although ODs may prescribe topical drops to be administered three times daily, they often must bear the consequences of patients only managing one or maybe two drops per day—if luck is on their side.

Imagine a world where there’s no need to pry pinched eyelids open in the hopes of getting a single drop of medication to reach the eye surface. What if the exact intended dose could be delivered by a contact lens? In fact, this is not a contact lens of the future—drug-eluting lenses are actually part of the here and now.

“A drug-eluting contact lens containing an antihistamine for people with allergic eye itch won approval from the FDA,” Dr. Zhu reported. “This drug-eluting contact lens with ketotifen (Acuvue Theravision; Johnson & Johnson Vision Care, Florida, USA) is the world’s first drug-eluting contact lens.”

He added that this has been a long time in development. “The concept of drug-eluting contact lenses is not new—it was reported as early as 1960. The current challenge, however, is to achieve a sustained, long-term drug delivery with zero-order kinetics at the normal physiological temperature, pH and salinity of the human eye,” Dr. Zhu explained. “Another concern is to find the practical unmet need of the drug-eluting contact lens, although we identify several advantages compared to eye drops.”

The future of super vision

Finally, we asked Dr. Zhu about the direction of all these developments and how he sees them breaking into healthcare and eye care delivery in the future. “Along with technological developments such as the miniaturization of electronics, the development of artificial intelligence, and the popularization of AR, increasing public interest in personalized medicine has been accelerating the development of smart contact lenses,” he shared.

“In this respect, it can be said that the smart contact lens, a ‘visible medical device’, has reached a crucial point more than ever and will play an essential role in the future,” he concluded.

Editor’s Note: This article was published in COOKIE magazine Issue 13.

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Dr. Yangzhi Zhu

is an assistant professor at the Terasaki Institute for Biomedical Innovation. He received postdoctoral training at the University of California, San Diego, in 2020. Before that, he obtained his PhD at the University of California, Riverside, in 2019. His recent work focuses on wearable medical devices for diagnostic and therapeutic applications.

[Email: yzhu@terasaki.org]

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