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tagscortical-prosthesis, visual-cortex, neuroprosthesis, vision-restoration, implant, brain-computer-interface, clinical-trial, regulatory

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Cortical Visual Prosthesis

Subcategory of visual-prosthesis — devices that interface the visual cortex (usually V1, sometimes LGN) to create artificial vision, bypassing the eye and optic nerve entirely. No cortical device is commercially available yet (Aug 2026); the field is clinical/preclinical. See cortical-visual-prosthesis-companies for the company schema.

How it works

  • Phosphenes: electrical stimulation of visual cortex elicits dots of light at positions corresponding to the retinotopic map; coordinated multi-electrode stimulation can impose recognizable patterns. The brain must learn to interpret the stimulation (“the brain has to learn how to interpret the electrical stimulation” — Janssen).1
  • Targets: V1 surface (Orion: 60 micro-electrodes on the surface of visual cortex, wireless IPG, belt processor + camera glasses, µamps-to-milliamps currents? — surface requires mA); intracortical/deep V1 (ReVision Occular: arrays up to a few cm deep, ~5x better resolution per Martin Bak’s data, currents tens of µA, >1,000 electrodes, resorbable-coating insertion); LGN (phosphoenix Fountain Probe — compact retinotopic relay, clinically accessible).2
  • Channel-count ceiling: 1,000–2,000 electrodes estimated necessary for useful real-world vision (face recognition, navigation); currently: 60 (Orion, human), 96 (UMH 2021 human), 1024 (monkeys), >1,000 (Occular, preclinical).1

Landmark evidence

  • Chen et al. 2020 (Science): 1024-channel Utah-array prosthesis in monkey V1+V4; phosphene locations matched receptive fields; simultaneous multi-electrode stimulation → monkeys recognized simple shapes, motion, letters. First principled demonstration of cortex-induced form vision.3
  • Berna Gomez (UMH Elche, Spain, 2021): 96 microelectrodes in visual cortex linked to camera glasses; blind 16 years; discerned object outlines, left/right gestures, played maze-like video games (6 months, frontoparietal? — in situ 6 months).1
  • Cortigent Orion EFS (2018–2025; results NANS Jan 2026): 6 subjects, 60 electrodes; all devices functional at 6 years; <4% electrode loss; all subjects improved on/off tests (square detection, motion detection); FLORA positive/mild positive all subjects; 1 early seizure (adjusted, no further SAEs); 4 devices explanted (3 at 3-yr visits, 1 at study end) per patient/study decisions.4
  • Optogenetics adjacent: Bionic Sight (NYC) combines gene therapy + neural coding head-mounted device (retinal, not cortical) — first patient dosed in Phase 1/2.

EU ecosystem (funded research & companies)

  • NeuraViPeR (CORDIS 899287; Shih-Chii Liu, UZH; Sep 2020–Feb 2025): ultra-thin flexible electrode strips (thousands of electrodes, ~4x thinner than a hair).1
  • HyperStim (CORDIS 101071015; Peter Janssen, KU Leuven; Nov 2022–2026): smarter stimulation patterns; aim ≥20x resolution beyond physical electrode count.
  • Companies: phosphoenix (NL, LGN), revision-implant (BE, Occular, V1 deep arrays), Cortigent (US), Monash Gennaris (AU, preclinical), Neuralink Blindsight (US, FDA Breakthrough) — see cortical-visual-prosthesis-companies.

Open questions

  • Deep intracortical arrays: lifetime (-), surgical access (human visual cortex is buried up to ~4 cm), insertion trauma; surface arrays: low resolution, high currents.
  • Encoding: static phosphene fields vs dynamic stimulation (Beauchamp/Yoshor showed dynamic stimulation improves form vision) vs feed-forward “visual engine” decoding.
  • Regulatory: no cortical device commercially approved; MDR in EU (ReVision FIH Q3 2026) and FDA (Breakthrough designations) are the near-term paths.
  • Long-term versus retinal: PRIMA already delivers reading; cortex promises universality but resolution/commerce gap remains (see visual-prosthesis).

References

  • Chen X, et al. Science 2020;370(6521):1191-1196. DOI 10.1126/science.abd7435.
  • Vivani Medical / Cortigent press release (NANS, Jan 29, 2026); Horizon Magazine (EU, 2023).
  • Bionic Vision spotlight: Frederik Ceyssens interview (2025).

Footnotes

  1. raw/articles/eu-horizon-restoring-sight-2023.md ↩ ↩2 ↩3 ↩4

  2. raw/articles/bionic-vision-spotlight-ceyssens-2025.md ↩

  3. raw/papers/chen-2020-shape-perception.md ↩

  4. raw/articles/vivani-cortigent-orion-nans-2026.md ↩

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