Modern Medicine

Amazing electronic glasses help the legally blind see, but they are costly

Andrew Zaleski, special to
Key Points
  • About 10 million Americans are blind or visually impaired. Each year this number increases by 75,000.
  • Smart glasses, called eSight3, help people suffering from eye conditions — such as Stargardt disease, optic atrophy, macular degeneration and glaucoma — to see.
  • The eSight3 glasses are costly, with a price tag of about $10,000.
  • Medicare and health insurance companies determine whether eyesight technology will be reimbursable or covered at all.
Why the price of sight for the visually impaired is too high
Why the price of sight for the visually impaired is too high

Gary Foster was in his 50s when his eyesight started to fail. The native Canadian eventually lost all central vision in both his eyes a few years ago as a result of age-related macular degeneration. Place a peanut on a table, and Foster won't be able to see it; if he turns slightly and uses his peripheral vision, he might catch a glimpse of it. He can't see people's faces or read text on a page. After he lost his central vision, he lost his license. After he lost his license, he lost his job, since it required him to drive.

"There is no cure. All I ever heard from the doctor is, 'Sorry, there is nothing we can do for you,'" said Foster, now 63.

But several years ago Foster happened upon a piece of technology at a public exhibition in Calgary. It was a pair of glasses called eSight, and when he put them on, he realized that his vision drastically improved, so much so that he could see faces and read books. "When I first put it on, I was able to read to the bottom of the eye chart," Foster said.

Foster is not the only visually impaired person turning to new technologies to either improve vision or assist with everyday tasks. A growing cohort of companies, like eSight, offer visual tools that can enhance vision — making things bigger, brighter and bolder so that they're able to be visible to people like Foster. Other companies, like San Diego-based Aira, connect people to real-time support services that — thanks to devices such as Google Glass — can see what the blind can't and navigate users interacting with, for example, a vending machine by talking to them over the phone.

Founded in 2006 by Conrad Lewis, a computer engineer with two legally blind sisters, Toronto-based eSight developed its own pair of proprietary glasses, backed by a decade of in-house research. The company keeps many specifics under wraps. According to communications director Jeffrey Fenton, eSight is "backed by tens of millions of dollars," and there are "thousands of stories that showcase" people using eSight.

The company released its latest pair of glasses, eSight3, last February. The glasses, which look like a visorlike headset, are rechargeable and good for eight hours on a single charge. Each houses a high-speed, high-definition camera that captures what the user is looking at. The device uses algorithms to enhance the video feed and displays the video through eSight's OLED screens in front of the user's eyes. Almost immediately, the cameras enhance the footage that beams across two screens, one in front of each eye. A 24-times zoom also helps out.

Source: eSight

The wearable headset has Wi-Fi and HDMI capabilities to stream digital content, and it can send pictures and videos. Each person who wears the glasses are able to control color, contrast and magnification.

The result is that many people who use the eSight3 today are able to read books and street signs, see objects from far away and know what their friends' and relatives' faces actually look like.

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Glasses like the eSight3 are good for people suffering from any one of about a dozen eye conditions, among them Stargardt disease, optic atrophy, macular degeneration and some forms of glaucoma. According to the National Federation of the Blind, roughly 10 million Americans are blind or visually impaired, and about 1.3 million of that number are legally blind, defined as central vision acuity of 20/200 or less in the better eye.

"It works for the overwhelming majority of the legally blind," Fenton said, who added that its oldest user is 97. The youngest user: four years old.

Footing the bill

The main problem with technology like eSight is the cost.

"There's still a major group of people out there who want but cannot afford the technology," Fenton said.

Foster purchased his own eSight glasses for $15,000 out of pocket. The eSight 3, the new version of glasses, costs less, with a price tag of $9,995. Paying for this kind of technology when you're blind can be difficult, as the costs are often not covered by health insurance.

"The technology becoming available is phenomenal, and most people won't be able to get their hands on it," said Mindy Jacobsen, first vice president of the National Federation of the Blind of New York.

Mindy Jacobsen, first vice president of the National Federation of the Blind of New York, is able to see using Google Glass and the linked Aira service.
Source: CNBC

Each year, the overall tally of low-vision or blind people in the United States increases by 75,000, according to the NFB. But 70 percent of working-age blind adults are unemployed.

Medicare and health insurance companies determine whether eyesight technology is going to be reimbursable or covered at all. Historically, most insurance companies have seen glasses as something different from the correction of a medical problem, according to Melissa Chun, director of the Vision Rehabilitation Center at the Los Angeles-based Stein Eye Institute. For example, prosthetics technology for a person with a missing limb is classified as durable medical equipment and is therefore covered by insurance. Vision-assisted equipment, almost universally, are classified as glasses, which are not covered by insurance.

"This technology is wearable tech and video magnification, really, a whole different route for people with low vision. And it's really more appropriate to call it vision-assisted equipment rather than anything else," Chun said. "It can be perceived as a form of discrimination, actually, if [insurance companies] don't cover vision-assisted equipment."

The one-time cost of equipment like eSight contrasts with other pricing models. Aira, founded in 2015 with $15 million in venture capital from firms including New York City's Lux Capital, employs 70 agents throughout the United States who are available daily from 7 a.m. to 1 a.m. EST who provide over-the-phone instructions to people with low vision or blind vision. Aira users pay for one of four monthly plans and then receive a pair of Google Glasses and an AT&T data plan.

"Users connect to an agent using the phone, and when they connect to the agent, they can yield the camera to the agent," said Suman Kanuganti, CEO and co-founder of Aira. "Our agent is literally living in the world of the blind person whenever a call is coming in."

But a basic plan through Aira costs $89 per month and only gets a user 100 minutes to speak to someone over the phone.

So far, Aira counts thousands of users and 3,800 hours of service over the last six months, Kanuganti said. He added that navigation comprises only 20 percent of all calls. "Users cook; they go to museums to get descriptions of the artwork. Someone read a children's book to a daughter. Someone went to his father's funeral using Aira," he said.

The NFB's Jacobsen demonstrated using Aira in a recent video produced by CNBC. Again, the main problem with Aira for many users is the cost. The Aira plan with unlimited minutes costs $329 per month. For someone who can only afford the basic, $89 package, they have to judiciously use the 100 minutes they receive every month.

We continue to believe that society could and should provide this to the blind at low or no cost.
Jeffrey Fenton
eSight's communications director

Bringing the cost down of making products for those with vision impairments is going to be a matter of scale, Kanuganti said. Companies like eSight, on the other hand, think it's up to large organizations — companies and the government — to be willing to employ people with vision impairments and pay for eyesight technology.

"We continue to believe that society could and should provide this to the blind at low or no cost," Fenton said.

His company has a financial stake in the matter, but it does put its money where its mouth is: About 20 percent of eSight's own workforce of 100 are legally blind.

Foster is one of those employees. He's been working at eSight for the last couple of years, demonstrating the technology at various events throughout Canada. Before he lost his central vision, he was a highways supervisor for Parks Canada in charge of coordinating jobs like snow removal and clearing major accidents from roadways that pass by the Yoho and Banff national parks in the western provinces of Alberta and British Columbia, respectively. He lost that job when he lost his vision, since it meant he could no longer drive.

While he's still not licensed to drive, Foster said the glasses effectively restore his central vision. He's now able to travel on his own, without his wife's help, and take part in his main hobby of carpentry.

"My wife has normal vision, and she doesn't even try to read prescription bottles anymore. She just hands them to me," Foster said. "It just made me completely independent again."

— By Andrew Zaleski, special to