User:Starstriker7/Project Prakash

Project Prakash (Sanskrit for light) is a 501(c)3 non-profit organization founded in 2004 that identifies and provides medical treatment to individuals with conditions of reversible blindness and visual impairment in regions of limited medical access, particularly in northern India. The project lead is Pawan Sinha, a professor of vision and computational neuroscience at the Massachusetts Institute of Technology in Cambridge, Massachusetts. Research associated with the treatments done by Project Prakash has contributed empirically-grounded evidence towards solving the Molyneux Problem and has proposed evidence that the Müller-Lyer and Ponzo illusions are innate misconceptions.

Intent
As published in the peer-reviewed scientific journal PLOS Biology, the intention of Project Prakash is dual in nature. The organization’s humanitarian goal is to provide services to curably blind children who would have otherwise been untreated; its scientific goal is to longitudinally characterize a population of previously-blind human children to provide insight on the nature of neuroplasticity. The ultimate scientific goal of Project Prakash is to characterize the nature of the visual cortex’s adjustment to restored vision. In support of its humanitarian efforts, Project Prakash has also promoted tolerance and awareness of blind children in India, and has generated materials to assist the transitions of formerly blind children into the existing local educational infrastructure. As part of Project Prakash’s work, camps across rural portions of India are staffed by optometrists, ophthalmologists, and healthcare workers for the purposes of screening individuals who may benefit from surgery. Examinations for refractive errors, eye infections, congenital cataracts, and scarring caused from corneal damage were undertaken. Good candidates are sent to New Delhi for more intensive examination that includes ophthalmoscopy, ultrasounds, and generalized health assessments; the surgeries themselves are then scheduled in consultation with the guardians of selected children. The children then return periodically for checkups. The costs (approximately $300) are covered in full by Project Prakash. In 2013, Sinha described a desire to establish the “Prakash Center for Children” to consolidate the research, educational, and medical efforts into a single facility.

History
In 2002, after returning from India, Pawan Sinha applied to a grant from the National Eye Institute (of the National Institutes of Health) to fund correctional surgeries in India. Sinha then facilitated a collaboration with Dr. Shroff’s Charity Eye Hospital (SCEH) in New Delhi. Having secured the facilities and resources necessary to continue the project, the project was labeled “Project Prakash” after the Sanskrit word for “light”. The project launched in 2004. Two dominant varieties of treatable blindness have been identified in Indian children: cataracts and corneal opacities. By 2013, Project Prakash had screened 40,000 children and provided treatment to 1,800 of them (400 of them surgically) for these and related conditions. Nearly 500 children had been treated by October 2015. The project was featured in the New York Times in 2011 for having substantively addressed the Molyneux Problem, which questioned whether or not a newly sighted individual would be able to visually identify what had previously only been haptically distinguishable. A wider scope of its research was featured in a Science magazine issue released on October 23, 2015. As part of the work done on the project, Pawan Sinha was awarded the 2014 Pisart Vision Award by Lighthouse International, He was also selected by the Asia Society in 2014 for the Asia Game Changer Award alongside ten other individuals. Sinha has spoken on Project Prakash’s work as part of the TED conferences.

Behavioral studies
Previous studies done on cats and monkeys had previously led to a widely accepted conclusion that – due to visual deprivation – it would most likely not possible for humans to recover vision after a critical age between 6 and 8 years old. This work justified the Nobel Prize in Physiology or Medicine in 1981 to David Hubel and Torsten Wiesel. Project Prakash has since challenged this notion and has re-opened this regime and field for discussion. Studies characterizing the nature of the neuroplasticity are enabled via Project Prakash to examine a subset of subjects previously inaccessible for study. The only equivalent entities in the newly-sighted population from amongst the normally-sighted population are newborn children; due to operational and ethical constraints, it is not possible to reliably and reasonably retrieve high-fidelity responses from among this population. The subjects’ periods of adjustment following operation have been scrutinized across a number of different lines of research. A study associated with the Sinha Lab concluded – contrary to the results of previous studies – that individuals suffering early-onset blindness (starting up to 6 months of age) and who lacked treatment across an extended period of time were still able to make marked improvements in contrast sensitivity, although not to the degree of that of a normally-sighted person. Another study attempted to characterize whether (and if so, how) experience shapes the human ability to spatially understand their surrounding environment by studying ten newly-sighted children that underwent surgeries through Project Prakash. The study concluded that there was a strong correlation between experience and spatial imagery capabilities, and noted that there did not appear to be an age-critical period substantially limiting the learning ability of individuals in the tested age range (up to 22 years of age).

Ponzo and Müller-Lyer illusions
Another study pubished in Current Biology examined the susceptibility of newly-sighted children from Project Prakash to the Müller-Lyer and Ponzo illusions, misconceptions surrounding the lengths of lines thought to be attributed to experience as children learn to navigate three-dimensional space. The study discovered, conversely, that nine children examined within 48 hours of surgery demonstrated the same types of spatial misconceptions as normally-sighted children. The possibility of transfer of tactile experience was considered, but in light of other evidence demonstrating that a bridge in fact did not exist between the two modes of vision. This strongly suggests that these illusions do not arise from experience, but from a more innate mechanism.

Molyneux Problem
In 2011, as part of work done by Project Prakash, an MIT study investigated the Molyneux Problem. First posited in 1688 by William Molyneux to John Locke, the problem questioned whether not a blind person—suddenly able to see—would be able to immediately identify an object that they recognized previously only by touch. Previous experimental approaches in the 18th century did not rigorously describe the ability of a patient to see after an operation, or did not test soon enough after surgery to meaningfully describe the reactions of someone still unexperienced with vision. Five subjects in rural northern India—four boys and one girl aged from 8 to 17—underwent treatments that corrected the disorders (particularly cataracts and a cornea disorder) that had effected their blindnesses. Initially, every child had been able to perceive light, and two of them were able to perceive direction. However, none of the individuals had been able to sense objects. Their operations led to a vision correction to 20/160 (or better), sufficient to distinguish individual objects. The experiment itself entailed placing 20 small objects visibly on a table and providing the same 20 small objects underneath the table to be felt. The number of correct and incorrect matches were then recorded. The test itself took place within 48 hours of the patients’ operations. Although the children displayed no difficulty in matching objects identified by using only sight or touch, the subjects were only able to pair felt objects with seen ones about half of the time. They, however, became rapidly acclimated to the process in as little as five days, and exhibited accuracies exceeding 80% within three months. In light of this information, the MIT study concluded that the answer to the Molyneux Problem was most likely “no” because it was not possible for the experiment’s subjects to immediately identify by sight what they had previously recognized in a tactile sense. Furthermore, it was concluded that any innate connection linking one’s ability to visually and haptically identify objects was likely to be tenuous at best. However, the observed children rapidly acquired the skills necessary to make these connections, suggesting that the neural plasticity associated with vision does not subside after early childhood.