When the Eyes of the Blind Are Opened

"Never since the world began has it been heard that anyone opened the eyes of a man born blind," the beggar whose eyes were opened by Jesus told the Pharisees (John 9:32, ESV). He was healed more than you know.

Just as Jesus took mud and placed it on the man's eyes, in the last 2000 years we too have dug into the earth and taken God's good, natural, created world. We've studied it and used the creative minds God gave us in his image when he formed us out of clay. And we've figured out how to open the eyes of others born blind.

There are, of course, many causes of congenital blindness, and one of the most treatable is cataracts. In the U.S. and most developed western nations, such cataracts are removed shortly after they're diagnosed—at birth. Similarly, scarred corneas can be replaced. But globally, treatable forms of blindness go untreated. In India, for example, cataracts account for about 60 percent of cases of blindness, which affects about 1 percent of the population (3 times higher the rate of the U.S.). Less than 20 percent of India's cataracts are treated.

Pawan Sinha grew up in New Delhi, but it wasn't until he'd studied at University of California, Berkeley, and MIT and returned to India at age 35 that he was struck by how many Indians were unnecessarily blind.

Like many other computer scientists at MIT, Sinha has a keen eye for problems and possible mathematical solutions. He once fell asleep during a presentation at an academic conference and dreamed of writing the Bhagavad Gita (a key Hindu sacred text) on a grain of rice. When he woke up, he started calculating how small the text would have to be. Six years later, he and his research associate (and wife) created a five-millimeters-square tablet of the entire text of the New Testament. The letters are about as large as red blood cells.

Sitting in the waiting room of an Indian medical clinic a year later, Sinha considered a blind boy and his impoverished parents. "We don't do free surgeries," the clinic doctor told Sinha when he asked if the boy's cataracts would be removed. Sinha considered the dozens of other blind and begging children he had seen on this visit home.

"I realized that if I were to try to do something just on a personal scale, I would be able to provide funding for the surgeries of a handful of these children, which would be satisfying but would not really begin to make a dent in the larger scope of the problem," he later told the American Psychological Association's Monitor on Psychology. He continued:

And that's when I realized that the scientific question I'd been struggling with found almost a perfect approach in the treatment of these children. If you have a child who's, say, 10 years old, who has been blind since birth, and in this child you are able to initiate sight, then you have an unprecedented opportunity to examine visual development, right from point zero.

Once I had that realization, then the path forward became reasonably clear. As a scientist I know how to define a scientific problem and how to approach scientific grant-making bodies. So I could describe to them the humanitarian crisis and the scientific benefits to be derived by addressing this humanitarian crisis.

It worked. Funders came on board, and so far Project Prakash (prakash means light in Sanskrit) has helped more than 440 children who were born with cataracts to see. Sinha's surgical partners make a small incision in the cornea—about half the length of his microscopic New Testament—and insert a lens that costs about $1.50. That's it—in terms of fixing the eye itself. (Project Prakash has treated another 1,400 children nonsurgically.)

But turning the eyes on, it turns out, is the easy part. Teaching the brain to see, to make visual sense of the world, to distinguish between objects and to gauge their distance is difficult and complex—and increasingly so as we age.

'The World Looks the Same'

Yuri Ostrovsky, one of Sinha's research associates, remembered how, in the early days of the project, they eagerly awaited the moment when the childrens' bandages would be removed and they would be able to use their eyes for the first time.

"We got ready for that moment, and we asked them, 'How does the world look now?' And they said, 'Pretty much the same,'" he told MIT Technology Review. "That was a little surprising and maybe, in some ways, a little bit of a letdown."

Sinha's research is shaping our understanding not just of how we see, but of how we learn, how our brains work, how autistic children process information differently, and how computers can process visual data. One day, it may help adults blinded from birth to be able to process visual information once their eyes are healed. But for now, that's extremely rare.

In a major study published in 1971, one ophthalmologist concluded that "the number of cases of this kind over the last 10 centuries known to us is not more than 20." In his research, he focused on six cases of people who surgically recovered sight after long-term blindness. Two healed after a few years were elated. Two blind for 20 to 40 years, but who had experienced many years of normal vision before going blind, took a long time to reintegrate their ability to see. Eventually, with much effort and after significant bouts of depression, they relearned how to view the world. But two patients blind from infancy were never able to use their eyes well, even after gaining the ability to see. They continued to act blind—and needed more help than before they had sight.

"An infant merely learns," Oliver Sacks wrote in a 1993 The New Yorker profile of a man who gained sight after being blind since childhood. "A newly sighted adult, by contrast, has to make a radical switch … [that] flies in the face of the experience of an entire lifetime."

In 1690, John Locke's An Essay Concerning Human Understanding reflected on a question from fellow philosopher William Molyneux: if someone born blind can feel the difference in shapes, like spheres and cubes, and then he were suddenly given the ability to see, could he tell which was the sphere and which was the cube? Molyneux (whose wife was blind) and Locke thought not. Sinha's research demonstrated that they were right. But children given sight got much better at the experiment, some within a week. Viewing an entire visual field, however, is much more difficult. Where does one object begin and another end? Is a shadow an object?

In the case of Virgil, the man profiled by Oliver Sacks, "in this first moment he had no idea what he was seeing," Sacks wrote. "There was light, there was movement, there was color, all mixed up, all meaningless, a blur. Then out of the blur came a voice that said, 'Well?' Then, and only then, he said, did he finally realize that this chaos of light and shadow was a face—and, indeed, the face of his surgeon."

But Virgil's experience reflected so many similar journeys, Sacks wrote. "After an initial exhilaration, a devastating (and even lethal) depression could ensue."

"Individuals who recover sight after prolonged blindness battle severe mental health problems," an MIT profile of Sinha notes. "Some threaten to tear out their eyes or simply continue to act blind. Some are so depressed they commit suicide."

Sinha hopes his work can one day help adults like Virgil. The brain is much more "plastic" (able to change) than earlier thought, he said. He's seen significant visual progress in teens and even one 29-year-old.

Jesus' Real Miracle

So far there are no cases like that of the man in John 9. When Jesus healed him, he didn't just heal his eyes. He also gave him the ability to see the world clearly. He changed the man—body, mind, soul, and spirit—as Jesus said, "so that the works of God might be revealed."

Jesus radically changed both the man's eyes and mind so that he could see the world immediately and clearly. He did not simply "open the man's eyes." He rewired his mind and gave him the world.

Still, I find it interesting that even in the midst of revealing light, color, shape, and perspective to the man born blind, Jesus only revealed himself gradually, like those Indian children whose minds have to learn how to see the world for the first time. To his neighbors, the newly-sighted man said, "the man they call Jesus" healed him. Then when the Pharisees start debating, he says, "he is a prophet." Then, after the Pharisees started yelling, he raised it to "he is from God." As the pressure grew, his understanding grew. It wasn't until the Pharisees threw him out of the synagogue that he finally, for the first time, saw Jesus. "Do you believe in the Son of Man?" Jesus asked. "You have seen him, and it is he who is speaking to you."

John records the man's immediate response (v. 38): "He said, 'Lord, I believe,' and he worshiped him."

Ted Olsen is news and online managing editor of Christianity Today and editor of The Behemoth.

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