Junaid, 14, is slim and handsome, with straight white teeth, a shock of black hair, and thick eyebrows. Although there is no history of blindness in his family, Junaid and two of his six siblings in Delhi, India, were born sightless. The local school could not accommodate Junaid, so he grew up a virtual prisoner within the four walls of his poverty-stricken family’s tiny home.
If not for an MIT initiative created and led by Pawan Sinha, associate professor of brain and cognitive sciences, Junaid’s world would likely have remained a milky, formless morass of shadows and light. His parents, like thousands in India, could not afford — and most likely did not know about — a simple operation that would improve Junaid’s vision.
Sinha’s Project Prakash (“light” in Sanskrit) meshes humanitarian and scientific missions to identify, treat, and help rehabilitate children such as Junaid. In the process, it offers unprecedented glimpses into the workings of the human brain.
“For many scientific enterprises, the societal benefits are realized long after the research effort. However, in rare instances, even the process of conducting research directly benefits people’s lives. Project Prakash is, I believe, one such instance,” Sinha said.
Junaid is one of more than 1 million blind children in India, which has the highest population of blind children in the world — and an incidence rate that is more than three times that of the U.S. and Europe. Adding to the estimated annual economic loss to the country of $10 billion is the human tragedy that 60 percent of all cases of childhood blindness in India are preventable or treatable.
Sinha’s motives are twofold. As a scientist who studies the brain and perception, children who acquire sight at ages 5, 10, or older present a unique opportunity. Using simple behavioral visual tests and brain imaging techniques to noninvasively assess the spatial distribution of children’s brain activity before and after the operation, he records evidence of how the brain rearranges its use of neurons to respond to new external stimuli. Among the questions he hopes to answer: How soon after sight is restored do different object perception skills emerge? What are the intermediate stages on way to acquiring proficiency on different visual tasks? Are some skills, such as face detection, innately present?
While scientists have long known that in animals, temporarily depriving one eye of vision soon after birth causes permanent blindness, Sinha is finding that the children in Project Prakash present a more optimistic picture. Why, he wonders, do children such as Junaid, sightless from birth, see so well after being deprived of visual stimuli during a critical period of development? The answer will likely reveal important insights about human brain plasticity.
Project Prakash results might reach beyond blindness and benefit children closer to home. Recent findings from the project have tied unexpectedly into hypotheses about underlying sensory processing issues related to autism. Sinha’s ongoing research on autism is funded by the Simons Foundation created by 1958 MIT alumnus Jim Simons.
Looking beyond the scientific goals, on a personal level, Sinha, who was born in New Delhi, wants to help as many blind children as possible. Project Prakash was instrumental in petitioning the Indian Supreme Court to pass a writ requiring children in schools for the blind to be screened to ensure that their conditions are not treatable.
Sinha along with Yuri Ostrovsky, Ethan Meyers, and Aaron S. Andalman, MIT brain and cognitive sciences graduate students, and Ming Meng, a post-doctoral fellow, have traveled to India eight times in the past few years, braving 120-degree heat waves and bouts of intestinal illness to seek out blind but treatable children through hospitals in many parts of the country. Several more such trips are planned.
To reach out to remote villages lacking modern medical care, Project Prakash has initiated a series of rural eye-camps in which medical personnel screen kids for the light sensitivity that indicates they may be candidates for treatment. Through eye-camps and other means, Project Prakash has screened more than 1,000 children and provided treatment ranging from glasses to surgery for about 200. Sinha hopes to outfit a van with a satellite hookup that would allow doctors in Delhi to remotely interact with prospective patients hundreds of miles away.
In 2005, Project Prakash paid for two surgeries that removed the cataracts and implanted small flexible lenses into Junaid’s eyes.
“Junaid noticed a marked improvement in sight after surgery,” Sinha said. “He can now recognize people and things and can move around, inside and outside the house, on his own. I also noticed a dramatic improvement in his demeanor; he now looks much happier and smiles more readily.”
But Junaid’s struggles are not over. Having never been to school, he cannot keep up academically with other students his age. His parents cannot afford a tutor.
In addition to expanding outreach efforts and keeping tabs on post-operative healing of Project Prakash patients, Sinha said the initiative — in concert with the Indian government and nongovernmental organizations — needs to get its patients access to education after their vision is improved.
“We need to provide special education training to schools, and also work with governmental agencies to enact policies to mandate the availability of special education facilities in all schools,” he said. “An effort as far-reaching and complex as Project Prakash can only succeed through a broad-based collaboration across multiple institutions.” In addition to MIT, the current Prakash team includes members from the Indian Institute of Technology, Delhi; the Shroff Eye Hospital in Mumbai, India; and the Mahajan Imaging Centres, based in New Delhi.
Sinha knows that his plans are ambitious, and that change will be agonizingly slow. “We don’t know how far our efforts will succeed,” he said, “but some things are beginning to move. Slowly, but surely, Project Prakash is bringing light into children’s lives.”