Neural Vision Restoration in Ophthalmology

Neural vision restoration is a rapidly advancing discipline at the intersection of neuroscience, bioengineering, and ophthalmology. This review synthesizes emerging strategies to restore visual perception through retinal prostheses, optic nerve and thalamic implants, cortical brain-computer interfaces (BCIs), optogenetics, and non-invasive stimulation. Although initial experiments have demonstrated primitive visual abilities such as light perception and motion detection, artificial vision remains cognitively demanding and fundamentally different from natural vision. Advances in artificial intelligence and machine learning may enable adaptive, closed-loop systems that optimize stimulation, enhance low-light vision, and integrate environmental inputs for more intelligible percepts. At the same time, a growing understanding of neural plasticity, cortical remapping, and perceptual learning highlights the need for multidisciplinary strategies in visual rehabilitation. Ethical and regulatory concerns, including informed consent, data protection, neural enhancement, and equitable access, remain central to responsible implementation. The potential of BCIs to bypass the eye entirely, and of neuroprosthetics to be used in spaceflight, disaster response, or military medicine, expands the applications of vision restoration beyond blindness alone. Bridging technological, clinical, and ethical strategies in this review outlines the challenges and opportunities that define the future of neural ophthalmology. Ultimately, restoring sight will require not only functioning hardware, but systems compatible with the reorganized brain and the lived experience of visual loss.