At the molecular level, there is real hope for gene manipulation and repair, and the distant hope that we will be able to prevent blindness or repair vision systems. Because this hope has so much emotional impact on individuals and families dealing with severe vision loss, it is unwise and unkind to hold this candle up too high. Cures are NOT just around the corner (in 2002). Many years and many scientific breakthroughs must occur before we can hope to eliminate vision (and many other) impairments. Yet one cannot help but see that we are moving in the right direction. Scientists can isolate genes for eye disorders, and can predict occurrence rates from family genetic histories. The revolution in biology and genetics will probably not give us the whole answer by itself, but with nanotechnology hope accelerates.

The discovery of stem cells and the subsequent application of stem cells to biological impairments is one of the greatest achievements in modern medicine. Stem cells are immortal as long as they get nutrients. They are "rare and primitive" cells located in every kind of tissue. They give rise to most (maybe all) of the other cells in the body. In general, they can do three things:

1. They can divide and make more stem cells.

2. They can give rise to multiple types of mature cell varieties

3. They can give rise to massive numbers of any specific kind of mature cell type.

There are two basic kinds of stem cells: embryonic and somatic. The embryonic stems cells can proliferate indefinitely (in culture) and can give rise to any kind of mature body cell, from heart tissue to brain neurons. Somatic stem cells are tissue specific, brain stem cells make brain tissue; blood stem cells make blood cells, etc.

At this stage of understanding (2002), embryonic stem cells are more useful medically than the somatic varieties. They can be genetically modified. Scientists are working to custom-make stem cells to be compatible with individual tissues to avoid rejection.

An example of biotechnology applied to the problem of blindness using stem cells made news in 1999. Badly scarred eyes cannot accept corneal implants, because there is no viable tissue upon which the new cornea can attach. When stem cells were implanted in scar tissue they created a living substrate for the new corneas. People who had been blind for most of their life suddenly regained usable vision. For a dramatic and thorough documentation of such a situation, see the personal notes of Mike May, the president of the GPS for the blind organization called the Sendero Group.

There will be many rapidly appearing intermediate "solutions" to blindness and vision impairment. I call these intermediate technologies "cyborg tools," because they involve the combining of body tissue with machines that think; human beings will become ever more sophisticatred cyborg creatures as time evolves. Just as rapidly as these intermediate tools evolve, they will merge with or be replaced by the next generation of cyborg tools, smaller, cheaper, better. Each generation faces a better future (but not without serious ethical questions).