Vision Restoration to People with Long-Term Blindness Using the Brain-Computer Interface Technology: A Sociotechnical Research Framework to Improve Usefulness for Users.

Invasive and non-invasive brain-computer interface (BCI) represent a promising technology for treating various diseases and disabilities. BCI-based invasive solutions also include visual prostheses. Currently, there is rapid development of cortical prostheses and bold statements, eg, about the potential of Neuralink's experimental neuroprosthetic Blindsight to restore vision. However, questions arise about the usefulness of such solutions for people with long-term blindness, considering other compensatory aids and referring to the empirical basis of cases where vision has been successfully restored surgically in the past. These cases reveal that biological restoration of sight does not guarantee functional vision. Moreover, technological limitations, such as low-resolution phosphene-based vision, individual variability or postoperative complications, reduce usability and usefulness for potential users. Therefore, we draw on literature on visual prostheses, documented cases of vision restoration, and employ a sociotechnical approach used in design science to discuss aspects that influence the usefulness of the vision restoration to people with long-term blindness, with emphasis on cortical prostheses. This approach emphasises the need to include or inscribe social values into designed BCI solutions to reveal what people with blindness need and what can be achieved with current technology. Research on user values and needs must shape the visual prostheses design, and their functions must be helpful to the user and synergistically complement his or her sociotechnical context (eg, interacting with other used aids and smart environments, or supporting needed social skills). Sociotechnical research can guide iterative design, improve future user acceptance and adoption, align prosthetic development with real-life needs, and prevent users from reverting to life with blindness due to cognitive overload or poor functional adaptation. Thus, we call for systematic and long-term sociotechnical research, which is lacking in this area. For this purpose, a relevant sociotechnical research framework and future research agenda are presented.