Visual Field Redirection for Central Vision Loss: Passive Metasurface Design and Computational PRL Prescription

Overview

Central vision loss affects over 200 million people worldwide, arising from macular diseases including age-related macular degeneration, Stargardt disease, and diabetic macular edema. As central photoreceptors degenerate, patients develop central scotomas while peripheral vision remains intact. Current compensatory approaches, primarily eccentric viewing training, require intensive behavioral adaptation, leaving a critical gap for a passive, lightweight optical solution. This work presents a passive metasurface engineered to perform angle-selective visual field redirection, shifting central visual input toward healthier peripheral retinal regions. Using adjoint-based topology optimization with finite-difference time-domain simulation, a subwavelength unit cell is designed to maximize directional transmission toward prescribed target angles. Multiple design strategies are evaluated for steering robustness, angular sampling density, and generalization beyond trained directions, including a scalable multi-zone framework derived from pupil-intercept geometry for full-aperture coverage. Simulations demonstrate consistent angle-dependent beam steering aligned with the intended visual field transformation, supporting feasibility of embedding passive metasurfaces into eyewear as a power-free solution for central vision loss patients. Additionally, Novea is an integrated software system providing the first quantitative, patient-specific PRL prescription framework, scoring candidate fixation loci by jointly optimizing retinal health, acuity falloff, and task-specific visual demand. Combining a digital Amsler grid diagnostic tool and a physics-based PRL optimizer, both developed as part of this work, Novea delivers a complete diagnosis-to-prescription workflow outputting patient-specific angular prescriptions applicable to both metasurface device specification and eccentric viewing guidance. Clinician-reviewed and structured for early clinical validation, no equivalent pipeline exists in current clinical practice.

Competition history

• CSEF 2026 Medicine & Physiology (Track 2) (Senior Division) · Entry S-21-24

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