Pathways: Prof. Lauren Ayton’s Journey from the Clinic to the Future of Sight Restoration

Interviewer (Lily Turkstra): Thank you so much for taking the time to speak with us, Prof. Ayton. Could you give us an overview of the path you took to where you are today, and share what drew you to the field?

Prof. Ayton: My interest in vision was actually very personal. I grew up with two brothers who had vision problems: one had amblyopia, which was easily managed, and the other was blind from a brain injury at birth. Seeing that stark contrast (that some vision problems can be fixed and others can’t) sparked this sense of injustice in me and made me want to work in eye health.

I trained as an optometrist, practiced for a few months, and realized I had endless questions about my patients. One of my mentors suggested a PhD, which turned out to be the best decision for me. My PhD was in pediatrics, then I worked in traumatic brain injury before moving into low vision and blindness research.

It’s been a winding path. I’ve had moments where it felt like I’d lost opportunities, only to find the “other door” opened to something better. After leading the clinical team at Bionic Vision Australia for nine years, I joined Joe Rizzo’s Bionic Eye Technologies in the US as Director of Clinical & Regulatory Affairs. I loved the fast pace and focus on translation—how to actually get these devices to patients.

In 2019, I was recruited back to the University of Melbourne through a program designed to bring industry-experienced researchers into academia. That led to my current roles: Associate Dean for Innovation & Enterprise, Deputy Director of CERA, and a multi-department professorship. I also work closely with startups to connect them with clinicians, patients, and investors to help get their innovations into the world. It’s a lot of hats, but they all interlace in really rewarding ways.

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“It’s never a straight career path. It twists and turns—and that’s okay.”

Interviewer: You were deeply involved in the first-in-human trials of Australia’s bionic eye and later worked on the Boston retinal implant. What were those experiences like?

Prof. Ayton: Leading the clinical team for Bionic Vision Australia was an incredible experience. I was there during the early “switch-on” moments, working closely with participants as they first perceived phosphenes. It was an extraordinary privilege to witness that.

At Bionic Eye Technologies, I moved into a more translational space: thinking strategically about how to run trials faster, how to get from promising data to real-world impact. It really suited my fast-paced brain! That role taught me how critical it is to bridge the gap between cutting-edge science and regulatory and clinical realities.

Interviewer: In 2017, you and Dr. Joseph Rizzo called for a multinational task force to standardize psychophysical testing for visual prostheses, which culminated in the 2020 HOVER consensus document. Why was this so important?

Prof. Ayton: We’d realized everyone was testing patients differently—and not learning from each other. At conferences, we’d swap stories about the same challenges, like participants using echolocation or wind cues during tabletop tasks, and yet none of it was documented or shared.

So we launched the HOVER (Harmonization of Outcomes and Vision Endpoints in vision Restoration) Task Force (opens in a new window), which eventually involved around 80 authors worldwide and took about eight years. It was like my third child.

The final consensus document outlined best practices for outcome measures in vision restoration trials. Even now, in my current work in gene therapy, we still use and cite it regularly. Seeing it continue to shape the field has been incredibly rewarding.

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“The key is finding outcome measures that are relevant to patients while still stringent enough to satisfy regulatory bodies. It’s a delicate balance.”

Interviewer: You’ve emphasized the importance of rigorous functional assessment in bionic eye trials. What’s still missing in how we assess performance?

Prof. Ayton: It’s enormously challenging, because people don’t just use vision—they combine it with all their other senses. Regulators want clear, measurable improvements directly attributable to the device, but the real-world gains are subtler: going from no useful vision to just enough to do simple daily tasks.

We’ve tried isolating vision by taking away other cues (earmuffs, no cane or guide dog), but that isn’t real life. The key is finding outcome measures that are relevant to patients while still stringent enough to satisfy regulatory bodies. It’s a delicate balance.

Interviewer: How can researchers balance the need for widely generalizable assessments with personally tailored testing and training?

Prof. Ayton: We need open conversations between everyone involved: researchers, regulators, and especially people with lived experience. I’ll never forget a participant in our early trials saying, “Just ask me if it’s better.” From their perspective, that was what mattered.

At the other end, the FDA wants precise luminance levels and repeated trials. So we explain to participants why tests are long and tiring: because we have to prove these devices work to make them available to others. It’s about transparency, empathy, and co-design.

Interviewer: What do you see as the biggest barriers to getting promising vision-restoration technologies from the lab into the clinic?

Prof. Ayton: Funding. The patient populations are relatively small, so big pharma and medtech companies don’t always see the market incentive. That makes investment hard to secure.

What gives me hope is how collaborative this field is. We might not have the numbers of cancer or heart disease, but by working together (researchers, clinicians, and patients), we can amplify our voice and attract the funding needed to move the field forward.

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“These once-separate fields are merging. Electronics, gene therapy, cell therapy—they’re starting to come together.”

Interviewer: You’ve mentioned shifting toward gene therapy. How do you see the prosthesis and gene therapy fields intersecting?

Prof. Ayton: I often describe myself as a T-shaped researcher. My vertical is outcome measures and patient performance (by that I mean, how to show a treatment actually improves quality of life) and my horizontal spans many technologies: prostheses, gene therapy, stem cells, low vision aids.

I love that these once-separate fields are merging. We’re seeing electronic technologies combined with cellular or genetic approaches, and even our clinical trial design and outcome measures are starting to converge.

A big focus for us now is understanding community perspectives. In surveys with over 1,500 people, 92% said they’d want gene therapy if available, but only 24% felt they understood it. That shows how important it is to communicate clearly—so if people join a trial, they really know what they’re signing up for.

Interviewer: Finally, what do you see in the near and distant future for vision restoration?

Prof. Ayton: I think the future is multidisciplinary. Instead of separate silos (prostheses here, gene therapy there), we’ll see hybrid approaches that combine the best of each.

Just as importantly, I think the community will lead more of the conversation. People with lived experience should shape what technologies are developed, how they’re tested, and what “success” means. That’s the future I’m most excited to see.