Introduction Retinal implants have now been approved and commercially available for certain clinical populations for over 5 years, with hundreds of individuals implanted, scores of them closely followed in research trials. Despite these numbers, however, few data are available that would help us answer basic questions regarding the nature and outcomes of artificial vision: what do recipients see when the device is turned on for the first time, and how does that change over time? Methods Semi-structured interviews and observations were undertaken at two sites in France and the UK with 16 recipients who had received either the Argus II or IRIS II devices. Data were collected at various time points in the process that implant recipients went through in receiving and learning to use the device, including initial evaluation, implantation, initial activation and systems fitting, re-education and finally post-education. These data were supplemented with data from interviews conducted with vision rehabilitation specialists at the clinical sites and clinical researchers at the device manufacturers (Second Sight and Pixium Vision). Observational and interview data were transcribed, coded and analyzed using an approach guided by Interpretative Phenomenological Analysis (IPA). Results Implant recipients described the perceptual experience produced by their epiretinal implants as fundamentally, qualitatively different than natural vision. All used terms that invoked electrical stimuli to describe the appearance of their percepts, yet the characteristics used to describe the percepts varied significantly between recipients. Artificial vision for these recipients was a highly specific, learned skill-set that combined particular bodily techniques, associative learning and deductive reasoning in order to build a “lexicon of flashes”—a distinct perceptual vocabulary that they then used to decompose, recompose and interpret their surroundings. The percept did not transform over time; rather, the recipient became better at interpreting the signals they received, using cognitive techniques. The process of using the device never ceased to be cognitively fatiguing, and did not come without risk or cost to the recipient. In exchange, recipients received hope and purpose through participation, as well as a new kind of sensory signal that may not have afforded practical or functional use in daily life but, for some, provided a kind of “contemplative perception” that recipients tailored to individualized activities. Conclusion Attending to the qualitative reports of implant recipients regarding the experience of artificial vision provides valuable information not captured by extant clinical outcome measures.

2829 Introduction: Retinal implants have now been approved and commercially available for certain 30 clinical populations for over 5 years, with hundreds of individuals implanted, scores of them closely 31 followed in research trials. Despite these numbers, however, few data are available that would help 32 us answer basic questions regarding the nature and outcomes of artificial vision: what do 33 participants see when the device is turned on for the first time, and how does that change over time? 34 35 Methods: Semi-structured interviews and observations were undertaken at two sites in France and 36 the UK with 16 participants who had received either the Argus II or IRIS II devices. Data were 37 collected at various time points in the process that implant recipients went through in receiving and 38 learning to use the device, including initial evaluation, implantation, initial activation and systems 39 fitting, re-education and finally post-education. These data were supplemented with data from 40 interviews conducted with vision rehabilitation specialists at the clinical sites and clinical 41 researchers at the device manufacturers (Second Sight and Pixium Vision). Observational and 42 interview data were transcribed, coded and analyzed using an approach guided by Interpretative 43 Phenomenological Analysis (IPA). 4445 Results: Implant recipients described the perceptual experience produced by their epiretinal 46 implants as fundamentally, qualitatively different than natural vision. All used terms that invoked 47 electrical stimuli to describe the appearance of their percepts, yet the characteristics used to 48 describe the percepts varied significantly between participants. Artificial vision for these 49 participants was a highly specific, learned skill-set that combined particular bodily techniques, 50 associative learning and deductive reasoning in order to build a "lexicon of flashes" -a distinct 3 51 perceptual vocabulary that they then used to decompose, recompose and interpret their 52 surroundings. The percept did not transform over time; rather, the participant became better at 53 interpreting the signals they received. The process of using the device never ceased to be 54 cognitively fatiguing, and did not come without risk or cost to the participant. In exchange, 55 participants received hope and purpose through participation, as well as a new kind of sensory 56 signal that may not have afforded practical or functional use in daily life but, for some, provided a 57 kind of "contemplative perception" that participants tailored to individualized activities. 58 59 Conclusion: Attending to the qualitative reports of participants regarding the experience of artificial 60 vision provides valuable information not captured by extant clinical outcome measures. These data 61 can both inform device design and rehabilitative techniques, as well as grant a more holistic 62 understanding of the phenomenon of artificial vision. 63 64 Introduction 65 66 Retinal prostheses are implantable microelectronic devices de...