UPFRONT: Helmet-Mounted Surgical Visualization


Joint Strike Fighter F-35 Lightning pilots use a $400,000 Gen III Helmet-Mounted Display System (HMDS) made from a lightweight carbon fiber that is custom fit to an individual pilot’s head to align the pilot’s eyes to the display. The most advanced and expensive fighter helmet offers a widefield, organic light-emitting diode (OLED) virtual heads-up display with built-in night vision so pilots can see numerous aircraft systems, navigation views, and artillery control systems in their line of sight no matter what direction their heads are turned or time of day. It is the first aircraft primary flight display that is worn by the pilot and that is fed from 6 cameras in the plane giving a 360-degree view of the airspace, including looking through the bottom of the plane.

As one would expect, there were several details that arose during early testing of the helmet that needed tweaking, including a TV-like glow from the screen that made landing on aircraft carriers difficult at night and latency of the display, which made seeing anti-aircraft gun strafing hard. The helmet, produced by a joint venture between Rockwell Collins and Elbit Systems, has come a long way since the first helmet-mounted displays were developed in the 1970s. Now pilots need only to look at a target to fire their weapons.

Ever since I saw my first Blue Angels air show, I thought being a fighter pilot was one of the coolest jobs, and I never miss the Cleveland Air Show, marveling at the precision maneuvers these elite pilots execute not far from major buildings. Recently, I had the opportunity to test the Beyeonics “helmet” (not commercially available or approved at the time of writing) and realized part of my boyhood dream of becoming a fighter pilot, except not while flying a billion-dollar fighter jet, by at least wearing their helmet. This ophthalmic helmet is produced by the same company that makes the HMDS.

With simple head gestures while wearing the HMDS, I could zoom, change views, change focus, take live OCT images, or bring up old OCT images and overlay them where I was working. The experience was transformative as I have always found 3D displays to have considerable latency, which has led me to change the way I operated when using the technology. This helmet required no such change as it had almost zero detectable latency.

It is wishful thinking that the $960 million it will take to produce the custom-fit helmets for the 2,400 fighter pilots in the Joint Special Operations Command would be enough to make the ophthalmic versions cheap. Nevertheless, I cannot wait to have more time with this amazing technology, and I look forward to other companies creating similar ophthalmic “helmets” that will hopefully improve our surgical visualization, efficiency, and safety. In this issue, we will explore new imaging technologies, including the Beyeonics helmet. RP

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