Purpose The conventional patching/ occlusion treatment for amblyopia sometimes gives disappointing results for a number of reasons: it is unpopular, prolonged, frequently resulting in poor or noncompliance, and also disrupts fusion. The aim of this research was to develop a novel virtual-reality (VR)-based display system that facilitates the treatment of amblyopia with both eyes stimulated simultaneously. Methods We have adopted a multidisciplinary approach, combining VR expertise with a team of ophthalmologists and orthoptists to develop the Interactive Binocular Treatment (I-BiT TM ) system. This system incorporates adapted VR technology and specially written software providing interactive 2D and 3D games and videos to the patient via a stereo (binocular) display, and a control screen for the clinician. Results We developed a prototype research system designed for treatment of amblyopia in children. Conclusions The result is a novel way to treat amblyopia, which allows binocular treatment. It is interactive, and as it is partially software based, can be adapted to suit the age/ability, and needs of the patient. This means that the treatment can be made captivating and enjoyable. Further research is on-going to determine the efficacy of this new modality in the treatment of amblyopia.

Improvements in vision were demonstrable within a short period of time, in some children after 1 h of treatment. This system is an exciting and promising application of VR technology as a new treatment for amblyopia.

Amblyopia, or 'lazy eye', is currently treated by wearing an adhesive patch over the non-amblyopic eye for several hours per day, over a period of many months. Non-compliance with patch wearing is a significant problem. Our multi-displinary team involved clinicians and technologists to investigate the application of virtual reality technology in a novel way. We devised a binocular treatment system in which children watch a video clip of a cartoon on a virtual TV screen, followed by playing an interactive computer game to improve their vision. So far the system has been used to treat 39 children, of whom 87% have shown some improvement in vision. Vision improvement tended to occur within the first three to four treatment sessions. This paper describes research development of the I-BiT™ system. We present a summary of results from the clinical case studies conducted to date and discuss the implications of these findings with regard to future treatment of amblyopia. INTRODUCTIONAmblyopia, or 'lazy eye', is reduced corrected visual acuity that exists in the absence of any detectable organic disease. Amblyopia can be the result of a squint (strabismic amblyopia), in which both eyes are not straight, a difference of the refractive state of each eye (anisometropic amblyopia), or the result of both squint and refractive inequality (mixed amblyopia, combined anisometropic and strabismic amblyopia), in which there is a squint as well as a stronger corrective glasses lens for one eye. This condition affects 2% to 5% of the population (1,2) and is currently treated by wearing an adhesive patch over the non-amblyopic eye for several hours per day, over a period of many months (3). Although this form of occlusion therapy is successful, the success rates are variable (4) and non-compliance with patch wearing is a problem that can result in unsuccessful treatment (5).