Virtual reality for interactive binocular treatment of amblyopia

Abstract

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).

The role of Interactive Binocular Treatment system in amblyopia therapy

“…In our study, I-BiT™ was found as an effective complementary method for amblyopia treatment like other studies 12, 13, 15, 16, 17. The mean of BCVA was increased in two groups significantly with more improvement in cases who received both I-BiT™ and patching therapy simultaneously.…”

“…Therefore, our cases received I-BiT™ as a complementary treatment to occlusion, unlike the previous studies which compared I-BiT™ with occlusion in separate groups 12, 13, 15, 16, 17…”

“…One advantage of the I-BiT™ method is its effectiveness at older age (>8 years old) due to the I-BiT™ ability to activate dormant cells of the visual cortex 15 . Furthermore, there is no need to patch the dominant eye during I-BiT™ exercises, so children are more eager to play with its games.…”

“…Furthermore, there is no need to patch the dominant eye during I-BiT™ exercises, so children are more eager to play with its games. Moreover, the significant improvement of VA has been reported during 6 weeks of I-BiT™ playing, while visual improvement by patching needs at least several months 15 . In addition, the condition of playing could be adjusted by contrast and illumination of images; the image can be rotated in all directions so that it is possible to conjugate with the child's pupillary distance and angle of ocular deviation as well 12, 15.…”

A Low-cost Virtual Reality Game for Amblyopia Rehabilitation

“…It is well known that video games can be very useful for visual rehabilitation [1]. Classical examples of games found in literature, include PAC-MAN and simple car racing games [8]. In this work we propose a simple car racing game.…”