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iMedicalApps: Using Virtual Reality to Battle Amblyopia

iMedicalApps: Using Virtual Reality to Battle Amblyopia

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An app for amblyopia might help those with the condition through virtual reality.

In amblyopia (or “lazy eye”), vision is reduced from one eye with the brain favoring signals from the other eye. Both eyes may appear normal, but one eye may not be focusing clearly, or one eye may be misaligned (strabismus).

Typical treatments for this condition include patching (forcing the weaker eye to be utilized instead of the stronger eye) or using atropine to blur the vision in the stronger eye. Both types of treatment, mostly done in children, are similar to constraint-induced movement therapy (done in rehabilitation for stroke recovery), as both are rather punitive, with the aim of forcing use of the disused region. However, a recent study has explored the use of a novel, non-punitive treatment for amblyopia through virtual reality.

Published in BMC Ophthalmology, this non-controlled study released preliminary results of using an immersive VR headset (Oculus Rift) combined with a vision train game app for lazy eye, called Vivid Vision, with 17 subjects. These individuals all had amblyopia, ranged from 17-69 in age, and had their vision (best corrected visual acuity, BCVA) evaluated before and after eight sessions of VR. Each session was 40-minutes long, and average BCVA scores improved significantly, as did stereoacuity scores (assessment of differences in binocular vision). No significant side effects were noted, other than occasional reports of fatigue.

Of note, the BCVA didn’t improve in three patients and the authors concluded that such failure rates were consistent with known vision treatment failure rates in this population.

They also noted the possible role of younger patients having a greater potential for beneficial neuroplastic changes as a potential contribution.

Perhaps most promising was the motivational aspect noted by the authors of this intervention. The Vivid Vision VR experience offers interactive games as the treatment, including flying a spaceship and breaking virtual blocks. Such gamification of therapy offers the potential for improved adherence and patient engagement, especially in an immersive environment. Of course, this is still just a preliminary study, lacking a control group and long-term follow-up (although the authors noted at least three patients have had 6 months of stable visual scores). As such and as always, further research is needed.

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