iPad Games Show Promise as Faster Alternative to Patching for Lazy Eye
Amblyopia, commonly known as lazy eye, is the leading cause of diminished vision in one eye among children. Traditionally, treatment involves patching the stronger eye – a method called occlusion – to force the weaker eye to work and improve its visual acuity. While effective in up to 90% of cases, 15-50% of children don’t achieve normal vision despite prolonged treatment.
Amblyopia frequently enough stems from underlying conditions like strabismus (misaligned eyes) or anisometropia (unequal refractive power between the eyes). Increasingly, new therapies are focusing on binocular approaches, aiming to train both eyes to work together.
A recent clinical study, led by Krista R. Kelly at the Retina Foundation of the Southwest in Dallas, investigated the effectiveness of a novel binocular therapy: an iPad adventure game called “Dig Rush,” compared to traditional patching.
The study involved 28 children aged 4.6 to 9.5 years diagnosed with amblyopia. Participants were divided into two groups: 14 received treatment with the iPad game, playing for one hour daily, five days a week, while the other 14 underwent standard occlusion therapy for two hours a day over two weeks. Researchers measured changes in visual acuity of the weaker eye after two weeks, and improvements in stereo vision and suppression after four weeks.
The “Dig Rush” game utilizes a unique approach. Children wear red-green anaglyph glasses that separate the visual details for each eye. The weaker eye sees high-contrast red elements, while the stronger eye perceives low-contrast blue elements, with background elements visible to both. Prosperous gameplay requires both eyes to focus on their respective components. The contrast for the stronger eye gradually increases as the game progresses, demanding greater effort from the weaker eye and encouraging visual cooperation.
After two weeks, both therapies showed improvements in visual acuity and reduced suppression. Though,the iPad game group demonstrated a significantly greater average improvement - 1.5 lines on a vision chart – compared to the 0.7 lines achieved by the patching group.
Interestingly, after the initial two-week period, the patching group transitioned to the iPad game for an additional two weeks, meaning all participants ultimately benefited from the game therapy. By the end of the four-week study, both groups exhibited similar levels of improvement in visual acuity, with the patching group catching up to the gains initially made by the game group.
The study’s authors conclude that this playful, binocular therapy approach is not only effective but can lead to faster improvements than traditional patching. While long-term superiority over patching remains to be proven, the initial results suggest that the iPad game offers a potentially more engaging and child-friendly alternative for treating amblyopia. Further research is needed to confirm these findings and assess the long-term benefits of this innovative therapy.
