Can video games treat amblyopia?

In recent years, many firms that address vision therapeutics have been using technology as an innovative approach to develop digital solutions for treating eye difficulties. Many companies providing vision therapy connect with eye doctors, so they can offer this service to patients. As with every relatively new thing, different questions and doubts arise, so we will discuss in this blog post how vision therapy based on gamification can help improve the visual condition and what factors influence the outcome of the therapy. Our source for this blog post was the article titled ”Video game treatment of amblyopia”.

The article outlined that the ability of video games to treat amblyopia is mostly determined by three factors: treatment procedure, patient characteristics, and assessment criteria.

Treatment procedure

To begin with, treatments that include fun activities have a high percentage of compliance. As video games and watching movies are both very engaging, a greater compliance is achieved. Therapy programs with a high degree of compliance had relatively large treatment effects. On the other hand, computer game therapies with monotonous activities had a lower compliance rate than patching treatment with a wide variety of activities. What is more, patching has a low compliance rate, which represents a major issue. When compared to training on acuity-based tasks, Astle and colleagues found that training on contrast-based tasks led to greater progress.

Patient characteristics

There are various types of amblyopia and according to some papers, the type has impact on treatment outcomes. In one research, they made amblyopic children play video games for 20 hours. Seven out of twelve patients with anisometropic amblyopia improved their stereoacuity, whereas just one of the nine strabismic patients improved. Anisometropic and strabismic individuals improved to varying degrees while receiving the same treatment. For change in binocular outcomes, another iPad game trial reported no treatment effect difference between children with anisometropic amblyopia and children with strabismic and anisometropic combined amblyopia. Other study suggests that amblyopia type does not influence treatment effects. Best-corrected visual acuity (BCVA) improvement did not differ between children with strabismic, anisometropic, or combined type. No significant difference in BCVA improvement was found among patients with severe versus moderate amblyopia or among patient with different causes.

Commonly, patient age has been considered an important factor determining amblyopia treatment effects. Current studies did not find a major relationship between perceptual learning treatment effect and age. An iPad treatment study also found significant difference in BCVA between children younger than seven and children aged 7-12. Additionally, another study compared video game treatment with traditional occlusion treatment and found that, despite their older age, the video game group experienced slightly greater visual improvement than the occlusion-only group.

Comparison between video game treatments and traditional treatments

Researchers included 10 different studies, and based on available data on visual acuity (VA) improvement and treatment types, video game treatments seemed to have achieved a slightly better treatment effect than other treatments. Furthermore, Fu et al. carried out meta analysis and compared visual improvement among studies with no treatment, non-video game treatment, and with video game treatment. Results showed that video game treatment seemed to achieve better treatment effects and consequently higher visual acuity improvement than non-video game treatments.

They also compared the effects of different treatment time on visual acuity improvement. Visual acuity improved more with longer treatment hours in video game treatment, while the connection between treatment effects and time was not significant in patching treatment.

An additional factor that needs to be taken into consideration is the prospect of maintenance of treatment effects. While many traditional amblyopia treatments have a linear relationship between training time and result size, this is not the case with video game treatment. The BCVA improvement was not proportional to the number of hours spent playing iPad games. Furthermore, the therapy impact did not improve after four weeks of treatment, nor did it change three months later. The number of hours spent playing video games was not substantially related to improvements in BCVA.

AmblyoPlay uses video games for therapy

AmblyoPlay uses the video game approach combined with anaglyphic glasses. During our cooperation with clinics and communication with patients, we can confirm the findings of the article, meaning that age does not play a major role in the success of the therapy process. But what we have found as a factor playing an important role is the motivation to consistently do exercises, especially with younger kids. AmblyoPlay addressed this matter and strives to frequently change exercises and break the monotony of the game. We also issued our own AmblyoPlay comic book for children, intended to help parents and doctors alike explain to kids why their vision therapy exercises are important and that regular exercise is paramount for improving their vision and developing a well-functioning visual system.

We are very happy that research has found that innovative approaches based on the advantages that technology has to offer can replace classical approaches to some extent. We believe these conclusions even gained importance during the COVID-19 outbreak, as we can play games in the comfort of our home independently, without the need to visit an eye doctor.

Source: Fu, E., Wang, T., Li, J., Yu, M., & Yan, X. (2021). Video game treatment of Amblyopia. Survey of Ophthalmology.