Video Games + Perceptual Learning for Lazy Eye
Recruiting in Palo Alto (17 mi)
Overseen byRoger W Li, OD, PhD
Age: Any Age
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Nova Southeastern University
Disqualifiers: Ocular pathological conditions, nystagmus
No Placebo Group
Trial Summary
What is the purpose of this trial?This trial involves adults and children with amblyopia practicing visual tasks or playing video games using their weaker eye. The goal is to improve vision by taking advantage of the brain's ability to adapt and change. By using their weaker eye over time, participants may see improvements in their visual abilities. Video games have been shown to be effective in improving vision and promoting brain adaptability in amblyopia treatment.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of this treatment for lazy eye?
Research shows that video game-based perceptual learning can improve visual functions like stereoacuity (depth perception) in patients with amblyopia (lazy eye), even when traditional patching therapy is not effective. Studies indicate that these video games can enhance both binocular (using both eyes) and monocular (using one eye) vision, suggesting they could be a useful alternative or complement to traditional treatments.
12345Is the video game and perceptual learning treatment for lazy eye safe for humans?
The research does not report any safety concerns for video game and perceptual learning treatments for amblyopia (lazy eye), suggesting they are generally safe for humans.
23467How does the Video Games + Perceptual Learning treatment for lazy eye differ from other treatments?
This treatment is unique because it combines video game play with perceptual learning and dichoptic training, which involves using both eyes together to improve vision, unlike traditional methods that often focus on patching one eye. It offers a more engaging and potentially more effective approach to improving visual functions like visual acuity and stereoacuity, especially in older children and adults who may not respond well to conventional patching therapy.
34589Eligibility Criteria
This trial is for both adults and children who have normal vision or amblyopia, commonly known as 'lazy eye', where there's a noticeable difference in visual sharpness between the eyes. People with any eye diseases or involuntary eye movement (nystagmus) cannot participate.Inclusion Criteria
I have a difference in vision between my eyes.
My vision is either normal or I have a lazy eye.
My vision is either normal or I have a lazy eye.
Exclusion Criteria
I have an eye condition.
I experience involuntary eye movements.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants engage in video games, perceptual learning tasks, or occlusion therapy for amblyopia
1-6 months
4-5 sessions per week
Follow-up
Participants are monitored for changes in stereoacuity, contrast sensitivity, positional acuity, and visual acuity
9 months
Participant Groups
The study is testing new treatments for lazy eye by using video game vision training, perceptual learning exercises, and traditional occlusion therapy which involves covering the stronger eye to improve the weaker one.
3Treatment groups
Experimental Treatment
Active Control
Group I: Video GamesExperimental Treatment1 Intervention
Participants will be required to play video games for a period of time: 1-2 hrs per session, 4-5 sessions/week for \~1-6 months
Group II: Perceptual learningExperimental Treatment1 Intervention
Participants will be required to practice a visual discrimination task (e.g. visual acuity, position acuity, contrast sensitivity, \& stereoacuity) for a period of time: 1-2 hrs per session, 4-5 sessions/week for \~1-6 months
Group III: Occlusion therapyActive Control1 Intervention
Participants will be required to cover the dominant eye during the day in order to push the brain to use the fellow amblyopic eye: 1-2 hrs per session, 4-5 sessions/week for \~1-6 months
Occlusion Therapy is already approved in European Union, United States, Canada for the following indications:
🇪🇺 Approved in European Union as Occlusion Therapy for:
- Amblyopia
- Strabismus
- Anisometropia
🇺🇸 Approved in United States as Patching Therapy for:
- Amblyopia
- Lazy Eye
- Strabismus
- Anisometropia
🇨🇦 Approved in Canada as Monocular Occlusion Therapy for:
- Amblyopia
- Strabismus
- Anisometropia
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Nova Southeastern University College of OptometryFort Lauderdale, FL
Loading ...
Who Is Running the Clinical Trial?
Nova Southeastern UniversityLead Sponsor
References
A Random Dot Computer Video Game Improves Stereopsis. [2019]Currently, treatments for amblyopia are occlusion or penalization of the stronger fellow eye. Fewer than 30% of patients improve stereoacuity using these treatments. In order to improve these outcomes, this group proposes a treatment to stimulate the stereoacuity through perceptual learning in a game format for use at home.
The iPod binocular home-based treatment for amblyopia in adults: efficacy and compliance. [2022]Occlusion therapy for amblyopia is predicated on the idea that amblyopia is primarily a disorder of monocular vision; however, there is growing evidence that patients with amblyopia have a structurally intact binocular visual system that is rendered functionally monocular due to suppression. Furthermore, we have found that a dichoptic treatment intervention designed to directly target suppression can result in clinically significant improvement in both binocular and monocular visual function in adult patients with amblyopia. The fact that monocular improvement occurs in the absence of any fellow eye occlusion suggests that amblyopia is, in part, due to chronic suppression. Previously the treatment has been administered as a psychophysical task and more recently as a video game that can be played on video goggles or an iPod device equipped with a lenticular screen. The aim of this case-series study of 14 amblyopes (six strabismics, six anisometropes and two mixed) ages 13 to 50 years was to investigate: 1. whether the portable video game treatment is suitable for at-home use and 2. whether an anaglyphic version of the iPod-based video game, which is more convenient for at-home use, has comparable effects to the lenticular version.
Short-term Perceptual Learning Game Does Not Improve Patching-Resistant Amblyopia in Older Children. [2021]To investigate self-administered, at-home use of a perceptual learning-based video game consisting of target detection of stimuli in different sizes, spatial frequency, orientation, and contrast as a potential dichoptic therapy to improve binocular function in amblyopic patients resistant to patching.
An updated review about perceptual learning as a treatment for amblyopia. [2022]The purpose of our work is to do an update of recent investigations about amblyopia treatment based on perceptual learning, dichoptic training and videogames. Therefore, we conducted a search of the studies published about this subject in the last six years. The review shows that the investigations during that period have used several kinds of treatments regarding their design (e.g., type of stimulus and context used, duration of the training), and in a wider range of age that also include adults. Most of the studies have found an improvement in some mono and binocular visual functions, such as visual acuity, contrast sensitivity and stereopsis, which for now, it seems advisable that these processes could be used, as an alternative or a complement of the traditional passive therapy. Nevertheless, it would be plausible to conduct additional, controlled and random, clinical trials in order to discover in a more deeply way which perceptive learning method of treatment is more effective for the improvement of visual functions and for how long the effects of the treatment could persist.
Stereoacuity Improvement using Random-Dot Video Games. [2020]Conventional amblyopia therapy involves occlusion or penalization of the dominant eye, though these methods enhance stereoscopic visual acuity in fewer than 30% of cases. To improve these results, we propose a treatment in the form of a video game, using random-dot stimuli and perceptual learning techniques to stimulate stereoacuity. The protocol is defined for stereo-deficient patients between 7-14 years of age who have already received treatment for amblyopia and have a monocular best corrected distance visual acuity of at least 0.1 logMAR. Patients are required to complete a perceptual learning program at home using the video game. While compliance is stored automatically in the cloud, periodic optometry center visits are used to track patient evolution and adjust the game's stereoscopic demand until the smallest detectable disparity is achieved. The protocol has proved to be successful, and effectiveness is gauged in terms of a two-level gain on a random stereoacuity test (global stereoacuity or cyclopean stereoacuity reference test). Moreover, the random-dot stimuli learning transfers to medial lateral stereoscopic acuity according to a Wirt Circles test, in which success criteria is a final stereoacuity of over 140", and the attained enhancement corresponds to no less than two levels of stereoscopic acuity. Six months later, a random-dot stereoacuity test recorded no reduction in the stereoacuity that was achieved.
Pilot Study Evaluating the Feasibility of Comparing Computer Game Play with Close Work During Occlusion in Children Aged 2-7 Years with Amblyopia. [2022]Computer games have been used to stimulate vision in amblyopia with varying degrees of success. The aim of this pilot study was to evaluate the feasibility of conducting a randomised controlled trial to test the effectiveness of computer game play compared to close work during occlusion treatment in children.
New insights into amblyopia: binocular therapy and noninvasive brain stimulation. [2022]The current approach to the treatment of amblyopia is problematic for a number of reasons. First, it promotes recovery of monocular vision but because it is not designed to promote binocularity, its binocular outcomes often are disappointing. Second, compliance is poor and variable. Third, the effectiveness of the treatment is thought to decrease with increasing age. We discuss 2 new approaches aimed at recovering visual function in adults with amblyopia. The first is a binocular approach to amblyopia treatment that is showing promise in initial clinical studies. The second is still in development and involves the use of well-established noninvasive brain stimulation techniques to temporarily alter the balance of excitation and inhibition in the visual cortex.
A dichoptic custom-made action video game as a treatment for adult amblyopia. [2022]Previous studies have employed different experimental approaches to enhance visual function in adults with amblyopia including perceptual learning, videogame play, and dichoptic training. Here, we evaluated the efficacy of a novel dichoptic action videogame combining all three approaches. This experimental intervention was compared to a conventional, yet unstudied method of supervised occlusion while watching movies. Adults with unilateral amblyopia were assigned to either play the dichoptic action game (n=23; 'game' group), or to watch movies monocularly while the fellow eye was patched (n=15; 'movies' group) for a total of 40hours. Following training, visual acuity (VA) improved on average by ≈0.14logMAR (≈28%) in the game group, with improvements noted in both anisometropic and strabismic patients. This improvement is similar to that obtained following perceptual learning, video game play or dichoptic training. Surprisingly, patients with anisometropic amblyopia in the movies group showed similar improvement, revealing a greater impact of supervised occlusion in adults than typically thought. Stereoacuity, reading speed, and contrast sensitivity improved more for game group participants compared with movies group participants. Most improvements were largely retained following a 2-month no-contact period. This novel video game, which combines action gaming, perceptual learning and dichoptic presentation, results in VA improvements equivalent to those previously documented with each of these techniques alone. Our game intervention led to greater improvement than control training in a variety of visual functions, thus suggesting that this approach has promise for the treatment of adult amblyopia.
Broad-based visual benefits from training with an integrated perceptual-learning video game. [2021]Perception is the window through which we understand all information about our environment, and therefore deficits in perception due to disease, injury, stroke or aging can have significant negative impacts on individuals' lives. Research in the field of perceptual learning has demonstrated that vision can be improved in both normally seeing and visually impaired individuals, however, a limitation of most perceptual learning approaches is their emphasis on isolating particular mechanisms. In the current study, we adopted an integrative approach where the goal is not to achieve highly specific learning but instead to achieve general improvements to vision. We combined multiple perceptual learning approaches that have individually contributed to increasing the speed, magnitude and generality of learning into a perceptual-learning based video-game. Our results demonstrate broad-based benefits of vision in a healthy adult population. Transfer from the game includes; improvements in acuity (measured with self-paced standard eye-charts), improvement along the full contrast sensitivity function, and improvements in peripheral acuity and contrast thresholds. The use of this type of this custom video game framework built up from psychophysical approaches takes advantage of the benefits found from video game training while maintaining a tight link to psychophysical designs that enable understanding of mechanisms of perceptual learning and has great potential both as a scientific tool and as therapy to help improve vision.