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Amblyopia (lazy eye) is the main cause of decreased vision in a single eye in children. This problem has mainly been viewed as an eye-related condition that can be managed by patching the opposite eye in order to force the affected amblyopic eye to be used. This form of therapy though doesn't seem to teach the eyes to work better together or restore full 6/6 vision.
Since amblyopia is as a result of binocular discordance, then binocular treatment is more likely to result in better visual outcomes. The issue with this train of thought is that it isn't clear whether binocular treatment can be compared to patching the unaffected eye when wanting to treat amblyopia. A study was therefore performed to deduce whether other forms of treatment were more effective than patching.
Researchers at the Retina Foundation of the Southwest in Dallas, Texas, U.S.A. randomly chose 28 children (at 7 years of age) diagnosed with amblyopia. The children were randomly divided into 14 of them taking part in the binocular treatment game and the other 14 having the patching treatment performed on them.
The binocular game is an action-adventure game that uses an iPad format. The game requires children to wear specialised eye-wear that separates elements of the game seen by each eye. The amblyopic eye sees high-contrast elements, the opposite eye sees reduced-contrast elements and both eyes visualise high-contrast background elements. In order for the game-play to be successful, both eyes have to visualise their respective game components. The children were asked to play the game at home for 1 hour a day, 5 days a week for 2 weeks (to complete 10 hours of total game-play).
The primary discovery of the study was that there was a change in the best-corrected visual acuity (BCVA) of the amblyotic eye, in children who were exposed to the binocular treatment game, at the 2-week follow-up visit.
The comparison was staggering since it was found that the children's BCVA in the amblyotic eye, that was managed with the iPad game, had improved more than double than that of the children whose unaffected eyes were patched, and in half of the treatment time too (10 hours of game-play versus 28 hours of patching).
Another discovery was that 5 of the 13 children, nearly 40%, who had received binocular treatment reached 6/8 or better visual acuity compared with 1 of 14 children (only 7%) who were patched.
The study went on further to allow the children who were patched to start playing the binocular treatment game at the 2-week follow-up stage. All 28 children then continued with the iPad game for another 2 weeks and at the 4-week visit, no difference was found in the BCVA change of the amblyopic eye of both groups of children. It seemed that the children who changed over to the binocular game caught up with the children who were initially treated with the iPad game.
The researchers did admit that further investigations need to be performed to determine whether long-term binocular treatment is as effective in completely managing amblyopia as performing patching.