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HomemiequipmentAmblyopia Treatment in the 21st Century

Amblyopia Treatment in the 21st Century

Amblyopia, known as ‘lazy eye’ to the majority of lay people, has been a major challenge for the past centuries. Although treatment of lazy eye goes back to the early 1700s, this doesn’t mean we have to keep using ‘outmoded’ treatment strategies such as patching, that have their limitations.

Vivid Vision is the company behind an evolutionary innovation that uses Virtual Reality (VR) headsets to treat amblyopia.

The technology was co-founded by James Blaha who grew up with amblyopia and struggled with binocular vision. Now CEO of Vivid Vision, he recalls being non-compliant with patching and would remove his patch whenever he could and would ‘peek out the side’ to watch TV.

In 2014, inspired by new research into neuroplasticity and new VR technology Mr. Blaha developed a prototype. Using this prototype he obtained stereopsis for the first time in his life. He then founded Vivid Vision so as to provide access to a better and more powerful treatment for binocular vision issues. Vivid Vision VR therapy consists of a software and hardware bundle that goes beyond just treating amblyopia and strabismus and is also useful for vergence disorders. According to Mr. Blaha, it makes treatment fun and enjoyable rather than frustrating, boring and tedious.

More recent binocular approaches to the treatment of amblyopia have shown improvements in visual acuity and stereopsis in children as well as in adults

A study by UVEA Mediklinik in Slovakia1 has shown promising results. Sixty per cent of patients in this study showed an increase in visual acuity of one to three lines after just eight, 40-minute sessions using Vivid Vision VR therapy. There are more studies in the pipeline and researchers at the Department of Ophthalmology, University of California, San Francisco and collaborators at Vivid Vision have established protocols for investigating and validating research into this new methodology.

In a poster presented at ARVO 20152, the researchers explained that amblyopia results from disruption of normal binocular visual during critical periods of cortical development. Caused by strabismus, anisometropia or visual deprivation it ultimately affects two per cent of adults in the United States. After correction of refractive error, the mainstay of therapy for children is ocular penalisation in the form of patching or atropine. However, large clinical trials have demonstrated minimal efficacy of this treatment after the age of 12.

More recent binocular approaches to the treatment of amblyopia have shown improvements in visual acuity and stereopsis in children as well as in adults. One approach involves dichoptic therapy, whereby complementary images of different brightness and contrast are displayed separately to each eye, with the amblyopic eye seeing the brighter image. Dichoptic therapy encourages binocular fusion in order to complete a task. Virtual Reality platforms provide a highly immersive environment that not only motivates participants, but also delivers more complex stimuli to each eye. This makes VR well suited for dichoptic therapy and may enhance its treatment effect in amblyopia.

The researchers have developed and are currently enrolling subjects in a single-centre, masked, randomised-controlled trial to study the effects of a dichoptic VR platform on visual acuity and stereopsis in adults with amblyopia. The company states that remote testing of visual parameters is possible and correlates well with validated in-clinic measurements. Remote monitoring also allows for determination of compliance and can provide red-flag alerts.

We will keep an eye on further developments and evidence of efficacy.

Vivid Vision is available now. Patient and practitioner testimonials are enthusiastic and positive. www.seevividly.com . The Australian distributor is France Medical www.francemedical.com.au .

References
1. Ziak P, Holms A, Halicka J, Mojziš P, Piñero DP. Amblyopia Treatment of Adults with Dichoptic Training Using the Virtual Reality Oculus Rift Head Mounted Display: Preliminary Results
2. Aderman M, Deiner M, Gupta M, Blaha J, Levin MH. Dichoptic Virtual Reality Therapy for Amblyopia in Adults. ARVO Poster 2015