The use of specialized computer games for the treatment of amblyopia in Latvia; pp. 310–316Full article in PDF format | 10.3176/proc.2021.4S.01
The classical treatment option for amblyopia in Latvia is occlusions of the non-amblyopic eye. The newest methods involve specialized computer games that involve both eyes in visual processing during the treatment as well as stimulate binocularity. To assess the efficiency of specialized computer games in the treatment of amblyopia in school-age children in Latvia, 237 children (7–18 years old) participated in the experiment, of whom only 22 completed it: 11 participants had occlusion therapy, 11 participants played the specialized dichoptic computer game Tetris®. The visual acuity of the amblyopic eye as well as stereopsis were evaluated at near and far distances before the treatment, 2 months and 4 months after the beginning of the treatment. The results show statistically significant improvement in visual acuity in both treatment groups after four months of therapy. The extent of improvement is similar in both groups. Specialized computer games for amblyopia treatment may be recommended to patients from an age when they are able to use a computer along with a keyboard and computer mouse, who want to improve their visual acuity in the amblyopic eye but are not willing to use occlusions. The only requirement for using specialized games is that the patients need to have binocular single vision. In conclusion, the use of specialized computer games is an alternative type of amblyopia treatment compared to occlusion therapy.
1. Rouse, M. W., Cooper, J. S., Cotter, S. A., Press, L. J. and Tannen, B. M. Care of the Patient with Amblyopia: Reference Guide for Clinicians. American Optometric Association, 1994.
2. Von Noorden, G. K. and Campos, E. C. Binocular Vision and Ocular Motility. 6th ed. Mosby, St. Louis, MO, 2002.
3. Grönlund, M. A., Andersson, S., Aring, E., Hård, A.-L. and Hellström, A. Ophthalmological findings in a sample of Swedish children aged 4–15 years. Acta Ophthalmol. Scand., 2006, 84(2), 169–176.
4. Robaei, D., Kifley, A., Gole, G. A. and Mitchell, P. The impact of modest prematurity on visual function at age 6 years: findings from a population-based study. Arch. Ophthalmol., 2006, 124(6), 871–877.
5. Robaei, D., Rose, K. A., Ojaimi, E., Kifley, A., Martin, F. J. and Mitchell, P. Causes and associations of amblyopia in a population-based sample of 6-year old Australian children. Arch. Ophthalmol., 2006, 124(6), 878–884.
6. Sapkota, Y. D., Adhikari, B. N., Pokharel, G. P., Poudyal, B. K. and Ellwein, L. B. The prevalence of visual impairment in school children of upper-middle socioeconomic status in Kathmandu. Ophthalmic Epidemiol., 2008, 15(1), 17–23.
7. Shrestha, G. S., Sujakhu, D. and Joshi, P. Refractive error among school children in Jhapa, Nepal. J. Optom., 2011, 4(2), 49–55.
8. Mazarei, M., Fard, M. A., Merat, H. and Roohipoor, R. Associations of refractive amblyopia in a population of Iranian children. J. Optom., 2013, 6(3), 167–172.
9. Bhandari, G., Byanju, R. and Kandel, R. P. Prevalence and profile of amblyopia in children at Bharatpur eye hospital. J. Paediatr. Child Health, 2015, 3(8), 1085.
10. Sushil, O., Meenu, B., Vaibhav, J., Reena, S., Brijesh, S. and Singh, S. Pattern of refractive error in paediatric patients coming to rural tertiary care hospital of Central India. Indian J. Clin. Exp. Ophthalmol., 2016, 2(1), 72–75.
11. Dzenite, B. Prevalence of amblyopia types. Bachelor thesis. University of Latvia, Riga, Latvia, 2007.
12. Wong, A. M. F. New concepts concerning the neural mechanisms of amblyopia and their clinical implications. Can. J. Ophthalmol., 2012, 47(5), 399–409.
13. Parks, M. M. Treatment of the sensorial adaptations and amblyopia. In Clinical Ophthalmology, vol. 1 (Duane, T. D., ed.). Harper and Row, Hagerstown, MD, 1989, 1–14.
14. Baroncelli, L., Maffei, L. and Sale, A. New perspectives in amblyopia therapy on adults: a critical role for the excitatory/inhibitory balance. Front. Cell. Neurosci., 2011, 5(25), 1–6.
15. Astle, A. T., McGraw, P. V. and Webb, B. S. Can human amblyopia be treated in adulthood? Strabismus, 2011, 19(3), 99–109.
16. Spiegel, D. P., Li, J., Hess, R. F., Byblow, W. D., Deng, D., Yu, M. and Thompson, B. Transcranial direct current stimulation enhances recovery of stereopsis in adults with amblyopia. Neurotherapeutics, 2013, 10(4), 831–839.
17. Hess, R. F. and Thompson, B. Amblyopia and the binocular approach to its therapy. Vision Res., 2015, 114, 4–16.
18. Žiak, P., Holm, A., Halička, J., Mojžiš, P. and Piñero, D. P. Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results. BMC Ophthalmol., 2017, 17(1), 105.
19. Loudon, S. E. and Simonsz, H. J. The history of the treatment of amblyopia. Strabismus, 2005, 13(2), 93–106.
20. Webber, A. I., Wood, J. M., Gole, G. A. and Brown, B. Effect of amblyopia on self esteem in children. Optom. Vis. Sci., 2008, 85(11), 1074–1081.
21. Scheiman, M., Hertle, R. W., Beck, R. W., Edwards, A. R., Birch, E. E., Cotter, S. A. et al. Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch. Ophthalmol., 2005, 123(4), 437–447.
22. Foss, A. J., Gregson, R. M., MacKeith, D., Nicola, H., Ash, I. M., Cobb, S. V. et al. Evaluation and development of a novel binocular treatment (I-BiTTM) system using video clips and interactive games to improve vision in children with amblyopia (‘lazy eye’): study protocol for a randomised controlled trial. Trials, 2013, 14, 145.
23. Li, S. L., Jost, R. M., Morale, S. E., Stager, D. R., Dao, L., Stager, D. and Birch, E. E. A binocular iPad treatment for amblyopic children. Eye (Lond), 2014, 28(10), 1246–1253.
24. Kelly, K. R., Jost, R. M., Dao, L., Beauchamp, C. L., Leffler, J. N. and Birch, E. E. Binocular iPad game vs patching for treatment of amblyopia in children: a randomized clininal trial. JAMA Ophthalmol., 2016, 134(12), 1402–1408.
25. Jeon, S. T., Maurer, D. and Lewis, T. L. The effect of video game training on the vision of adults with bilateral deprivation amblyopia. Seeing Perceiving, 2012, 25(5), 493–520.
26. Knox, P. J., Simmers, A. J., Gray, L. S., Cleary, M. An exploratory study: prolonged periods of binocular stimulation can provide an effective treatment for childhood. Investig. Ophthalmol. Vis. Sci., 2012, 53(2), 817–824.
27. Li, J., Thompson, B., Deng, D., Chan, L. Y. L., Yu, M. and Hess, R. F. Dichoptic training enables the adult amblyopic brain to learn. Curr. Biol., 2013, 23(8), 308–309.
28. Hess, R. F., Babu, R. J., Clavagnier, S., Black, J., Bobier, W. and Thompson, B. The iPod binocular home-based treatment for amblyopia in adults: efficacy and compliance. Clin. Exp. Optom., 2014, 97(5), 389–398.
29. Birch, E. E., Li, S. L., Jost, R. M., Morale, S. E., De La Cruz, A., Stager, D. Jr, Dao. L. and Stager, D. R. Sr. Binocular iPad treatment for amblyopia in preschool children. J. AAPOS, 2015, 19(1), 6–11.
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