Occlusion vs. video gaming for treatment of refractive / anisometropic amblyopia
Reviewed by Fiona Rowe

The authors conducted a comparative study of a novel low-cost video game platform – BarronVision (BV) – with standardised occlusion in the treatment of paediatric amblyopia. BarronVision uses a monocular perception learning approach in which the size of optotypes can be manipulated to the limit of visual acuity of the amblyopic eye whilst fully suppressing the optotypes presented to the fellow eye by using a cyan lens of anaglyph glasses. The video game included four different five-minute games played five times per week for a total 20 minutes per day vs. occlusion of two or six hours daily dependent on level of visual acuity. A standardised 12-week treatment programme included 49 participants with refractive / anisometropic amblyopia, randomised to occlusion (n=23) or video game (n=26). Forty completed the treatment and assessment period (19 occlusion and 21 video game). There were 21 females and 19 males aged 5–18 years. Visual acuity in the amblyopic eye at baseline was mean 0.52logMAR (SD 0.27) in the occlusion group and 0.56logMAR (SD 0.19) in the video game group. After 12 weeks of treatment, visual acuity improved by -0.131logMAR in the occlusion group and -0.122 in the video game group. The video game group was non-inferior to occlusion. Mean average relative compliance was 79.5% for occlusion and 85.7% for the video game (non-significant difference). The authors conclude video gaming treatment provides an alternative treatment option that may be more acceptable and time efficient than occlusion. However, further large-scale trials with longer follow-up are needed.

Evidence of a novel video game platform in the treatment of pediatric amblyopia.
Poltovski D, Adams RJ, Biberdorf D, Patrie JT.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2024:61(1):20–9.