Pilot trial of virtual reality to treat amblyopia beyond the age of seven years
Reviewed by Lauren Hepworth

A pilot double-blind randomised controlled trial is presented. Patients were required to be between seven and 38 years of age, have a diagnosis of anisometropic and / or strabismus unilateral amblyopia, visual acuity in the amblyopic eye between 0.3-1.0 LogMAR despite previous therapy, with stable visual acuity for 16 weeks prior to recruitment. Exclusion criteria were high myopia, photosensitivity and light-induced epilepsy. Participants were randomised to either the full treatment group who received one hour per day of binocular treatment for eight weeks or sham-crossover group who received one hour per day of device use with therapeutic changes for four weeks, followed by four weeks of binocular treatment. The therapeutic changes included contrast reduction, monocular flicker and alternate binocular flicker. Twenty participants were recruited with 11 in the full-treatment group and nine in the sham-crossover group. Both groups were described as similar at baseline. Six participants missed one or more follow-up visits and two participants from the full-treatment group withdrew. Better adherence was noted in the full-treatment group, however, this was not significant. No adverse events were reported. No improvement of visual acuity was reported, however, there was some improvement of stereoacuity. The authors suggest that this study provides the evidence that a larger clinical trial is warranted.

Virtual reality prototype for binocular therapy in older children and adults with amblyopia.
Elhusseiny AM, Bishop K, Staffa SJ, et al.
JOURNAL OF THE AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2021;25:217.