The purpose of this study was to compare the visual outcomes of occlusion with game playing through a virtual reality (VR) system in children with unilateral amblyopia. The study was undertaken at the Negah Eye Hospital in Iran. This was an randomised control trial (RCT) with 50 children. Inclusion criteria were unilateral amblyopia, central fixation, alignment within 8PD and aged 4-10 years. Children were split equally to two groups. VR group involved one hour / day, five times per week for four weeks giving a 20-30 hour dose. Occlusion group was two, four or six hours daily for mild, moderate and severe amblyopia respectively. Compliance was 75% of either treatment dose. Cases were 64% orthophoria, 28% esophoria and 4% exophoria. Mean best corrected visual acuity (BCVA) improved significantly in both groups with no significant difference between groups. BCVA different between groups was significant at baseline and at follow-up, but was not significant after baseline group adjustment. There was a similar level of poor compliance in both groups and with similar outcomes.