Action Video Games Improved Amblyopia In Two Weeks Interview with:
Krista Kelly, PhD

Postdoctoral Fellow
Crystal Charity Ball Pediatric Vision Evaluation Center
Retina Foundation of the Southwest
Dallas, TX 75231 What is the background for this study?

Response: Amblyopia is one of the most common causes of monocular impairment in children, affecting 1 or 2 children in every US classroom. Patching of the fellow eye has been used for decades to improve visual acuity in the amblyopic eye. But patching does not always restore normal vision and does not teach the two eyes to work together. A novel technique originally designed by Drs Robert Hess and Ben Thompson at McGill University that works to reduce interocular suppression by rebalancing the contrast between the eyes has shown promising results in amblyopic adults. Dr Eileen Birch at the Retina Foundation of the Southwest worked with Dr Hess to adapt this contrast re-balancing approach to an iPad game platform suitable for children. Her research showed that the games were successful in improving visual acuity in amblyopic children as well. However, these initial games were rudimentary and resulted in low compliance. What are the main findings?

Response: For the current study, we worked again with Dr Hess, and Amblyotech and Ubisoft to design an action-oriented game more similar to today’s games with many levels of mazes and obstacles to overcome. In our randomized clinical trial, we compared patching to this new binocular iPad game treatment. We found that after two weeks of treatment, children who played the game improved 1.4 lines on the letter chart, which was double the improvement than children who patched. Children who patched were able to take the game home for another two weeks of treatment and at their four week visit, they caught up to children who started with the game first. Both groups improved 1.7 lines in just 4 weeks, and 39% of the children had recovered normal vision for their age. What should readers take away from your report?

Response: Amblyopia should be reconsidered as a binocular, not monocular disease. Binocular treatments that rebalance contrast are an additional option for amblyopia treatment. What recommendations do you have for future research as a result of this study?

Response: In order to evaluate binocular games as a long-term treatment for amblyopia, more games are needed. It is also important to investigate how contrast changes should be manipulated to achieve maximum acuity improvements. Options for younger children who cannot play the games must also be explored, such as animated movies or television shows. These methods are currently being investigated at the Retina Foundation of the Southwest. Is there anything else you would like to add?

Response: Amblyopia not only results in decreased visual acuity, but is related to depth perception issues, slow reading and fine motor impairments. Early detection and treatment of amblyopia may also remediate these potential roadblocks to academic and social success. Thank you for your contribution to the community.


Holmes JM, Manh VM, Lazar EL, Beck RW, Birch EE, Kraker RT, Crouch ER, Erzurum SA, Khuddus N, Summers AI, Wallace DK, . Effect of a Binocular iPad Game vs Part-time Patching in Children Aged 5 to 12 Years With AmblyopiaA Randomized Clinical Trial. JAMA Ophthalmol. Published online November 03, 2016. doi:10.1001/jamaophthalmol.2016.4262

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on November 11, 2016 by Marie Benz MD FAAD