Assessment of a computer-based treatment for older amblyopes: the Glasgow Pilot Study

Eye (Lond). 2009 Jan;23(1):124-31. doi: 10.1038/sj.eye.6702977. Epub 2007 Oct 12.


Purpose: There have been few viable alternatives to patching the better eye as a treatment of amblyopia for more than two centuries. The success of patching depends on compliance, which is problematic for up to 59% of children and their families.

Methods: This pilot study trialled the interactive binocular treatment (I-BiT) system as an alternative amblyopia treatment in 12 older amblyopes (6.1-11.4 years, median 8.2), who had not complied with or responded to occlusion. Virtual reality images were projected to each eye simultaneously via a headset during eight treatment sessions of 25-min duration. Outcome measures were changes in high- (HCVA) and low-contrast log MAR acuity (LCVA) at 1 week, 4 weeks and a final follow-up (3-18 months) after the final treatment.

Results: Sustained improvements in HCVA were observed in seven children (58%) and in LCVA in eight children (67%), including two for whom amblyopia was eliminated. Five children had visual acuities equivalent to 6/12 or better at least 6 months after stopping treatment, compared with one child prior to treatment. Significant improvements in HCVA occurred up to the fourth treatment; in LCVA to the seventh treatment.

Conclusion: Sustained improvements in visual acuity were observed for 58% of this small group of children using the I-BiT system, despite prior failure with conventional treatment. This offers hope for a potential time-saving alternative to patching, in which compliance can easily be monitored, but the results need to be validated by means of a randomised controlled trial.

Publication types

  • Evaluation Study

MeSH terms

  • Amblyopia / therapy*
  • Child
  • Contrast Sensitivity / physiology
  • Female
  • Humans
  • Male
  • Ophthalmology / instrumentation
  • Pilot Projects
  • Therapy, Computer-Assisted / methods*
  • Treatment Outcome
  • Visual Acuity / physiology