Amblyopia (or ‘lazy eye’) is a common visual disorder that affects about 4% of people.  The most common causes are strabismus (where the child has a large squint or ‘turned eye’) and anisometropia (where there is a large difference in the refractive error between the two eyes).  Amblyopia is associated with decreased vision and reduced binocularity (hence people with amblyopia cannot generally not see 3D).  It is the most common cause of childhood visual impairment and it can range from mild, where vision is only slightly reduced, to severe, in which case the vision is very poor in the affected eye.

 

Up to now, conventional treatment for amblyopia has included patching of the non-amblyopic (normal) eye during childhood.  Patching requires the child to use their lazy eye and it is based on the belief that amblyopia is a monocular disorder.  While this treatment is usually effective, it is often not well tolerated as children can resent having to spend a certain number of hours each day only being able to see out of their ‘bad’ eye.

 

Current research now suggests that amblyopia is a monocular consequence of a primary binocular obstacle to normal visual development and so a binocular approach to treating amblyopia may be preferable.  Studies have shown that a video-game based treatment using an iPod – where the game is viewed with both eyes open – is effective in children and adults, and can improve both vision and binocularity.

 

A new study on this topic is about to commence at the Centre for Eye Research Australia (CERA) in Melbourne.  Dr Lionel Kowal – a world renowned expert in this area – will be the chief investigator and a total of 108 people (adults and children over the age of seven years) will be enrolled in the study.  This ‘Binocular treatment for amblyopia with videogame (BRAVO) study’ will involve six weeks of home-based use of a modified Tetris video game that runs on an iPod touch device.  The results of this research could certainly revolutionize our thinking about amblyopia and – more importantly – how we treat this visual disorder.

 

Richard