Evaluation of the Role of Monocular Video Game Play as an Adjuvant to Occlusion Therapy in the Management of Anisometropic Amblyopia

Purpose: To evaluate the role of monocular video game play as an adjuvant to occlusion therapy in the treatment of anisometropic amblyopia. Methods: In a prospective randomized study design, 68 children with ages ranging from 6 to 14 years who had anisometropic amblyopia with a best corrected visual acuity (BCVA) in the amblyopic eye of better than 6/36 and worse than 6/12 and no manifest strabismus were recruited. They were randomly allocated into two groups: 34 children received 1 hour per day of video game play for the first month plus 6 hours per day of occlusion therapy (video game and occlusion group) and 34 children received 6 hours per day of occlusion therapy alone (occlusion only group). Patients were then evaluated at baseline and 1 and 3 months after treatment for BCVA, stereoacuity, and contrast sensitivity. Results: In the video game and occlusion group, BCVA improved from 0.61 ± 0.12 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.51 ± 0.14 logMAR ( P = .001) at 1 month and 0.40 ± 0.15 logMAR ( P = .001) at 3 months. In the occlusion only group, BCVA improved from 0.65 ± 0.09 logMAR at baseline to 0.60 ± 0.10 logMAR ( P = .001) at 1 month and 0.48 ± 0.10 logMAR ( P = .001) at 3 months. There was significantly more improvement in the video game and occlusion group compared to the occlusion only group ( P = .003 at 1 month and P = .027 at 3 months). Conclusions: Video game play plus occlusion therapy enhances the visual recovery in anisometropic amblyopia. [ J Pediatr Ophthalmol Strabismus . 2017;54(4):244–249.]