• Dig Rush Binocular Game for Children With Amblyopia

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, March 2019

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    Studies of binocular games in children with amblyopia have been hampered by noncompliance, perhaps due to the mundane nature of the games. Holmes et al. prescribed treatment with the dichoptic binocu­lar Dig Rush game, which appeared engaging in a pilot study. They also compared visual outcomes between amblyopic children who played the Dig Rush game and those who continued with spectacle correction only. They found that the game did not result in better visual acuity (VA) or stereo­acuity within four or eight weeks of treatment.

    This multicenter randomized study included 138 children between the ages of 7 and 12 with amblyopia (resulting from strabismus, anisometropia, or both). Participants were required to have at least 16 weeks of optical treatment in spectacles, if needed, or to exhibit no improvement in the VA of the amblyopic eye for at least eight weeks leading up to enrollment.

    The children were assigned randomly either to receive eight weeks of treatment with the game and, if needed, specta­cle wear (n = 69) or to continue with spectacle correction alone (n = 69). The game, which was played on an iPad, was prescribed for one hour each day, five days per week.

    The main outcome measure was VA change in the amblyopic eye from baseline through week 4, assessed by a masked examiner. Secondary out­comes included changes from baseline through eight weeks.

    By the four-week mark, the mean VA letter score of amblyopic eyes had improved by 1.3 with binocular game treatment and by 1.7 with spectacle correction alone. After adjusting for baseline VA, the difference in letter score be­tween the groups (binocular minus control) was –0.3. After eight weeks of treatment, there was no difference in letter scores. Among the binocular group, adherence data obtained from the iPad indicated that just over half of the participants com­pleted more than 75% of prescribed treatment (58% for four weeks; 56% for eight weeks).

    Although the authors found no VA benefit from the binocular game, there is evidence that such treatment may help some younger children, particularly those who have not been treated previ­ously. The issue is being evaluated in an ongoing study of children between the ages of 4 and 6.

    The original article can be found here.