Virtual Reality Therapy
Virtual Reality is a therapy tool we use to improve a patient’s binocular vision (how the eyes work together to produce a three dimensional representation of the world), reduce suppression (where a patient uses only one eye at a time) and improve amblyopia (lazy eye).
We are able to hide a training activity inside a game. Just like hiding running inside a game of touch football. Where you may say “come for a run with me?” and get turned down, when you say “do you want to play touch footy with me?” it is whole other response. The eyes, patient and brain want to play the game, so they do the work.
Like learning to ride a bike, the skills learnt during therapy will be used over a life time.
Virtual Reality training is an emerging science and we are finding more applications for this technology every day. It is currently being used in the areas of lazy eye, sports vision, reading difficulties, brain injury rehabilitation, balance training and depth perception training.
Traditionally lazy eyes were treated with patching. Everyone hated patching; the patient, the parent and the optometrist. Patching works well for waking up one eye, however it is not good for teaching team work (connections) between the eyes. Virtual Reality works well at training the eyes to wake up and work together, all at once. Even more beneficial is that the patient is motivated to complete the training. They enjoy the games. This is much easier than trying to convince a patient to wear a patch and commit to training exercises. It is fast and effective.
We have found that Virtual Reality therapy has been able to help many of our patient’s vision problems. From children and adults with lazy eyes, children and adults struggling with reading, and children and adults with a traumatic brain injury.
The program starts with a comprehensive assessment by one of our behavioural optometrists. During this visit the nature and degree of the patient’s difficulties will be established.
Virtual Reality sessions run for 30 minutes and are conducted one on one, in the practice, with a vision therapist. Most often we book one per week for a block of 4 weeks and then reassess the patient’s progress.
During this time our optometrist will measure, review and discuss with the patient the progress made and will liaise with the vision therapist for future treatment.
Usually 2-3 blocks are required to create a lasting difference, but all cases are unique.
The are many studies to validate the efficacy of Virtual Reality. You may like to follow the links below for a selection of these studies.
Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results.
Žiak P, Holm A, Halička J, Mojžiš P, Piñero DP.
BMC Ophthalmol. 2017 Jun 28;17(1):105. doi: 10.1186/s12886-017-0501-8. Abstract.
Vedamurthy I1, Knill DC1, Huang SJ, Yung A, Ding J, Kwon OS, Bavelier D, Levi DM.
Philos Trans R Soc Lond B Biol Sci. 2016 Jun 19;371(1697). pii: 20150264. doi: 10.1098/rstb.2015.0264.
Clinical trial USA 2015
Christopher M. Aderman, M.D., Ph.D., Department of Ophthalmology, University of California, San Francisco.
Subjects are enrolled in a single-center, masked, randomised-controlled trial to study the effects of a dichotic VR platform on visual acuity and stereopsis in adults with amblyopia. The results show reductions in suppression among amblyopic subjects after VR therapy.
Remote testing of visual parameters is possible and correlates well with validated in-clinic measurements. Remote monitoring allows for monitoring of compliance and can provide red-flag alerts with broad application.A study conducted by UVEA Mediklinik was released in 2015 with patients using the Vivid Vision device. In that study, 60% of patients showed an increase in visual acuity of 1-3 lines after just 8, forty-five minute sessions of Vivid Vision.
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