Home-Based Dichoptic Treatment Improves Stereoacuity in Non-Strabismic Amblyopia

Home-based dichoptic therapy significantly improves stereoacuity in adults with anisometropic amblyopia without strabismus, according to a prospective study published in Clinical Optometry. 

Researchers enrolled 38 adults including 19 participants with non-strabismic anisometropic amblyopia (mean age, 24.05 years; 10 men; moderate amblyopia, n=15, severe amblyopia, n=4) and 19 control group participants without amblyopia (mean age, 24.10 years; 10 women) in the prospective analysis. All participants used their spectacle correction regularly for at least 16 weeks before undergoing home-based dichoptic therapy using a handheld game played on a tablet.  

Participants used the home-based treatment 4 times per day at 15 minute intervals during the 8-week study duration for a total treatment time of 40 hours. Patients underwent Stereo Fly testing at baseline and after treatment to assess stereoacuity improvements following the home-based dichoptic therapy.  

Compared with control group participants, home-based dichoptic therapy significantly improved stereoacuity in patients with non-strabismic anisometropic amblyopia after 8 weeks (mean improvement, 345.26 sec arc⁻¹; interquartile range [IQR], 260-600; P <.001).

A linear mixed effect model revealed that age did not affect the rate of change of stereoacuity during the 8 weeks of home-based dichoptic therapy (P =.544) and showed that amblyopia severity did not have any significant influence on stereoacuity improvement rate (β=-40.42; 95% Cl, 96.10-15.26; P =.153).

“We discovered that just within a short period of 3 weeks (15 hours) of home-based dichoptic therapy in young adults resulted in a significant improvement in stereo-acuity,” according to the researchers. “Home-based dichoptic iPad therapy may represent a feasible treatment option for anisometropic amblyopia in adults. This may better suit the lifestyle of economically active adults who may not be able to comply with clinic-based therapy.”

Study limitations include a failure of some participants to report for follow-up visits at the required time, overuse of the game beyond the required 15 minutes per session in some participants, and an inability to determine whether an individual other than the study participant played the game.