A virtual reality (VR)-based gamified binocular application demonstrated potential for treating adult amblyopia, according to a study published in Entertainment Computing. A panel of experts determined the smartphone accessible game may improve visual acuity, contrast, and depth.

A total of 4 gamification experts and 4 optometrists with expertise in amblyopia treatment evaluated the game. The experts played the game, examined its features, and completed a questionnaire based on a Nielsen’s heuristics evaluation. 

Researchers briefly outline the application’s functioning. The game presents images separately to both eyes using virtual reality technology. Patients must place a Bangerter filter or an added lens on their glasses over the non-amblyopic eye. This will force the brain to use the amblyopic eye during the game. The level of blur vision contrast gradually increases during the treatment process until the vision is balanced in both eyes.


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The manufacturer designed the game considering 3 components for amblyopia treatment success: color of the game elements, size of the game elements, and CAM vision stimulation. They identified effective colors (red, yellow, green, blue, and orange) for use in the game and calculated 3 different sizes for game elements depending on amblyopia severity. The team designed the game’s floor level in a checkered pattern that rotates during the game. The direction of rotation and the design of its space lines change to simulate the Cam stimulator. 

The researchers scored most of the heuristic principles and therapeutic elements highly (above 65% satisfaction) demonstrating the potential application of the game for treating amblyopia. The experts also concluded the application was entertaining and engaging and may positively affect patients’ motivation to continue treatment.

The team evaluated a variety of Neilsen’s heuristic factors and expressed satisfaction with system status visibility (80%), matching between the system and real world (79%), consistency and standards (82%), error prevention (86%), flexibility and efficiency in use (75%), and its aesthetic and minimalist design (80%).

Researchers acknowledge the need to improve certain gaming elements and conduct larger-scale studies using participants with amblyopia. They highlight the game’s high level of engagement and state, “the use of virtual reality technology and gamification can maintain the motivation of adults to complete a long and effective treatment process.”

Study limitations include a low number of expert participants and difficulty in reaching the target population due to COVID-19 concerns.

Reference

Khaleghi A, Aghaei Z, Hosseinnia F. Toward using effective elements in adults’ amblyopia treatment in a virtual reality-based gamified binocular application. Entertainment Computing. Published online June 3, 2022. doi:10.1016/j.entcom.2022.100504