title: A binocular iPad treatment for amblyopic children.
abstract: OBJECTIVE
  Monocular amblyopia treatment (patching or penalization) does not always result in 6/6 vision and amblyopia often recurs. As amblyopia arises from abnormal binocular visual experience, we evaluated the effectiveness of a novel home-based binocular amblyopia treatment.
  
  
  METHODS
  Children (4-12 y) wore anaglyphic glasses to play binocular games on an iPad platform for 4 h/w for 4 weeks. The first 25 children were assigned to sham games and then 50 children to binocular games. Children in the binocular group had the option of participating for an additional 4 weeks. Compliance was monitored with calendars and tracking fellow eye contrast settings. About half of the children in each group were also treated with patching at a different time of day. Best-corrected visual acuity, suppression, and stereoacuity were measured at baseline, at the 4- and 8-week outcome visits, and 3 months after cessation of treatment.
  
  
  RESULTS
  Mean (±SE) visual acuity improved in the binocular group from 0.47±0.03 logMAR at baseline to 0.39±0.03 logMAR at 4 weeks (P<0.001); there was no significant change for the sham group. The effect of binocular games on visual acuity did not differ for children who were patched vs those who were not. The median stereoacuity remained unchanged in both groups. An additional 4 weeks of treatment did not yield additional visual acuity improvement. Visual acuity improvements were maintained for 3 months after the cessation of treatment.
  
  
  CONCLUSIONS
  Binocular iPad treatment rapidly improved visual acuity, and visual acuity was stable for at least 3 months following the cessation of treatment.
authors: Crystal Charity Ball Pediatric Vision Evaluation Center, Retina Foundation of the Southwest, Dallas, TX, USA.
authors: S L
authors: SL
authors: Li
authors: Crystal Charity Ball Pediatric Vision Evaluation Center, Retina Foundation of the Southwest, Dallas, TX, USA.
authors: R M
authors: RM
authors: Jost
authors: Crystal Charity Ball Pediatric Vision Evaluation Center, Retina Foundation of the Southwest, Dallas, TX, USA.
authors: S E
authors: SE
authors: Morale
authors: Pediatric Ophthalmology and Center for Adult Strabismus, Dallas, TX, USA.
authors: D R
authors: DR
authors: Stager
authors: Pediatric Ophthalmology and Adult Strabismus, Plano, TX, USA.
authors: L
authors: L
authors: Dao
authors: Pediatric Ophthalmology and Adult Strabismus, Plano, TX, USA.
authors: D
authors: D
authors: Stager
authors: 1] Crystal Charity Ball Pediatric Vision Evaluation Center, Retina Foundation of the Southwest, Dallas, TX, USA [2] Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors: E E
authors: EE
authors: Birch
mesh_terms: D000550:Amblyopia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015858:Anisometropia / Q000150:complications; D002648:Child; D002675:Child, Preschool; D034201:Computers, Handheld; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D013285:Strabismus / Q000150:complications; D018910:Video Games; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology