Efficacy of patching combined with action video games in amblyopic children aged 4-10 years: A randomised clinical trial.

Purpose: To determine the impact of using child-friendly action video games combined with monocular occlusion for the treatment of children with amblyopia compared with occlusion alone.

Methods: Twenty-eight children aged 4-10 years (mean age: 5.80 ± 1.54 years) with anisometropic and/or strabismic amblyopia were included. Each participant was previously prescribed an optimal refractive correction, and after 8 weeks was randomly assigned to one of the treatment groups: action video games (AVG) plus occlusion (n = 14) or passive occlusion alone (PO) (n = 14). Visual acuity (VA) and stereoacuity (ST) were measured at baseline and following 14, 28 and 42 h of treatment. Compliance was monitored using parental registry and Google Analytics.

Results: After 42 h, both groups showed significant improvement in the visual acuity of the amblyopic eye, p < 0.001 and p = 0.04 for the AVG and PO groups, respectively. However, VA recovery was significantly greater (p = 0.01) and faster with monocular AVG plus occlusion (0.18 logMAR) compared with occlusion alone (0.06 logMAR) in the amblyopic eye. The small improvement (0.02 logMAR) in the non-amblyopic eye was not significant for either group. No significant differences between groups were observed for ST (p = 0.38).

Conclusions: These findings suggest that combining occlusion and action video games at home results in greater effectiveness and efficiency in improving VA in children with anisometropic and strabismic amblyopia.