Computerized Gaming Technology as an Effective Form of Vision Therapy for Convergence Insufficiency



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Computerized Gaming Technology as an Effective Form of Vision Therapy for Convergence Insufficiency

Authors


Christopher Herriot, School of Optometry, University of Waterloo

Tristan Carvelho, Computer Science and Engineering, York University

Robert Allison, Computer Science and Engineering, York University

Elizabeth Irving, School of Optometry, University of Waterloo


Purpose

The prevalence of convergence insufficiency (CI) has been estimated between 2.2 and 13%. CI is most often treated with some form of eye exercises. However, traditional forms of the exercises are tedious and boring, leading to poor patient compliance. The purpose of this pilot study is to investigate the efficacy and user acceptance of computerized gaming as a form of treatment for convergence insufficiency.


Methods

Four participants were selected for the study, with ages ranging from 11 to 34 years. Participants had to have corrected visual acuity of 6/12, stereo-acuity threshold  40 seconds of arc, near point of convergence (NPC) ≥ 6cm, exophoria greater at near than at far, and a positive fusional vergence (PFV) < 15 or not meeting Sheard’s criterion. Participants were asked to play a revised version of Pac-Man using a stereoscope to fuse two separate images. As the participant’s convergence improved, the convergence demand was increased and operant conditioning paradigms were used to keep the participant motivated. Training was performed for 20 minutes each day, 5 days of the week for 2 weeks. Participants were asked to complete as visual symptom questionnaire prior to their training and an acceptance questionnaire after completion.


Results

Prior to training the average NPC and PFV values were 12.9 ± 7.6 cm and 13 ± 4.2 respectively, and two participants reported visual symptoms of CI. Upon completion of the training, the average NPC decreased to 5.8 ± 3.0 cm and the average PFV increased to 25 ± 4.1. The two symptomatic participants reported relief of their symptoms, and all participants reported that computerized vision therapy was easy to understand, entertaining, and motivating.


Conclusion

Computerized gaming is a promising method to improve patient motivation and compliance. Further testing is required to directly compare its effectiveness to traditional methods.


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