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A study trialling video games as a treatment for amblyopia is getting underway in Melbourne and optometrists are needed to help recruit local participants.

Amblyopic children and adults are needed to take part in the study assessing video games as a treatment for unilateral amblyopia.

The binocular treatment for amblyopia using videogame (BRAVO) study is an international multi-centre randomised clinical trial of a dichoptic Tetris-based treatment for unilateral amblyopia. Unlike traditional treatments, it does not involve patching one eye.

Tetris is a popular electronic game that aims to fit into a box different geometric-shaped pieces formed out of squares.

Chief orthoptist at The Private Eye Clinic in Melbourne, Roberto Pieri, said the study aimed to assess whether this binocular treatment, implemented on a take-home iPod device, was effective at improving visual acuity and binocular vision in people with amblyopia.

Participants will be asked to play the video game for one to two hours each day for six weeks, and need to attend at least five appointments at the Centre for Eye Research Australia Clinic at the Royal Victorian Eye and Ear Hospital.

The study is being led by the University of Auckland’s Department of Optometry and Vision Science in collaboration with the university’s Department of Ophthalmology, the University of Melbourne and the University of Waterloo and McGill University in Canada.

Optometrist Dr Ann Webber from Queensland University of Technology is doing a separate but closely-related study in seven- to 12-year-old amblyopic children, researching Tetris therapy as an alternative to patching or atropine. She is looking at implementation in primary care practice and impact on fine motor skills.

The studies follow pioneering research on video games for amblyopia by Professor Robert Hess, director of research in the Department of Ophthalmology at McGill University, who is a collaborator on both studies.

He developed this new approach to treat amblyopia following his trials in adults and children, comparing patching over the ‘good’ eye with a dichoptic approach, while playing video games.

His results confirmed that patching of the ‘good’ eye in patients older than 10 years was not effective but found that playing video games created conditions under which both eyes worked together, and dichoptic training resulted in significantly greater learning effects than monocular training, greater improvements in stereopsis and greater reductions in suppression.

During the Melbourne study, participants will be asked to wear up-to-date refractive correction, either spectacles or soft contact lenses, full-time. The team can provide free spectacles if participants do not have suitable lenses.

Mr Pieri said that people could take part regardless of whether they had previously received treatment for lazy eye including patching, atropine drops, strabismus surgery or vision therapy.

The criteria are that they must be aged a minimum of seven years but as there is no upper age limit adults can apply, have unilateral amblyopia due to constant unilateral strabismus and/or anisometropia, have best corrected acuity in the amblyopic eye of 6/12 to 6/60 inclusive and best corrected acuity in the fellow eye of 6/7.5 or better.

Other criteria are that myopia must be of spherical equivalent power less than -6.00 dioptres with no limit on hyperopia or astigmatism, no ocular diseases, no previous history of intraocular surgery although LASIK and PRK are acceptable, and no neurological conditions such as migraine, epilepsy, Parkinson’s disease or Alzheimer’s disease.

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