Treatment and compliance with virtual reality and anaglyph‐based training programs for convergence insufficiency

Abstract

Background: Convergence insufficiency may be treated by visual exercises designed to increase convergence while maintaining single, clear, binocular vision. However, compliance with treatment is problematic, as patients often cease treatment when symptoms start to improve and before treatment is complete. The purpose of the present study was to assess the feasibility of using gamification of vision training to: (a) treat convergence insufficiency; and (b) improve compliance to treatment in comparison to a conventional treatment over a six-week treatment period. Methods: Two interventions, anaglyphs and a virtual reality game of Snakes, were evaluated for their effectiveness in treating adults with convergence insufficiency. The prescribed training regimen was 20 minutes, three times per week for six weeks. Vision was assessed before and after the treatment period. Participants also filled in the Core Elements of the Gaming Experience Questionnaire to gauge impact of game design on compliance. Results: Eighteen participants (mean age 20.8 AE 1.8 years) met the inclusion criteria for convergence insufficiency and nine participants were randomly assigned to each intervention. Repeated measures analysis of variance showed a significant effect of visit for near point of convergence (F 1,16 = 38.32, p < 0.0001), near positive fusional reserves break (F 1,16 = 21.94, p < 0.0001) and recovery (F 1,16 = 26.87, p < 0.0001), but not of intervention type. Total time played was significantly longer for the virtual reality Snake Game than the anaglyph intervention (p < 0.0001), which translated to mean compliance of 82 per cent and 51 per cent respectively. Conclusion: Gamification of vision training in a virtual reality environment is feasible and associated with increased compliance, hence may be a useful strategy to treat convergence insufficiency.

Virtual Reality-based Vision Therapy Versus OBVAT in the Treatment of Convergence Insufficiency, Accommodative Dysfunction: A Randomized Controlled Trial

“…In this study, the mean improvements in positive fusional vergence were 11.8 and 13.5 △ base-out in the virtual reality and OBVAT groups, respectively, and these were similar to the values reported in two other studies [22,23] that used virtual reality therapy for adults with convergence insu ciency (3.9 and 14.7 △ base-out, respectively). However, the mean improvement was less than that reported in previous adult studies [15,26,27] using OBVAT for vision therapy.…”

“…Similarly, the mean improvement in the NPC was 2.08 and 2.18 cm in the virtual reality and OBVAT groups, respectively, which was similar to the 2.4 cm improvement reported in a previous study [23] that also used virtual reality therapy for adults with convergence insu ciency. However, the mean improvement in near point of convergence was less than that in previous adult studies [15,26,27] using OBVAT.…”

“…In this study, the OBVAT group was chosen as the control group because OBVAT is the most effective therapy currently known for improving binocular vision functions and symptoms in patients with convergence insu ciency or accommodative dysfunction [14,16]. Previous studies [22,23] have shown that virtual reality-based vision therapy is promising, and the results of the present study suggest that virtual reality training can be an effective method for patients with convergence insu ciency and accommodative dysfunction.…”

“…Yaramothu et al [22] found that virtual reality therapy effectively improved the vergence function and relieved symptoms of convergence insu ciency. Moreover, Boon et al [23] found that a virtual reality therapy group had higher compliance when patients with convergence insu ciency were trained using anaglyphs and a virtual reality game of snakes. Munsamy et al [24] reported that virtual reality gaming for 25 min improved accommodative and vergence facility.…”

The Influence of COVID-19 Isolation on Physical Activity Habits and Its Relationship with Convergence Insufficiency

“…Also, the Σ−CISS is inversely correlated to the emotional state E-state (r = −0.31; p < 0.001). The increase in PC use, Δ−PC, is positively correlated to the Σ−CISS score ( r = 0.22; p < 0.01); an increase in PC use of 28.68% means that the participant is doing an intense reading task [ 33 ], which causes CI problems to increase [ 34 ] due to eye’s crystalline accommodation that introduces a convergence problem related to reading tasks [ 35 ].…”