Improvement of visual acuity in residual meridional amblyopia by astigmatic axis video games

This study was carried out to evaluate the efficacy of developed "astigmatic axis video games" in children and adolescents having meridional amblyopia, with the aim to improve the visual acuity (VA). Till date, no studies are available on the treatment of amblyopic meridian. Meridional amblyopia (MA) results when astigmatism remains untreated for a long period. The aim of the study was to assess the effectiveness of a set of novel video games, the astigmatism axis video games (AAVGs), in improving the visual acuity (VA) in MA.

We included 50 eyes with residual myopic MA (cylinder ≥2.0 and ≤4.0 D) whose VA did not improve beyond 0.3 LogMAR equivalent, despite patching for 2 h/day for the preceding 3 months. Patients were subjected to AAVG in conjunction with best-corrected glasses and patching of the better eye for 2 h/day for 3 months.

Out of 50 eyes, 32 eyes were from children between 8 and 12 years and 18 were >12 years. Full improvement of LogMAR VA up to 0.0 was seen in 36/50 (72.0%) oblique astigmatism eyes. Partial improvement of LogMAR VA at least 0.3 LogMAR or more was observed in another 7 eyes (14%) eyes. The mean VA improved from 0.43 ± 0.1 LogMAR at baseline to 0.077 ± 0.08 at 3 months (P < 0.001). Good number of eyes (n = 16, 32%) showed speedy visual improvement between 2 and 4 weeks after initiation of AAVG. No adverse effects were observed.

Satisfactory improvement in VA in eyes with residual MA provides preliminary data into the effectiveness of stimulation of the precise amblyopic axis by AAVG in conjunction with spectacles and "minimal patching" regimen of 2 h/day. Further comparative study is warranted.