Virtual Reality-Based Vision Therapy for Intermittent Exotropia: A Randomized Clinical Trial

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Vision Science

Background:

• Intermittent exotropia (IXT) is the most common childhood strabismus, impacting binocular vision and psychosocial well-being.
• Effective treatments for IXT are crucial for improving children's quality of life.

Purpose of the Study:

• To evaluate the efficacy and safety of virtual reality-based vision therapy (VRVT) for treating intermittent exotropia in children.
• To assess the impact of VRVT adherence on treatment outcomes.

Main Methods:

• A randomized clinical trial involving 161 children (aged 6-18) with previously untreated IXT.
• Participants were randomized to a 12-week home-based VRVT program or observation (control group).
• Primary outcome was the change in distance exotropia control score from baseline to week 12.

Main Results:

• The VRVT group showed a modest improvement in the distance exotropia control score compared to the control group (difference of -0.33).
• Participants with over 75% VRVT adherence experienced significantly greater improvement (difference of -0.71).
• Greater benefits were observed in patients with a baseline exotropia control score of 2 or higher.

Conclusions:

• Virtual reality-based vision therapy offers a modest benefit for children with intermittent exotropia.
• High adherence to VRVT is associated with significantly better outcomes, highlighting its potential clinical value.
• VRVT appears safe, with no reported intervention-related adverse events.