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Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system

Herbison, Nicola; MacKeith, Daisy; Vivian, Anthony; Purdy, Jon; Fakis, Apostolos; Ash, Isabel M.; Cobb, Sue V.; Eastgate, Richard M.; Haworth, Stephen M.; Gregson, Richard M.; Foss, Alexander J.E.


Nicola Herbison

Daisy MacKeith

Anthony Vivian

Jon Purdy

Apostolos Fakis

Isabel M. Ash

Associate Professor

Richard M. Eastgate

Stephen M. Haworth

Richard M. Gregson

Alexander J.E. Foss


Background Traditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye.

Methods A randomised control trial was performed on patients with amblyopia aged 4–8 years with three arms. All three arms had dichoptic stimulation using shutter glass technology. One arm had DVD footage shown to the amblyopic eye and common background to both, the second used a modified shooter game, Nux, with sprite and targets presented to the amblyopic eye (and background to both) while the third arm had both background and foreground presented to both eyes (non-interactive binocular treatment (non-I-BiT) games).

Results Seventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus. The visual acuity improved in all three arms by approximately 0.07 logMAR in the amblyopic eye at 6 weeks. There was no difference between I-BiT DVD and non-I-BiT games compared with I-BiT games (stated primary outcome) in terms of gain in vision.

Conclusions There was a modest vision improvement in all three arms. Treatment was well tolerated and safe. There was no difference between the three treatments in terms of primary stated outcomes but treatment duration was short and the high proportion of previously treated amblyopia and strabismic amblyopia disadvantaged dichoptic stimulation treatment.


Herbison, N., MacKeith, D., Vivian, A., Purdy, J., Fakis, A., Ash, I. M., …Foss, A. J. (2016). Randomised controlled trial of video clips and interactive games to improve vision in children with amblyopia using the I-BiT system. British Journal of Ophthalmology, 100(11),

Journal Article Type Article
Acceptance Date Jan 25, 2016
Online Publication Date Oct 21, 2016
Publication Date Nov 1, 2016
Deposit Date Aug 17, 2017
Publicly Available Date Aug 17, 2017
Journal British Journal of Ophthalmology
Print ISSN 0007-1161
Electronic ISSN 1468-2079
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 100
Issue 11
Public URL
Publisher URL


Herbison et al bjophthalmol 2016.pdf (481 Kb)

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