Barriers to successful dichoptic treatment for amblyopia in young children

Aveen Kadhum, Emily T.C. Tan, Dennis M. Levi, Linda Colpa, Maria Fronius, Huibert J. Simonsz, Sjoukje E. Loudon*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)
35 Downloads (Pure)


Purpose: In an ongoing randomised clinical trial comparing dichoptic VR video games with patching for amblyopia, we evaluated any potential barriers to successful use of this novel amblyopia treatment method. Methods: From December 2017, all newly diagnosed amblyopic children were recruited. Excluded were children under age 4 and patients with strabismus exceeding 30PD. The video game was played for 1 h per week at the outpatient clinic under direct supervision. Records were kept of difficulties encountered during treatment and categorised into domains. Factors influencing the successful completion of this treatment were identified and related to patient characteristics. Results: Ninety-one children were recruited for the trial, 20 parents refused participation before randomisation, because of the logistical challenges the outpatient dichoptic treatment would cause them. Of the 17 children who commenced dichoptic treatment (median age 6.2 years; IQR 4.9–8.4 years), 10 did not complete treatment. Children under age 5.5 years were unable to comprehend the game settings or the game itself. Older children (N = 7; 41%) were less willing to comply with the video game. Loss of interest in the game (N = 8; 47%) was found to be a limiting factor at all ages. Conclusion: Half of the children failed to complete VR dichoptic treatment, mainly due to young age. In countries with nationwide screening where amblyopia is detected before age 6, the applicability of such dichoptic treatment is limited.[Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)3149-3157
Number of pages9
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Issue number10
Early online date31 May 2021
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
This study was funded by Uitzicht (2016–25), Lijf & Leven (No.36), ODAS (2016–04).

Publisher Copyright:
© 2021, The Author(s).


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