Using Eye Tracking to Measure Video Game–Assisted Therapy for Improved Visual Outcomes in Pediatric Strabismus: Randomized Control Trial

Abstract

Background: Strabismus, commonly known as crossed eyes, is a condition characterized by the misalignment of the eyes, leading to impaired binocular vision and depth perception. Traditional management often involves occlusion therapy, which can be hindered by poor compliance. Video game therapy has emerged as a promising adjunct to traditional treatments, potentially improving compliance and directly stimulating visual and cognitive functions. Objective: This study compares the effectiveness of traditional occlusion therapy with and without the addition of video game therapy in improving visual outcomes among children with strabismus. Methods: This randomized, controlled clinical trial included 30 children aged 5 to 10 years diagnosed with various types of strabismus. Participants were randomly assigned to 2 groups: the control group (eye patching alone) and the treatment group (eye patching combined with video game therapy). The intervention lasted 3 months, with data collected at baseline and after the treatment. Primary outcomes included visual acuity, angle of deviation, and stereoacuity, while fixation stability was measured using the Tobii eye tracker. Data were analyzed using paired 2-tailed t tests, independent 2-tailed t tests, Mann-Whitney U tests, and multivariate analysis of variance, with a significance level set at P