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Dr.John Davis Akkara,Dr.Anju Kuriakose,Dr.Davis J Akkara,Dr. EATHAMMA JACOB

Abstract

Stereopsis is one of the components of vision that we find difficult to test without specialized equipment. Conventionally, stereopsis testing requires Titmus Fly test, Lea Symbols test, TNO test, RanDot test or other stereopsis testing instruments. Amblyopia Therapy uses Synaptophore and other equipment. These are expensive and not available with most ophthalmologists. The authors evaluated some smartphone apps designed for stereopsis testing which makes use of low cost Virtual Reality Headsets and Red-Blue Anaglyph Glasses with an ordinary Android or iOS smartphone. In addition, similar Apps for Amblyopia Therapy were also found and evaluated. These Apps were found to be very cost effective, with the cost of the testing and therapy several times lower than conventional equipment. The authors also made their own App for Stereopsis testing and Amblyopia Treatment using the best features from the evaluated apps. The authors propose that this free app will make it affordable for all ophthalmologists to evaluate stereopsis and for patients to use low cost amblyopia therapy.

Key Words

smartphone, apps, stereopsis, amblyopia, TNO, titmus fly, virtual reality, anaglyph

Body of the Manuscript

Introduction

Binocular Single Vision and Stereopsis is an aspect of vision that is rarely tested due to the high cost of stereopsis testing equipment. With the recent advances in smartphone technology and affordable virtual reality headsets, it has become possible to do stereopsis testing on these low cost smartphone based virtual reality headsets. It is also possible to do stereopsis testing using low-cost anaglyph glasses. Amblyopia Therapy with binocular exercises is another aspect of pediatric ophthalmology that can be upgraded using these same virtual reality headsets and anaglyph glasses. The authors evaluated the use of these technologies with the help of some smartphone apps and proceeded to make

Methods

An Android smartphone, Anaglyph 3D glasses and Smartphone based Virtual Reality Headsets were obtained. Apps for Stereopsis Testing and for Amblyopia Exercises were installed from Play Store and evaluated.Some of the apps used low Red-Blue Anaglyph Glasses and other apps used low cost Virtual reality headsets.Several Apps were found, many of them free and some paid. After testing, some apps were found to be useful.

Results

Apps evaluated were tested for their usability and the following apps were useful for the respective uses. Some of the apps used Anaglyph glasses and others used Virtual Reality Headsets.

Stereopsis Testing

  • NTU RDS Stereopsis screening app
  • StereoAcuity test – Cardboard
  • iDoctor JD (new App developed by authors)

Amblyopia Therapy

  • Lazy Eye Fighter (Dr MS Ravindra)
  • MyEyeGym (SNEC, Singapore)
  • LazyEye 3D Bricks
  • Lazy Eye Blocks
  • Amblyo Mobile
  • Amblyopia Games
  • iDoctor JD (new App developed by authors)

Discussion

Vision testing includes not just visual acuity1, contrast sensitivity and color vision, but also stereopsis testing. Conventional methods of stereopsis testing includes TNO2 test, RanDOT3 test, Titmus Fly Test, Frisby Davis4 Distance Stereotest and Lang5 Stereo Test. Stereopsis is also required for surgeons6 in addition to several other skilled workers.

Amblyopia7 therapy has slowly shifted from plain eye occlusion to active exercises including video games8 and virtual reality games. The age9 of patient is a critical factor for amblyopia10 treatment and maintaining continuous adherence11 to treatment is difficult in children. These video games gamify the therapy and improve adherence and patient cooperation drastically.

Stereopsis testing & Amblyopia therapy12 are now affordable with smartphone apps13. Stereopsis testing can be done in camps. Patients can do Amblyopia therapy14 at home. Moreover, children find smartphone based amblyopia therapy games fun15& thus improves adherence to therapy. Further study is required to validate the efficacy of these innovations, but it looks very promising.

References

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  13. Innovative smartphone apps for ophthalmologists Akkara JD, Kuriakose A – Kerala J Ophthalmol [Internet]. [cited 2018 Oct 15]. Available from: https://www.kjophthal.com/article.asp?issn=0976-6677;year=2018;volume=30;issue=2;spage=138;epage=144;aulast=Akkara
  14. Paudel N. Smartphone Applications for Amblyopia Treatment: A Review of Current Apps and Professional Involvement. Telemed J E-Health Off J Am Telemed Assoc. 2018 Jan 18;
  15. Gambacorta C, Nahum M, Vedamurthy I, Bayliss J, Jordan J, Bavelier D, et al. An action video game for the treatment of amblyopia in children: A feasibility study. Vision Res. 2018;148:1–14.

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