Inthisproject,weproposetodevelopanddemonstratefeasibilityofaheadmountedsmartphone?basedapplicationfor in?hometrainingandremotemonitoringofprogressforpatientswithconvergenceinsufficiency(CI).CIdevelopsinan estimated 13?17% of school?age children in the U.S. (3?8% overall) and causes symptoms of eye strain, blurred vision, andreducedconcentration,resultinginsignificanteducationaldisadvantages.Ifdiagnosed,thedisordercanbetreated by a well?established training program that has been demonstrated to alleviate the symptoms. Recent studies have foundthatthevisiontherapyforCIismoresuccessfulwhenperformedinthedoctor?sofficeundermonitoringandthen reinforcedwithat?hometraining.However,significantbarriersofcost/timeofin?officetreatmentandpoorcompliance at home limit the benefits of the vision therapy and greatly hamper its success. The proposed head mounted smartphone system will consist of two components: one for binocular vision assessment and another module to broadcast remote display content wirelessly to a virtual reality headset. This novel Universal Vision Therapy and Entertainmentplatformwillenablethepatientstowatchtheirfavoritevideocontentorplayavideogameofchoiceon aheadmountedsystemaspartofthetherapy.Oncethevideostreamischosenbytheuser,thesystemwillconvertitto a dichoptic stimulus with variable induced vergence demand. During the therapy session, the system will log usage statisticsandsystemparameterssuchasinducedvergencedemandrangeforpost?hocanalysisandremotemonitoring by the doctor. We hypothesize that an increase in compliance will be achieved due to the low invasiveness of the trainingprotocolandawidevarietyofvideocontentthatwillkeepthetherapyengagingforprolongedduration. Through our clinical collaborations we will evaluate the compliance of the proposed therapy relative to standard methodologies in patients. At the conclusion of the Phase I project, we will have demonstrated feasibility and complianceofthenovelmobileentertainmentforvisiontherapy,showingaccuracyofbinocularmeasurementsandthe user acceptance of our method compared to the tests and therapies currently employed in clinics and ophthalmology practices.Thewideavailabilityofsmartphonesandlow?costvirtualrealityheadsets(googlecardboard),whencoupled with our universal platform, have the potential to bring about a paradigm shift in cost?compliance calculations and increase awareness for binocular vision disorders, resulting in greater access to treatment for CI?affected individuals. Once the accuracy and compliance for the system meet or exceed those of current methods in a representative population,wewillprepareforanin?depthevaluationoftherapyefficacyinPhaseII.
Convergenceinsufficiency(CI)affectsanestimated13?17%ofschool?agechildrenintheU.S.(3?8%overall)andcauses symptoms of eye strain, blurred vision, and reduced concentration, resulting in significant educational disadvantages. NIH funded clinical studies have demonstrated the feasibility and effectiveness of vision therapy to restore binocular vision, but public health efforts to perform training for CI have been hampered by significant barriers of cost and time related to in?office therapy, and poor compliance in the case of in?home therapy. A significant challenge for patient compliancewithin?hometherapyhasbeenthemonotonyofvisiontrainingtasks,limitedtosimpleexercisesorasingle videogame.ArecentstudyofCItherapyreported67%complianceforin?homecomputer?basedtherapyasopposedto 91% for in?office therapy. If patient compliance with in?home therapy can be improved, the overall success rate of CI training will likely be increased significantly. The overall goal of the proposed Phase I project is to develop a head? mountedsmartphone?basedvisiontherapysystemthatwirelesslyconvertsanyvideoentertainmentfromanexternal, user?defined source to a dichoptic training stimulus. Using such a cost?effective, widely available system, the affected populationwillbeabletoreceivein?homevisiontherapywithautomateddoctormonitoringviatelemedicine,allwhile enjoyingtheirregularTVshows,moviesorvideogames.
