'Lazy eye' in kids is an age-old problem: A new VR headset brought treatment into the 21st century

For centuries, eyepatches have been the gold standard for treating amblyopia, also known as “lazy eye.”

Amblyopia is the most common cause of visual impairment in children, health experts say, and is usually treated by covering the stronger eye with a sticky patch to train the weaker one.

Although the treatment works, getting kids to stick with it can be tough.

“After a year and a half of patching, Camille became very resistant to it. She would run and cry,” said Jaye Setty-Collier, whose 7-year-old daughter was diagnosed with amblyopia when she was 3. “And I don’t blame her. When you pull the sticky patch off, it feels like your eyebrow is being waxed.”

Fortunately, for children like Camille, a new therapy recently approved by the Food and Drug Administration has introduced a modern approach.

The product, called Luminopia One, is a virtual reality headset that plays popular, kid-friendly TV shows and movies. While children watch their favorite programs, the headset blurs the image in one eye to strengthen the other.

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The headset is FDA approved for children ages 4 to 7 for one hour a day, six days a week. A study conducted by Luminopia, a digital therapeutics company and published in the peer-reviewed journal Ophthalmology, found children’s vision in the weaker eye improved by nearly two eye chart lines in 12 weeks.

“It was a night and day difference” for Camille, who participated in the trial, Setty-Collier. “She went from crying and resisting patches to actually asking for more time with the headset.”

Patients with amblyopia usually require months to years of patching before seeing marked improvement, said Dr. Allison Babiuch, a pediatric ophthalmologist at the Cleveland Clinic’s Cole Eye Institute, who is not affiliated with the study or the product's development. And even then, most children don’t reap the full benefits of the patch because they eventually stop wearing it.

“It’s very exciting,” Babiuch said of the headset. “The treatment for amblyopia has been the same boring thing for so long and this feels like a 21st century treatment.”

The headset feeds data into a dashboard accessible to doctors that shows it is being used as prescribed. Although parents reported a 100% compliance rate in the Luminopia study, the headset reported children were 88% compliant.

Babiuch called that compliance rate “quite good.”

Of the participants with prior patching history in the treatment group, 94% of parents said they were “likely” or “very likely” to choose the headset over patching.

“All of us that treat a lot of patients with amblyopia, it’s a fight with the families. It’s a fight with the kids and parents have a hard time complying,” said Dr. Monte A. Del Monte, Skillman professor of pediatric ophthalmology at the University of Michigan’s Kellogg Eye Center. “The headset is popular and more palatable to the kids and families.”

He said the extra hour of screen time, which has doubled among kids since the start of the COVID-19 pandemic, shouldn't have a big impact on eye health. Additionally, virtual reality doesn't affect near-sighted vision like a phone or tablet, said Scott Xiao, co-founder and CEO of Luminopia.

"The unique thing about VR is that the optical system projects the images at distances more akin to watching something in a movie theater rather than looking at a phone," he said.

Health experts recommend treating amblyopia early in life as it generally develops from birth up to age 7.

In amblyopic patients, the brain begins to turn off its connection to the lazy eye favoring the stronger one. As a child grows older, Babiuch said, the condition becomes harder to treat and can cause permanent vision loss.

“In order to see, you have to have healthy eyes and healthy diversionary of the brain,” she said. “The reason why the treatment has to be done when you are young is because the brain is still moldable.”

The most common type of lazy eye is strabismus amblyopia, where the muscles in the weaker eye cause it to cross in or turn out and prevent the two eyes from working together.

The second most common type is refractive amblyopia, which is when the eyes have a significant difference in prescription. In some children, lazy eye can be caused by a combination of these problems.

Health experts suggest parents watch for early warning signs in their younger children. This may include an eye that wanders inward or outward, eyes that appear to not work together, poor depth perception, squinting or shutting an eye and head tilting, according to the Mayo Clinic.

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Camille, however, had none of those symptoms when she was diagnosed with amblyopia. Setty-Collier brought her to the ophthalmologist after she complained of white light in her vision.

It’s a lesson “for parents to be diligent with your children’s vision,” Setty-Collier said. “Had she not given us that white light situation, we would not have gotten her to an ophthalmologist that early in life.”

The Luminopia One trial has been over since January 2020, but Camille still asks her father about the headset.

The company says it will be available to the public in June 2022. Parents have a choice of buying their own compatible headset and downloading the Luminopia One application, or renting one directly from the company with the application installed, Xiao said.

Although pricing has not been finalized, the company is working with insurance companies to determine coverage and reimbursement options. Researchers also plan to conduct more studies on older children.

“It really is a total game changer and I’m thankful for the opportunity we got to have our daughter use it,” Setty-Collier said. “The team that made this a reality will be changing so many lives.”

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: FDA approves new ‘lazy eye’ treatment for kids using virtual reality