Towards a Gaze-Based Immersive Virtual Reality Game for Improving Visual Acuity with Amblyopia

Amblyopia is the most common neurological eye disorder worldwide, decreasing vision in approximately 1–5% of the global population. To reduce this loss of visual acuity, occlusion therapy is often beneficial for people with Amblyopia, yet this conventional rehabilitation method often suffers from low compliance and adherence rates due to its repetitive nature. Immersive Virtual Reality (iVR) applied to occlusion therapy games has a unique potential to engage players and stimulate their visual acuity. Advances in modern untethered Head-Mounted Display (HMD) systems that increase the accessibility of iVR open up new opportunities for more significant serious games interventions with Amblyopia. To this end, this paper investigates Project Star Catcher, a novel serious iVR HMD exergame refactored as a short 3-minute gaze-based color-matching intervention, and examined the game's effects on the vision of adults with Amblyopia. We present a pilot study [N=51 adults with Amblyopia] that measures changes in LogMAR visual acuity between the serious game (moving a drone to catch shooting stars) vs placebo (moving a drone in an empty starry sky) and younger adults (under 39 years old) vs older adults (39+ years old) from a mean age split comparison between users. Our results suggest that 3-minutes of serious iVR gameplay with experiences such as Project Star Catcher can significantly improve near distance visual acuity by over a mean of 6.2 letters when compared to placebo. We also found that older adults improve their near-distance visual acuity seven times greater than younger adults from gameplay. This paper concludes with discussion and considerations on utilizing iVR HMD serious games for visual acuity and Amblyopia.