A New Approach to Vision Therapy Based on Naturalistic 3-D Computer Gaming

描述（由申请人提供）：会聚障碍和屈光性弱视是一般验光临床实践中最常见和可治疗的视力问题。居家视力治疗（分别为OBVT和HBVT）是此类疾病的标准治疗方法。计算机视频治疗的最新进展，模拟在验光师办公室进行的视力治疗练习，为OBVT提供了一种成本更低、更方便的替代方案。目前商业HBVT系统的缺点是推荐的眼保健操是高度重复、单调和无趣的，这导致患者高度不遵守。这就提出了一个问题，因为一致的表现和适当的技术是实现治疗效益的关键。另一种可能提高HBVT成功率的方法是将视力治疗纳入有趣的交互式电脑游戏中，让患者更感兴趣。为了满足这一需求，Barron Associates建议开发一种名为iCare的新型计算机虚拟现实HBVT系统，该系统将通过解决成功家庭治疗的三个障碍来克服现有系统的局限性：(1)患者依从性；(2)程序准确性；(3)验光师监控培训的能力。所提议的方法利用了为视频游戏市场开发的先进人机界面设备（HIDs）（例如，Wii远程控制器）。由于电子游戏的普及，HID技术在最近还非常昂贵，现在可以以低成本广泛使用（例如，低于40美元）。这些现成的HIDs允许在计算机显示器（用于“近点”视力治疗）或等离子显示器（用于“远距离”视力治疗）上创建虚拟三维（3-D）环境。基于“3d眼镜”（即红蓝解析）的传统3d图形技术相对于观看设备的框架是静态的；也就是说，无论观看者相对于显示器的位置如何，图像都是相同的。提出的iCare技术通过低成本跟踪患者头部位置和方向来利用运动视差，创造一个动态的视觉三维环境。从视觉上看，这项技术允许观看者感知物体，就好像它们出现在屏幕上或后退到屏幕上。这使得在几乎无限的三维空间中创建虚拟轴向对象成为可能。用户甚至可以看到“背后”并操纵虚拟物体。根据SBIR快速通道拨款申请，提案小组将使用上述技术开发和测试HBVT的原型电脑游戏环境，以提高治疗效果。I期治疗的目标是治疗8-12岁儿童的屈光性弱视；二期将重点治疗青少年和成人的屈光性弱视，以及两类人群的会聚性弱视。这些疾病显然可以接受视力治疗，并且在临床实践中很常见。对于这两种视力问题，将在儿童中进行比较最流行的计算机HBVT程序和iCare系统游戏的有效性的临床研究，以评估iCare系统的准确性。

DESCRIPTION (provided by applicant): Convergence disorders and refractive amblyopia are among the most common and treatable vision problems seen in general optometric clinical practice. Oce- and home-based vision therapy (OBVT and HBVT, respectively) are standard treatments for such disorders. Recent advances in computerized video therapies that emulate vision therapy exercises performed in the optometrist's oce provide a lower-cost and more convenient alternative to OBVT. The downside of current commercial HBVT systems is that the recommended eye exercises are highly repetitive, monotonous, and uninteresting, which leads to high levels of patient noncompliance. This presents a problem since consistent performance and proper technique are key to achieving therapeutic benet. An alternative approach, which oers strong potential to increase the success of HBVT, is to incorporate vision therapy into fun and interactive computer games that patients will nd more engaging. To address this need, Barron Associates proposes to develop a novel computerized virtual reality HBVT system called iCare that will overcome the limitations of present systems by addressing three obstacles to successful home treatment: (1) patient compliance; (2) procedural accuracy; and (3) the ability of the optometrist to monitor training. The proposed approach takes advantage of advanced human-interface devices (HIDs) (e.g., Wii Remote Controllers) that have been developed for the video gaming market. Due to the popularity of video gaming, HID technology that would have been prohibitively expensive in the recent past is now widely available at low cost (e.g., < $40). These o-the-shelf HIDs permit the creation of virtual three-dimensional (3-D) environments on computer monitors (for \near-point" vision therapy) or plasma displays (for \distance" vision therapy). Traditional 3-D graphics technology based on \3-D glasses" (i.e., red-blue anaglyphs) is static with respect to the frame of the viewing device; that is, the image is the same regardless of the viewer's position relative to the monitor. The proposed iCare technology exploits motion parallax via low-cost tracking of the patient's head position and orientation, creating a dynamic visual 3-D environment. Visually, the technology allows the viewer to perceive objects as if they are coming o of, or receding into, the screen. This enables the creation of virtual xation objects in a nearly innite 3-D space. Users can even see \behind" and manipulate virtual objects. Under this SBIR Fast Track grant application, the proposing Team will develop and test prototype computer gaming environments for HBVT using the technology outlined above to improve treatment eectiveness. Phase I therapy will be aimed at treating refractive amblyopia in children 8-12 years of age; Phase II will focus on treating refractive amblyopia in teens and adults, as well as convergence insuciency in both populations. These disorders are clearly amenable to vision therapy and are common in clinical practice. For both vision problems, clinical studies of the comparative eectiveness of the most popular computerized HBVT programs vs. the iCare system's games will be conducted in children to assess the ecacy of the iCare system.