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在普通验光临床实践中最常见和最可治疗的视力问题。OCE和基于家庭的视觉疗法(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，模拟在验光师的OCE中进行的视力治疗练习，为OBVT提供了一种更低成本和更方便的替代方案。目前商业HBVT系统的缺点是推荐的眼操高度重复、单调和乏味，这导致患者高度不依从性。这带来了一个问题，因为始终如一的表现和适当的技术是实现治疗贝奈特的关键。另一种方法是将视觉疗法融入有趣和互动的电脑游戏中，使患者更感兴趣，这一方法具有增加HBVT成功的巨大潜力。为了满足这一需求，Barron Associates建议开发一种名为iCare的新型计算机化虚拟现实HBVT系统，该系统将通过解决成功的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。建议的方法利用了为视频游戏市场开发的高级人机界面设备(HID)(例如Wii遥控器)。由于视频游戏的流行，HID技术在最近的过去会贵得令人望而却步，现在可以以低成本(例如，40美元)广泛获得。这些现成的HID允许在计算机显示器(用于近点视力疗法)或等离子显示器(用于远距离视力疗法)上创建虚拟三维(3-D)环境。基于3-D眼镜的传统3-D图形技术“(即红蓝浮雕)相对于观看设备的边框是静态的；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。拟议的iCare技术通过低成本跟踪患者的头部位置和方向来利用运动视差，创建动态的可视3-D环境。在视觉上，这项技术允许观看者感知物体，就像它们从屏幕上走出来或消失在屏幕上一样。这使得能够在近乎原始的3-D空间中创建虚拟Xation对象。用户甚至可以看到“背后”，并操纵虚拟物体。根据这项SBIR快速通道拨款申请，提议团队将使用上述技术为HBVT开发和测试原型计算机游戏环境，以提高治疗效率。第一阶段的治疗目标是治疗8-12岁儿童的屈光性弱视；第二阶段的治疗重点是治疗青少年和成年人的屈光性弱视，以及这两个人群的趋同障碍。这些障碍显然可以接受视力治疗，在临床实践中也很常见。对于这两种视力问题，将在儿童中进行最受欢迎的计算机化HBVT程序与iCare系统游戏的效率比较的临床研究，以评估iCare系统的有效性。

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.