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Home » Amblyopia » Tetris therapy for amblyopia? Yes, please.

Tetris therapy for amblyopia? Yes, please.

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A new study, about amblyopia, has been published and it is really getting attention. From CBS news to Huffington Post to CNET, everyone is covering it, probably because they get to use the word "Tetris" in the title. Tetris, of course, is the hugely addictive block-stack game that, at least in my memory, was the first hand-held videogame blockbuster.

Amblyopia, known to many people as "lazy eye" is a visual adaptation to conditions that interfere with visual development. On a simple level, it means that even with the best glasses or contact lenses, the eye does not see and function as well as expected. It is not due to disease or injury, but rather a situation where the brain doesn't communicate well with one eye and can't use the eyes as a team.
Think of the brain being someone on the internet, and one eye is a friend with 14.4K dial up and the other has a 4G smart phone. Yes, you can communicate with both eyes, but you are going to prefer the 4G because it is faster and can do more things. Trying to use both eyes simultaneously as a team is hard because one is lagging behind and missing information.

I am extremely glad to see this study and I do have some thoughts on it:
First, do not get too excited about the Tetris part. While I really have no doubt that Tetris and similar games stimulate visual planning and cognitive development, I suspect that the main benefit of using Tetris in this study is that it is very engaging, requires attention to visual detail, and requires the  player to make decisions based on visual information. Basically this is true for most video games (and real world games, for that matter). So Tetris is not the magic here.

What IS a big deal about this study is the goggles - they required the eyes to work together to play the game. If you play, you can't just shut off the amblyopic eye, or you'll lose because you won't see the falling blocks. And that isn't motivating or good therapy.  It isn't patching or covering the good eye because you won't see the blocks on the bottom. You still won't win. This is like conventional patching. You can stimulate the amblyopic eye (upgrading the modem), but that alone only helps somewhat.

What this study shows is that only when both eyes can see and are given the opportunity to work together to achieve a common visual goal is there significant improvement in the amblyopic eye. In my internet analogy, this is not only giving the amblyopic eye a 4G smartphone but making sure it is net savvy. Both eyes are now friends on Facebook and Twitter so they can work together in real time to solve visual-spatial problems efficiently. (Just to be clear: the eyes do not use Facebook, and they do not communicate directly - all that happens in the brain).

So why is this so exciting? Because this is exactly what we do in vision therapy every day. We "upgrade" the eyes to work well individually (4G) but also "network" them to work together (Facebook, Twitter). We don't use Tetris, but we do use paper & pens, balls, special glasses, computer programs, 3D art, optical illusions and lots of other fun tools to make it fun and productive.

It is great to see more research on this on adults with amblyopia. For too many years, patients have been told that after early childhood there is no hope of improving the vision in the amblyopic eye. It simply is not true. I did a blog post awhile back on the science behind amblyopia. You can see that here. For a great look at binocular treatment of amblyopia, see this recent post on the VisionHelp blog.

Dr. Nate

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care

2 responses to “Tetris therapy for amblyopia? Yes, please.”

  1. Thank you for your posts. My 12 year old son has just been diagnosed with amblyopia and I was told there is nothing I could do. This gives me some hope. Thank you.

  2. Carol Nason says:

    Nothing you can do?!!!! There’s LOTS you can do!!! PLEASE see another optometrist, PLEASE!!! Not an ophthalmologist, an optometrist, in this case. For your son, please.

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