Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.
In this episode, Dr. Nate talks with James Blaha From Vivid Vision about virtual reality vision therapy.
** See the related episode with Edna Moore - #8 VISION THERAPY.
The Full transcript:
Intro: 00:01 Welcome to the bright eyes podcast advise for healthy vision for all ages. Your hosts are Dr. Nate Bonilla- Warford and Dr. Beth Knighton residency trained optometrist providing eye care to all ages with exams for glasses and contacts and specialty services including vision therapy, Myopia control, Ortho-keratology, and sports vision training. Their mission is to empower patients by providing the best in friendly, professional and individualized care.
James: 00:39 It's march and so that means it's fall in Florida when all the leaves and pollen make everyone miserable. This is the bright eyes podcast. This is episode number nine. I'm Dr Nate Bonilla- Warford, Dr. Beth is away, and I have a special guest with me, James Blaha. Vivid vision. How are you doing, James?
James: 00:59 I'm good. Thanks for having me on.
Dr. Nate: 01:01 Yeah, well I've, uh, I'm excited about doing this. We've talked many times over the last few years and I had wanted to have you as a guest on our podcast for a while and so, I'm glad that it worked out. So for listeners who don't know, vision therapy is a program of treatment to help people who have certain types of functional visual problems that can be an eye movement problem, an eye focusing problem, an eye alignment problem, or other kinds of problems. There are many different strategies in many different ways that vision therapy can be performed, but vivid vision is a way to apply those same principles in a virtual reality environment. And that is the product of years of work that James had done. Now, the interesting thing about this is that James is not an optometrist. What is your background?
James: 02:01 I'm I'm a programmer and an entrepreneur, um, but I also grew up with Amblyopia and Strabismus. So I got Interested in all of this from my own personal perspective going through treatment as a kid and later as an adult reading about it.
Dr. Nate: 02:16 Yeah. Which I think is fascinating. So when you were first developing this, it was nowhere near the level that it is now in terms of features and sophistication. What was the first kind of prototype like?
James: 02:32 Yeah. So when I, when I first started building it, I guess I was kind of a naïve as to what the complexities of all this would actually be like. I thought it would be a lot simpler than it actually is. The first version I had a cube in VR (Virtual Reality) and basically I can use the arrows on my keyboard to make it brighter and my weak eye in dimmer in my strong, and I would make an adjustment until I could see parts of the cube with my weak eye. So that was sort of our first, the first test we made. And that was basically a rough estimate of suppression of the weaker eye first game I had, it was actually a version of what's now Breaker, which is like a breakout style game, but in 3D in VR where you use paddles to hit a ball to destroy bricks on the other side of a marina. So the very first version we would take a measurement of the suppression using the first tool and then we would set up the game so the bricks were brighter and the weak eye and dimmer in the strong eye according to that measurement, and that was about four years ago, I guess
Dr. Nate: 03:35 Four years ago and a lot in four years. So for patients who might be listening with the features and the current state of the virtual reality treatment, a vivid vision in particular who would be a candidate?
James: 03:50 You would probably be able to answer that even better than that I could, you know. But in general Amblyopia, Strabismus, although with Strabismus it can be complicated and it really depends on the case I think. And also convergence problems and divergence problems. We've seen the most success with refractive Amblyopia. That seems to be easiest to treat.
Dr. Nate: 04:15 Yeah. Well, I agree with that. In our office, uh, we use it for people who have Amblyopia, which commonly is called a lazy eye by people. People also use the term lazy eye to mean Strabismus, where the eyes aren't necessarily aligned all the time, or maybe not, some of the time. Those conditions result in a condition called suppression where one, it sort of takes over, dominates the other one, is dominant and less dominant eye. And so the whole point of this virtual reality treatment is to stimulate the eye that suppressed, to get the eyes to work together in a very, very engaging in immersive way. Uh, what we see in the clinic is that it works extremely well, it's very very effective. But also it's, very fun.
James: 05:01 Yeah. The motivation part of it is sort of one of the missing parts of other treatments. It's a lot easier to do the actual therapy time and I think the therapy times more effective when people want to do it and are engaged in it as well.
Dr. Nate: 05:17 Yeah, I think that that's true kind of across the board. If it's more engaging, if it's more interesting the brain's gonna learn faster and make better use of that information and so we try to do that as much as possible, but few things are has engaging has a virtual reality video games, I think we're gonna see a lot more of in different contexts. And I'm excited to be able to be able to offer it. Now we've had some tremendous success stories, people who've improved dramatically in terms of how clear they can see with their Amblyopia eye. We've had patients who formerly didn't see in 3D, but then we're able to develop their depth perception. I would imagine that you've heard just a huge number of wide variety of success stories all over the country and all over the world. Do you have maybe like a couple of, like a favorite case that really you really kinda sticks with you, I guess, aside from your own because your own is pretty compelling?
James: 06:21 Yeah, I'd have to I'd have to think about that a little bit. I think, um, we have heard of cases all over, you know, one of the cases that sort of sticks out in my mind was a guy in his fifties who had a strabismus surgery and following the surgery, he used a vivid vision with an ophthalmologist and actually saw a really big results getting stereo for the first time in his fifties after the surgery. And it sort of surprised the ophthalmologists and um, usually we don't expect recovery and Strabismus and let that, you know, later in life, but it seems like right after her surgery is the right time to be doing this practice. And so that, that case really interested because um, you know, it could be, uh, something we're going to study a little more closely in the future whether or not there's this period after surgery that's really optimal for, for doing the perceptual training.
Dr. Nate: 07:16 And that's actually one thing that's exciting, you know, your team has grown a whole lot since four years ago and now you have a optometrists visual scientists research and so that'll be, you know, that's going to be great to see, you know, as we learn more about what the opportunities are and what the results are right now. It's all so new. It's exciting but it'll be even more exciting when we have more data behind it.
James: 07:48 Yeah. I'm working with a number of universities right now. Each group has sort of a specific area they're looking at in detail. One of the sort of hard things about this is that every patient has has a unique situation going on and so it's really difficult to study, you know, lazy eye when it's really a bunch of different things each with their own causes and effects.
Dr. Nate: 08:10 Right. Yeah, absolutely. And I know that the newest update also includes one of the activities that's beneficial for sports vision, so peripheral vision, reaction time and so, I assume that you are working on more opportunities for treatment as time goes on. I'm sure you have a lot of stuff that kind of in the pipeline that you're not ready to talk about, but it's probably super exciting. So, you know, that's, that's gotta be really fun to be, you know, this far ahead of something that has so much potential.
James: 08:48 Yeah, I think, um, you know, over the next couple of years, like you said, we've been growing and are hoping to grow a little more. Part of that is expanding, researching development and sort of expanding the kinds of things we measure in treat with VR headsets. So sports vision is part of that. We're doing a little work in low vision as well, and we actually just announced publicly that we're working on a visual field test. I'm using that headset
Dr. Nate: 09:16 Now, one of the things that's most exciting, I think, is that the virtual reality VR devices are becoming so common and widespread,at home, everything from kind of higher end oculus rift to like the Samsung gear VR. So the opportunity to be able to do what is extremely sophisticated visual treatment at home is something that I think has been a goal of yours for a long time. And I know that people are interested because we get emails from all over the world. We actually had a family that, lives in Brazil, but they came to Florida to go to Disney world for vacation. But then they took a day off of their Disney world vacation to come to my office to see if they were a candidate for vivid vision. And she is, this young girl had had two different surgeries to align her eyes. And I thought she was an excellent candidate, so they just recently started doing a vivid vision at home in Brazil, which is way more exciting, I think with potential for benefit, than they were able to do a locally before, you know, that's just one story. And I'm sure that there are many stories like that, that people have access to, you know, to this kind of therapy where they didn't before. So I think that that's going to be a wonderful for patients all over.
James: 10:44 Yeah. You know, that's, um, our original mission was to have some kind of home treatment and then we found out how complicated it is, found out doctors really, really do need to be involved in and make that initial diagnosis and follow-up on the treatment and sort of manage it on and make sure things are going correctly. And so it took us a little longer than we expected to get out the home version and sort of make sure we were doing it correctly. Um, but now that it's out, you know, we've been hearing a lot of stories like that of doctors. I'm managing the treatment of patients who normally wouldn't have access to a good care.
Dr. Nate: 11:19 Yeah. I think it's anything, it's extremely exciting. And I, you know, we talked to you kind of early on and as soon as it was kind of out of the Beta testing stage, we, you know, we implemented in the office and we've been very happy with it. Uh, and so, uh, I know that I will see you at some of the, uh, upcoming vision therapy meetings, COVD is a big meeting and that's, you know, that's coming up soon. So that's, you know, that's exciting. Um, anything else that you'd like to share with patients before wrap this? Wrap this up?
James: 11:55 Yeah, I guess, uh, you know, one of the things that, that really helps companies like us to hear from patients and just sort of here, you know, what people want, what people need, um, those stories really help us figure out what we should prioritize, what we should be working on. So it's always great to, um, you know, getting, getting an email from somebody or something like that through our website. Just hearing you know, what their problems are and what we can try to figure out what we can do to help fix it.
Dr. Nate: 12:26 Yeah, that's a great point. I'll definitely make sure that we include your contact info and the website is seevividly.com
James: 12:26 Yeah, That's right.
Dr. Nate: 12:38 Yeah, absolutely. All right. Well, I really do appreciate you taking the time to talk to me today and uh, I'm looking forward to editing this, this episode so we can get it up for people to listen to.
James: 12:52 Yeah, very nice talking to you. Thanks for having me on.
Dr. Nate: 12:54 Yes. And to our listeners, thanks for listening. If you have any questions, comments, or suggestions, you can email us at firstname.lastname@example.org. And until next time we'll see you later.
Outro: 13:05 Brought to you by bright eyes, family, vision, care, and bright eyes kids. Find previous episodes and more detailed information at brighteyetampa.com, creative Commons, copyright attribution, non-commercial use. The only purpose of this podcast is to educate and to inform. It is no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Please consult your physician for diagnosis and treatment.
Intro/outro music: Lucas Warford of Three For Silver.