Download Blog Post Jan 23 2017 - Vision and Gaming

Gaze-Contingent Games for Vision Therapy – Jackie Nguyen
Vision is not defined as seeing 20/20; rather it is the ability to successfully coordinate and control
eye movements to achieve visual fluency in a dynamic environment. Currently, vision therapy utilizes
various tools to address vision problems such as convergence insufficiency, ocular motor control, and eye
movements (saccades and smooth pursuit). Past studies have found that vision therapy is most
successful when office-based vision therapy is paired with supplementary home training1. Office-based
vision therapy sessions can range from thirty minutes to one hour in duration on a weekly basis, but is
highly dependent on the individualized plan recommended by the optometrist. Depending on the
diagnosis, home training can vary, but most require a commitment of thirty minutes a day for five days a
week. At the end of the training plan, the optometrist conducts an evaluation examination, assessing
patient progress.
I am interested in gaining insight on how to develop more sophisticated and effective game-based
technology to support active vision in a broad range of vision therapy patients. Utilizing the attention
training games already developed by RADLab, we will collaborate with a local optometrist, Claude
Valenti, O.D., specializing in vision therapy to identify attributes of our games that align with the goals of
vision training.
Our current study with ASD individuals is an eight-week attention training study, with pre- and
post-training evaluations. The games are designed to improve attention orienting and are played using a
portable video-based eye-tracking device, which allows individuals to use their eyes to play. During
evaluations, speed and accuracy are measured using an eye tracking system with much greater spatial
and temporal resolution. We will work with a Unity game programmer in RADLab to improve and/or create
new games that address common vision deficits as well as integrate a wearable eye-tracking device
designed by Pupil Labs as an alternative eye tracker using AR code. Next we will demonstrate our
revised games to Dr. Valenti and his team, and discuss the realistic outcomes from introducing these
games in clinical setting and determine the clinical population we hope to help. Finally, we will engage a
few vision therapy clients in our intervention protocol (using an IRB amendment) and conduct a subset of
pre-and post-test assessments. The games will be played for fifteen minutes during office-based sessions
and 30 minutes, five days a week at home. We will compare our assessment results to metrics used Dr.
Valenti to measure success in vision therapy. By comparing outcome measures between researchers and
optometrists, we can ascertain the efficacy of the game-based technology as a tool in vision therapy
setting.
As a FISP recipient who is will be entering the optometry profession, I see engaging in this sort of
interdisciplinary research as crucial for the advancement the respective fields. I hope to integrate gazecontingent methods into my own behavioral optometry practice someday, providing families an objective
way to improve skills both at home and at the office. I also hope that this sort of collaborative research
can either create or refute support for vision therapy, which currently lacks a strong empirical evidence
base as a therapy for disorders of learning and reading. We need to collaborate in order to devise the
kind of studies that will test vision therapy in individuals who are still developing and using active vision to
understand the world around them.
1. Scheiman M., Mitchell, G.L., Cotter, S., Kulp, M.T., Cooper, J., Rouse., M. Borsting, E., London, R.,
Wensveen., J. (2005) A randomized clinical trial of vision therapy/orthoptics versus pencil pushups for the
treatment of convergence insufficiency in young adults. Optom. Vis. Sci. July: 82(7): 883-95.