Serious Games Integrating Perceptual Learning and Stereopsis Training in Children With Amblyopia: Single-Arm Pre-Post Feasibility Study
Bibliographic record
Abstract
Background: Amblyopia, a leading cause of preventable childhood blindness, often remains inadequately addressed by traditional treatment methods such as refractive correction and occlusion therapy, which can be noninteractive and lead to poor adherence. Objective: This study aimed to design and evaluate the feasibility and preliminary efficacy of a serious game intervention that integrates perceptual learning and stereoscopic vision training for pediatric amblyopia and to explore its potential as a complementary or alternative approach to conventional treatments such as occlusion or atropine therapy. Methods: We evaluated visual acuity, accommodative sensitivity, binocular accommodation, stereopsis, and compliance-related data in a cohort of children with amblyopia aged 7 to 12 years before and after a 3-month intervention. Participants engaged in visual training via a serious game, attending sessions 4 times weekly for 30 minutes each. Results: Best-corrected visual acuity improved significantly from 0.42 (SD 0.16) to 0.37 (SD 0.18) logMAR, yielding a mean difference of 0.05 (95% CI 0.03-0.08; t24=4.82; Cohen d=0.96; P<.001). Accommodative sensitivity showed marked enhancement following the intervention. In the amblyopic eye, mean values increased from 1.44 (SD 2.18) to 4.96 (SD 2.91) cycles per minute, corresponding to a mean change of -3.52 (95% CI -4.59 to -2.45; t24=-6.81; Cohen d=-1.36; P<.001). Under binocular viewing, accommodative sensitivity improved from 1.52 (SD 2.49) to 5.08 (SD 2.71) cycles per minute (Δ=-3.56, representing the mean paired difference (baseline minus post), 95% CI -4.88 to -2.24; t24=-5.56; Cohen d=-1.11; P<.001). Stereoacuity also improved significantly, decreasing from 780.0 (SD 613.6) to 448.8 (SD 472.2) arc sec (Δ=331.20, 95% CI 134.20-528.20; t24=3.47; Cohen d=0.69; P=.002). The proportion of participants with normal Worth 4 dot responses increased from 76% (19/25) at baseline to 96% (24/25) after the intervention, and treatment adherence was high under supervised clinical conditions. Conclusions: The integration of gamified elements into amblyopia treatment was associated with high adherence under supervised clinical conditions and with significant short-term improvements in visual function, suggesting a promising complementary approach to conventional therapies. This interactive approach effectively combines perceptual learning with stereopsis training, presenting a potential alternative to conventional therapies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".