Head mounted smartphone system for remote treatment of convergence insufficiency

PROJECT SUMMARYIn this projectwe propose to develop and demonstrate feasibility of a head mounted smartphone based application forin home training and remote monitoring of progress for patients with convergence insufficiencyCICI develops in anestimatedofschool agechildrenintheU Soverallandcausessymptomsofeyestrainblurredvisionand reduced concentrationresulting in significant educational disadvantagesIf diagnosedthe disorder can be treatedbyawell establishedtrainingprogramthathasbeendemonstratedtoalleviatethesymptomsRecentstudieshavefound that the vision therapy for CI is more successful when performed in the doctor s office under monitoring and thenreinforced with at home trainingHoweversignificant barriers of cost time of in office treatment and poor complianceathomelimitthebenefitsofthevisiontherapyandgreatlyhamperitssuccessTheproposedheadmountedsmartphonesystemwillconsistoftwocomponentsoneforbinocularvisionassessmentandanothermoduletobroadcastremotedisplaycontentwirelesslytoavirtualrealityheadsetThisnovelUniversalVisionTherapyandEntertainment platform will enable the patients to watch their favorite video content or play a video game of choice ona head mounted system as part of the therapyOnce the video stream is chosen by the userthe system will convert it toadichopticstimuluswithvariableinducedvergencedemandDuringthetherapysessionthesystemwilllogusagestatistics and system parameters such as induced vergence demand range for post hoc analysis and remote monitoringbythedoctorWehypothesizethatanincreaseincompliancewillbeachievedduetothelowinvasivenessofthetraining protocol and a wide variety of video content that will keep the therapy engaging for prolonged durationThroughourclinicalcollaborationswewillevaluatethecomplianceoftheproposedtherapyrelativetostandardmethodologiesinpatientsAttheconclusionofthePhaseIprojectwewillhavedemonstratedfeasibilityandcompliance of the novel mobile entertainment for vision therapyshowing accuracy of binocular measurements and theuseracceptanceofourmethodcomparedtothetestsandtherapiescurrentlyemployedinclinicsandophthalmologypracticesThe wide availability of smartphones and low cost virtual reality headsetsgoogle cardboardwhen coupledwithouruniversalplatformhavethepotentialtobringaboutaparadigmshiftincost compliancecalculationsandincreaseawarenessforbinocularvisiondisordersresultingingreateraccesstotreatmentforCI affectedindividualsOncetheaccuracyandcomplianceforthesystemmeetorexceedthoseofcurrentmethodsinarepresentativepopulationwe will prepare for an in depth evaluation of therapy efficacy in Phase IINARRATIVEConvergence insufficiencyCIaffects an estimatedof school age children in the U Soveralland causessymptomsofeyestrainblurredvisionandreducedconcentrationresultinginsignificanteducationaldisadvantagesNIHfundedclinicalstudieshavedemonstratedthefeasibilityandeffectivenessofvisiontherapytorestorebinocularvisionbutpublichealtheffortstoperformtrainingforCIhavebeenhamperedbysignificantbarriersofcostandtimerelatedtoin officetherapyandpoorcomplianceinthecaseofin hometherapyAsignificantchallengeforpatientcompliance with in home therapy has been the monotony of vision training taskslimited to simple exercises or a singlevideo gameA recent study of CI therapy reportedcompliance for in home computer based therapy as opposed toforin officetherapyIfpatientcompliancewithin hometherapycanbeimprovedtheoverallsuccessrateofCItrainingwilllikelybeincreasedsignificantlyTheoverallgoaloftheproposedPhaseIprojectistodevelopaheadmounted smart phone based vision therapy system that wirelessly converts any video entertainment from an externaluser definedsourcetoadichoptictrainingstimulusUsingsuchacost effectivewidelyavailablesystemtheaffectedpopulation will be able to receive in home vision therapy with automated doctor monitoring via telemedicineall whileenjoying their regular TV showsmovies or video games