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CompletedNCT06150391Updated Oct 20, 2026

Evaluation of Amblyopia Protocols Using a Dichoptic Gabor Videogame Program

An interventional study of Visionary: computer exercises using dichoptic Gabor Patches and band-filtered noise masks and Patching in Amblyopia, sponsored by Hospital de Merida. Completed at 1 site in Spain. Open to participants aged 4 Years to 12 Years. Per ClinicalTrials.gov, last updated 2026-10-20.

Sponsored by Hospital de Merida · Not applicable, Interventional, and Treatment

Updated Oct 20, 2026Now CompletedStart date moved+3 moreGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
125
Allocation
Randomized
Ages
4 Years to 12 Years
Sex
All
01

Study summary

Interest in developing alternative methods for the treatment of amblyopia (lazy eye) has long been a topic of interest among clinicians and researchers. Occlusion or penalization of fellow eye do not always provide the desired visual acuity improvement. Moreover, occlusion is associated with a high risk of recurrence and non-compliance. Here, it is presented a protocol of a randomized clinical trial to evaluate the safety and clinical efficacy of a novel home-based system, based on a computer game.

The goal of this prospective clinical trial is to compare in visual acuity improvements in patients with amblyopia, following conventional patching therapy or this novel computer-based therapy.

The main questions it aims to answer are:

  • Does computer-based therapy equal or improve patching therapy? Can it be used as an alternative to patching?
  • Does computer-based therapy used in combination with pathching solve amblyopia when patching fails alone (persistent amblyopia)?

Participants will be divided in two groups according to the previous occlusion o penalization of fellow eye. Both groups will be divided in two subgroups, experimental and control. Researchers will compare subgroups outcomes in order to asses this novel approach.

Read the detailed description

Amblyopia is a common neurodevelopmental abnormality that results in physiological alterations of the visual pathways and impaired vision in one eye or, less commonly, in both.Disruption of normal visual development early in life may result in perceptual, oculomotor and clinical abnormalities such as instability of fixation, anomalous retinal correspondence, and lack of stereoacuity.Amblyopia has a prevalence of around 2-4% in children and is associated with refractive error (anisometropia or isometropia) and strabismus.

The Pediatric Eye Disease Investigator Group (PEDIG) has produced several studies that analyze the most effective therapies for amblyopic eye. The gold standard treatment prescribed for this condition combines spectacle correction of the refractive error with penalization and/or occlusion of the dominant eye

Interest in developing alternative methods for the treatment of amblyopia (lazy eye) has long been a topic of interest among clinicians and researchers. Occlusion or penalization of fellow eye do not always provide the desired visual acuity improvement. Moreover, occlusion is associated with a high risk of recurrence and non-compliance.

This randomized clinical trial is designed to evaluate the safety and clinical efficacy of a novel home-based system, based on a computer activity that uses dichoptic Gabor Patches and band-filtered noise masks. It combines the concepts of perceptual learning, dichoptic training, home based therapy and gamification.

The goal of this prospective clinical trial is to compare in visual acuity improvements in patients with amblyopia, following conventional patching therapy or this novel computer-based therapy.

The main questions it aims to answer are:

  • Does computer-based therapy equal or improve patching therapy? Can it be used as an alternative to patching?
  • Does computer-based therapy used as coadjuvant to pathching solve amblyopia in patients where patching fails alone (persistent amblyopia)?

Participants will be divided in two groups according to the previous occlusion o penalization of fellow eye. Both groups will be divided in two subgroups, experimental and control. Researchers will compare subgroups outcomes in order to asses if this novel approach may lead to greater improvements in vision performance in amblyopic children as substitution of occlusion treatment in novel amblyopia or as coadjutant in persistent amblyopia.

02

Conditions studied

  • Amblyopia

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Keywords

  • amblyopia
  • perceptual learning
  • dichoptic therapy
  • visual acuity
03

In context

Amblyopia

189 studies on the registry are indexed under Amblyopia; 41 are open to participants now.

This study's enrollment of 125 is above the median of 60 across 137 interventional studies indexed under Amblyopia.

Browse Amblyopia studies →

Lead sponsor

This is the only study on the registry with Hospital de Merida as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
4 Years to 12 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • The sample will be made up of children with amblyopia from 4 to 12 years old (amblyopia will be defined as the best corrected visual acuity less o equal to 0.8 in decimal units or > 2 lines of difference between both eyes). Strabismus inclusion criteria will be \< 25 prismatic diopters, with a deviation ≥ 2 prismatic diopters.

Exclusion criteria

Exclusion Criteria:

  • Subjects with nystagmus, ocular pathology o cognitive delay will be excluded.
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
125 participants (actual)

Study arms

  • Experimental
    Group GA-E. Patients without previous occlusion o penalization treatment - Experimental

    GA-E volunteers (experimental) will be prescribed home therapy using computer-based exercises (Visionary) for 12 weeks, five days week, ½ half hour per day. Visionary target frequencies will be adjusted, considering BCVA, each three weeks. Contrast of Gabor patch frequencies will be adjusted to match patient contrast sensitivity thresholds. In case BCVA does not improve at least 2 lines in two consecutive visits (6 weeks), patients will change to GA-C.

    Device: Visionary: computer exercises using dichoptic Gabor Patches and band-filtered noise masks

  • Active comparator
    Group GA-C. Patients without previous occlusion o penalization treatment - Control

    GA-C patients (control) will be prescribed occlusion following Pediatric Eye Disease Investigation Group (PEDIG) criteria: 2 hours for mild and moderate amblyopia or 6 hours for severe amblyopia. Patients will receive a calendar to track patching accomplishment. In case BCVA does not improve at least 2 lines in two consecutive visits (6 weeks), patients will change to GA-E.

    Device: Patching

  • Experimental
    Group GB-E. Patients with previous occlusion o penalization treatment - Experimental

    GB-E volunteers will receive occlusion following PEDIG criteria and will be prescribed home therapy using Visionary. Patients will receive a calendar to track patching accomplishment. Visionary target frequencies will be adjusted, considering BCVA, each three weeks.

    Device: Visionary: computer exercises using dichoptic Gabor Patches and band-filtered noise masks · Device: Patching

  • Active comparator
    Group GB-C. Patients with previous occlusion o penalization treatment - Control

    GB-C volunteers will receive occlusion following PEDIG criteria and will be prescribed home therapy using Visionary. Patients will receive a calendar to track patching accomplishment. Visionary target frequencies will always be low, no matter patient VA. In case BCVA does not improve at least 2 lines in two consecutive visits (6 weeks), patients will be move to GB-E.

    Device: Visionary: computer exercises using dichoptic Gabor Patches and band-filtered noise masks · Device: Patching

Interventions

  • DeviceVisionary: computer exercises using dichoptic Gabor Patches and band-filtered noise masks

    Visionary exercises are computer gammified activities that run on a computer with internet connection to facilitate home therapy. Patient must wear anaglyph glasses. Visual stimuli consists in dichoptic Gabor Patches presented to the amblyopic eye. Frequency is adjusted to actual patient visual acuity, and contrast to actual patient performance (contrast sensitivity). A band-filtered noise mask at the same frequency than the Gabor patch is presented to the fellow eye in certain ocassions.

  • DevicePatching

    PEDIG (Pediatric Eye Disease Investigator Group) recommended amblyopia treatment. Consist on covering a child's better-seeing eye with a patch for 2 hours per day for mild and moderate amblyopia or 6 hours per day for severe amblyopia

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What researchers measure

Primary outcomes

  1. BCVA Best Corrected Visual Acuity

    Best Corrected Visual Acuity is the measurement of the ability to distinguish shapes and the details of objects at a given distance wearing full refraction. Different optotipes are used to measure clinically this ability (e.g. Snellen E, ETDRS, etc.). Refraction must be calculated under cyclopegia following PEDIG criteria. Crowding bars can be added to the optotypes. In this study, amblyopic eye BCVA will be measured using visual acuity chart ETDRS whitout crowding bars, in logarithmic scale.

    Time frame: Treatment will last 12 weeks, with BCVA measurements every 2 weeks. The stability control post treatment will last 12 months, with BCVA controls at 3, 6 and 12 months.

Secondary outcomes

  1. Stereoacuity

    In this stuty Randot Preschool Stereoacuity Test (Stereo Optical, Inc., Chicago, USA) will be used to asses stereoacuity in arc seconds. This is a random dot stereogram that measures global stereopsis (or cyclopean stereopsis) and does not contain monocular cues. Stereoacuity is measured at a constant distance of 40 cm.

    Time frame: Treatment will last 12 weeks, with stereoacuity measurements every 2 weeks. The stability control post treatment will last 12 months, with stereoacuity controls at 3, 6 and 12 months.

07

Study locations

1 site
  • Servicio de Oftalmología del Hospital de Merida
    Mérida, Extremadura 06800, Spain
08

References and documents

Publications

  • Verghese P, McKee SP, Levi DM. Attention deficits in Amblyopia. Curr Opin Psychol. 2019 Oct;29:199-204. doi: 10.1016/j.copsyc.2019.03.011. Epub 2019 Mar 22. PubMed 31030000 ↗
  • Fu Z, Hong H, Su Z, Lou B, Pan CW, Liu H. Global prevalence of amblyopia and disease burden projections through 2040: a systematic review and meta-analysis. Br J Ophthalmol. 2020 Aug;104(8):1164-1170. doi: 10.1136/bjophthalmol-2019-314759. Epub 2019 Nov 8. PubMed 31704700 ↗
  • Chen AM, Cotter SA. The Amblyopia Treatment Studies: Implications for Clinical Practice. Adv Ophthalmol Optom. 2016 Aug;1(1):287-305. doi: 10.1016/j.yaoo.2016.03.007. No abstract available. PubMed 28435934 ↗
  • Birch EE. Amblyopia and binocular vision. Prog Retin Eye Res. 2013 Mar;33:67-84. doi: 10.1016/j.preteyeres.2012.11.001. Epub 2012 Nov 29. PubMed 23201436 ↗
  • Buckle M, Billington C, Shah P, Ferris JD. Treatment outcomes for amblyopia using PEDIG amblyopia protocols: a retrospective study of 877 cases. J AAPOS. 2019 Apr;23(2):98.e1-98.e4. doi: 10.1016/j.jaapos.2018.12.007. Epub 2019 Mar 30. PubMed 30935990 ↗
  • GIBSON EJ. Perceptual learning. Annu Rev Psychol. 1963;14:29-56. doi: 10.1146/annurev.ps.14.020163.000333. No abstract available. PubMed 13947716 ↗
  • Rodan A, Candela Marroquin E, Jara Garcia LC. An updated review about perceptual learning as a treatment for amblyopia. J Optom. 2022 Jan-Mar;15(1):3-34. doi: 10.1016/j.optom.2020.08.002. Epub 2020 Nov 24. PubMed 33243673 ↗
  • Polat U, Ma-Naim T, Belkin M, Sagi D. Improving vision in adult amblyopia by perceptual learning. Proc Natl Acad Sci U S A. 2004 Apr 27;101(17):6692-7. doi: 10.1073/pnas.0401200101. Epub 2004 Apr 19. PubMed 15096608 ↗
  • Polat U, Ma-Naim T, Spierer A. Treatment of children with amblyopia by perceptual learning. Vision Res. 2009 Oct;49(21):2599-603. doi: 10.1016/j.visres.2009.07.008. Epub 2009 Jul 19. PubMed 19622368 ↗
  • Barollo M, Contemori G, Battaglini L, Pavan A, Casco C. Perceptual learning improves contrast sensitivity, visual acuity, and foveal crowding in amblyopia. Restor Neurol Neurosci. 2017;35(5):483-496. doi: 10.3233/RNN-170731. PubMed 28800339 ↗
  • Levi DM, Li RW. Perceptual learning as a potential treatment for amblyopia: a mini-review. Vision Res. 2009 Oct;49(21):2535-49. doi: 10.1016/j.visres.2009.02.010. Epub 2009 Feb 27. PubMed 19250947 ↗
  • Chen PL, Chen JT, Fu JJ, Chien KH, Lu DW. A pilot study of anisometropic amblyopia improved in adults and children by perceptual learning: an alternative treatment to patching. Ophthalmic Physiol Opt. 2008 Sep;28(5):422-8. doi: 10.1111/j.1475-1313.2008.00588.x. PubMed 18761479 ↗
  • Stewart CE, Moseley MJ, Stephens DA, Fielder AR. Treatment dose-response in amblyopia therapy: the Monitored Occlusion Treatment of Amblyopia Study (MOTAS). Invest Ophthalmol Vis Sci. 2004 Sep;45(9):3048-54. doi: 10.1167/iovs.04-0250. PubMed 15326120 ↗
  • Baker DH, Meese TS, Mansouri B, Hess RF. Binocular summation of contrast remains intact in strabismic amblyopia. Invest Ophthalmol Vis Sci. 2007 Nov;48(11):5332-8. doi: 10.1167/iovs.07-0194. PubMed 17962490 ↗
  • Li SL, Jost RM, Morale SE, Stager DR, Dao L, Stager D, Birch EE. A binocular iPad treatment for amblyopic children. Eye (Lond). 2014 Oct;28(10):1246-53. doi: 10.1038/eye.2014.165. Epub 2014 Jul 25. PubMed 25060850 ↗
  • Birch EE, Li SL, Jost RM, Morale SE, De La Cruz A, Stager D Jr, Dao L, Stager DR Sr. Binocular iPad treatment for amblyopia in preschool children. J AAPOS. 2015 Feb;19(1):6-11. doi: 10.1016/j.jaapos.2014.09.009. PubMed 25727578 ↗
  • Manh VM, Holmes JM, Lazar EL, Kraker RT, Wallace DK, Kulp MT, Galvin JA, Shah BK, Davis PL; Pediatric Eye Disease Investigator Group. A Randomized Trial of a Binocular iPad Game Versus Part-Time Patching in Children Aged 13 to 16 Years With Amblyopia. Am J Ophthalmol. 2018 Feb;186:104-115. doi: 10.1016/j.ajo.2017.11.017. Epub 2017 Nov 28. PubMed 29196184 ↗
  • Kelly KR, Jost RM, Dao L, Beauchamp CL, Leffler JN, Birch EE. Binocular iPad Game vs Patching for Treatment of Amblyopia in Children: A Randomized Clinical Trial. JAMA Ophthalmol. 2016 Dec 1;134(12):1402-1408. doi: 10.1001/jamaophthalmol.2016.4224. PubMed 27832248 ↗
  • Pediatric Eye Disease Investigator Group; Holmes JM, Manny RE, Lazar EL, Birch EE, Kelly KR, Summers AI, Martinson SR, Raghuram A, Colburn JD, Law C, Marsh JD, Bitner DP, Kraker RT, Wallace DK. A Randomized Trial of Binocular Dig Rush Game Treatment for Amblyopia in Children Aged 7 to 12 Years. Ophthalmology. 2019 Mar;126(3):456-466. doi: 10.1016/j.ophtha.2018.10.032. Epub 2018 Oct 22. PubMed 30352226 ↗
  • Birch EE, Morale SE, Jost RM, De La Cruz A, Kelly KR, Wang YZ, Bex PJ. Assessing Suppression in Amblyopic Children With a Dichoptic Eye Chart. Invest Ophthalmol Vis Sci. 2016 Oct 1;57(13):5649-5654. doi: 10.1167/iovs.16-19986. PubMed 27784068 ↗
  • Xiao S, Angjeli E, Wu HC, Gaier ED, Gomez S, Travers DA, Binenbaum G, Langer R, Hunter DG, Repka MX; Luminopia Pivotal Trial Group. Randomized Controlled Trial of a Dichoptic Digital Therapeutic for Amblyopia. Ophthalmology. 2022 Jan;129(1):77-85. doi: 10.1016/j.ophtha.2021.09.001. Epub 2021 Sep 14. PubMed 34534556 ↗
  • Martin S, Portela JA, Ding J, Ibarrondo O, Levi DM. Evaluation of a Virtual Reality implementation of a binocular imbalance test. PLoS One. 2020 Aug 21;15(8):e0238047. doi: 10.1371/journal.pone.0238047. eCollection 2020. PubMed 32822405 ↗
  • Li SL, Reynaud A, Hess RF, Wang YZ, Jost RM, Morale SE, De La Cruz A, Dao L, Stager D Jr, Birch EE. Dichoptic movie viewing treats childhood amblyopia. J AAPOS. 2015 Oct;19(5):401-5. doi: 10.1016/j.jaapos.2015.08.003. PubMed 26486019 ↗
  • Birch EE, Jost RM, De La Cruz A, Kelly KR, Beauchamp CL, Dao L, Stager D Jr, Leffler JN. Binocular amblyopia treatment with contrast-rebalanced movies. J AAPOS. 2019 Jun;23(3):160.e1-160.e5. doi: 10.1016/j.jaapos.2019.02.007. Epub 2019 May 16. PubMed 31103562 ↗
  • Manny RE, Holmes JM, Kraker RT, Li Z, Waters AL, Kelly KR, Kong L, Crouch ER, Lorenzana IJ, Alkharashi MS, Galvin JA, Rice ML, Melia BM, Cotter SA; Pediatric Eye Disease Investigator Group. A Randomized Trial of Binocular Dig Rush Game Treatment for Amblyopia in Children Aged 4 to 6 Years. Optom Vis Sci. 2022 Mar 1;99(3):213-227. doi: 10.1097/OPX.0000000000001867. PubMed 35086119 ↗
  • Sloper J. New Treatments for Amblyopia-To Patch or Play? JAMA Ophthalmol. 2016 Dec 1;134(12):1408-1410. doi: 10.1001/jamaophthalmol.2016.4296. No abstract available. PubMed 27832261 ↗
  • Liu XY, Zhang JY. Dichoptic training in adults with amblyopia: Additional stereoacuity gains over monocular training. Vision Res. 2018 Nov;152:84-90. doi: 10.1016/j.visres.2017.07.002. Epub 2017 Aug 4. PubMed 28736224 ↗
  • Liu XY, Zhang JY. Dichoptic De-Masking Learning in Adults With Amblyopia and Its Mechanisms. Invest Ophthalmol Vis Sci. 2019 Jul 1;60(8):2968-2977. doi: 10.1167/iovs.18-26483. PubMed 31307059 ↗
  • Liu XY, Zhang YW, Gao F, Chen F, Zhang JY. Dichoptic Perceptual Training in Children With Amblyopia With or Without Patching History. Invest Ophthalmol Vis Sci. 2021 May 3;62(6):4. doi: 10.1167/iovs.62.6.4. PubMed 33944893 ↗
  • Liu Z, Chen Z, Gao L, Liu M, Huang Y, Feng L, Yuan J, Deng D, Huang CB, Yu M. A New Dichoptic Training Strategy Leads to Better Cooperation Between the Two Eyes in Amblyopia. Front Neurosci. 2020 Nov 26;14:593119. doi: 10.3389/fnins.2020.593119. eCollection 2020. PubMed 33324154 ↗
  • Holmes JM, Manh VM, Lazar EL, Beck RW, Birch EE, Kraker RT, Crouch ER, Erzurum SA, Khuddus N, Summers AI, Wallace DK; Pediatric Eye Disease Investigator Group. Effect of a Binocular iPad Game vs Part-time Patching in Children Aged 5 to 12 Years With Amblyopia: A Randomized Clinical Trial. JAMA Ophthalmol. 2016 Dec 1;134(12):1391-1400. doi: 10.1001/jamaophthalmol.2016.4262. PubMed 27812703 ↗
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Updates

1 registry update since Sep 25, 2026
Status
Recruiting→Completed
changed Oct 20, 2026
Start date
Oct 5, 2023→Dec 4, 2023
Oct 20, 2026
Primary completion
Sep 30, 2024→Oct 15, 2026 (actual)
Oct 20, 2026
Study completion
Sep 30, 2024→Oct 15, 2026 (actual)
Oct 20, 2026
Enrollment
120 (estimated)→125 (actual)
Oct 20, 2026
Show all 1 update
  1. Oct 20, 2026
    Recruiting→Completed
    Start date Oct 5, 2023→Dec 4, 2023
    Primary completion Sep 30, 2024→Oct 15, 2026 (now actual)
    Study completion Sep 30, 2024→Oct 15, 2026 (now actual)
    Enrollment 120 (estimated)→125 (actual)
    + 5 other changes: verification date, contact details, site details, references and index terms

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06150391
Lead sponsor
Hospital de Merida
Collaborators
VisionaryTool, S.L.
Responsible party
Maria Perez-Benito (Dr., Hospital de Merida) — Principal investigator
First posted
Nov 29, 2023
Start date
Dec 4, 2023
Primary completion
Oct 15, 2026
Completion
Oct 15, 2026
Last update
Oct 20, 2026

Study contacts

Teresa Calderon-Gonzalez, Lic
study chair · VisionaryTool, S.L.
Juan A. Portela-Camino, PhD
study chair · VisionaryTool, S.L.
Santiago Martin-Gonzalez, PhD
study chair · VisionaryTool, S.L.
Maria Perez-Benito, Dra
principal investigator · Hospital de Merida
Esther Alvarez-Martin, Dra
study chair · Hospital de Merida

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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