What we learned from our first study, and what we have changed for the next

In our first study, children who played Vedea Amblyopia Therapy (VAT) improved as much as children who were patched. A great first step. But just as valuable was what we learned about the playing itself: how long children gamed, which games they chose, and what parents ran into.

Playing every day does not come naturally

The treatment asks for 30 minutes a day, for sixteen weeks. That sounds manageable, especially compared with hours of patching. In practice, it proved harder. On average, children played about 19 minutes a day. That is more than half, but clearly less than intended.

Parents of young children will probably not be surprised. A five- six- or seven-year-old is not always in the mood after a day at school or daycare, the novelty wears off after a few weeks, and finding a moment together every day asks a lot of a family. Even a fun game becomes ordinary after a while.

What the data told us

Because VAT records every session, we could see exactly how and when children played. Children who played less more often chose the simpler 2D games. The games in the 3D world held their attention better.

We also saw that parents had little insight into how things were going, and that a technical problem with the phone or the headset sometimes stopped play for a few days. Those are exactly the moments when a family loses its rhythm.

Our conclusion: daily playing time matters. A treatment only works if children want to play and parents can easily keep it up. That is what we have been working on.

What we are changing

For the follow-up study, we have improved VAT in four ways.

• Everything in 3D. The games that used to be 2D now take place in a 3D world. That brings more variety and more challenge, and children stay with it longer.

• A reward system. Every session earns something in the game. There is something to look forward to each day, and continuing to play feels like progress.

• An app for parents. Parents can see at a glance how long their child has played, get information about the treatment and ask for technical help directly when something does not work. An empty battery in thr controller or an update no longer has to cost days.

• Gamifying the parents. Small goals and milestones in the app help parents keep going together with their child. Keeping it up no longer rests on the child alone.

What comes next

In the follow-up study, with several clinics, we will test this improved version. At every check-up, the orthoptist can see how often and how long a child has played. It will show whether children play more and longer, and what that means for their vision.

We believe a treatment for young children has to fit into family life. With these changes, we are a big step closer.