Development of computer methods in binocular treatment of strabismus and amblyopia

Computer methods were introduced into the practice of strabismus and amblyopia treatment in the 1990s. In Russian ophthalmological institutes, several independent groups of specialists were organized to create interactive computer programs (ICP) for diagnosis and treatment of these binocular vision disorders. This resulted in the emergence of a variety of equipment based on ICPs differing in purpose, technology of left and right image separation, and design. The main factors determining the prospects of these computer methods are achievements of the fundamental researches of the visual system, the results of using ICPs in practice, and technical innovations. However, the realization of this potential is hindered by a number of marketing and social factors that impede the exchange of important information between different groups which develop and use ICPs, as well as the lack of theoretical discussion of the general methodology, methods of ICP optimization, and conditions of using different ICPs. Due to the emergence of fundamentally new data concerning the pathogenesis and treatment of amblyopia and the possibility of successful activation of long-blocked (“dormant”) binocular mechanisms in adult patients, the need to revise the current situation is acutely felt. Opinions regarding the effectiveness of computerized binocular therapy (BT) methods are contradictory: some researchers estimate it very high, while others see little or no specific benefit from BT compared to the traditional methods. In this article, some reasons explaining the lack of consensus are discussed: vague criteria of the methods belonging to the “BT class”, differences in technical implementation of BT, specificity of visual stimuli and conditions of BT application, differences in patient groups and interaction with patients (such as training, instruction, assistance, encouragement, involvement in the choice of working material, etc.). The requirements for adequate expertise of each method and comparative assessment of different methods are discussed.