Can an app help improve your eyesight?

You may have read an article in the news recently about an app that says its use can reduce the effects of presbyopia. Clinical Adviser, Daniel Hardiman-McCartney, explains the background and what you should tell patients that ask about its effectiveness.

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Author: Daniel Hardiman-McCartney MCOptom, Clinical Adviser 
Date: 21 April 2017

The recent news featured the story of an app that says its use can reduce the effects of presbyopia, through the playing of a smartphone game for 10-15 minutes three or four times a week. The app creators say that the game works by training and improving the brain’s ability to decode a blurry image and helps users perceive near-vision more clearly. This concept is based on published research on improving vision in amblyopia and the app uses high frequency contrast targets called Gabor patches to train and improve target detection. But even though the app is based on scientific theory, it is unclear as to whether it works, as the research is still in its infancy.

Uri Polat, co-founder of the app, says that people playing the game for 30 minutes, three times a week, can improve their minimum angle of resolution visual acuity by a factor of ≈ 1.6, from 2.44 ± 0.24 (geometric mean ± 95% confidence interval) arc min at pre-test to 1.56 ± 0.16 arc min at post-test, which is roughly equivalent to being about eight years younger. So the study found presbyopia could be delayed, by playing the app for 1.5 hours a week. However as critics pointed out, the trial was based on a small sample - of 30 subjects - and only had two control subjects. We do not know how this may translate into real-world readings or the extent and longevity of possible perceptual benefits, and more robust research is needed, in particular, a larger controlled and randomised trial (larger samples make findings more compelling as chance effects are likely to be evened out overall, making any found correlations more interesting). 

Very few health apps are validated and often only vaguely based on science.

It is definitely too early to recommend this app to our patients, and even if it works, you would have to be a very motivated person to spend 1.5 hours a week playing a computer game to postpone using reading glasses! More research on this could lead to real progress for those with amblyopia and maybe some assistance for those with early presbyopia.

There are many health-related apps now available. While empowering self-help and promoting preventative medicine has to be a good thing, it is important to bear in mind that the app sector is a global market and is poorly regulated. Very few health apps are validated and often only vaguely based on science. Another app which says it improves vision was recently fined in the US for failing to substantiate its claims, and if you search YouTube, there are thousands of videos proclaiming the benefits of various versions of the Bates method, with millions of views and likes.  Some give advice which not only is unlikely to work, but could actually result in harm.  It is important to stay abreast of this fast-growing sector of sight care, so we can engage with our patients to help them make informed decisions about what is best for their sight and long term eye health.

Daniel Hardiman-McCartney FCOptom
Clinical Adviser, The College of Optometrists

Daniel graduated from Anglia Ruskin University, where he won the Haag Strait prize for best dissertation. Before joining the College, he was Managing Director of an independent practice in Cambridge and a visiting clinician at Anglia Ruskin University. He has also worked as a senior glaucoma optometrist with Addenbrooke’s Hospital in Cambridge, with Newmedica across East Anglia and as a diabetic retinopathy screening optometrist. Daniel was a member of Cambridgeshire LOC from 2007 to 2015 and a member of the College of Optometrists’ Council from 2009 to 2014, representing its Eastern region.  

He is Clinical Adviser to the College of Optometrists for four days each week, dividing the remainder of his time between primary care practice and glaucoma community clinics. Daniel is a passionate advocate of the profession of optometry, committed to supporting all members of the profession and ensuring patient care is always at the heart of optometry. He was awarded Fellowship by Portfolio in December 2018.


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