The Treatment of Amblyopia and Astigmatism through Eye Tracking and Serious Games
Tahani Jaser Alahmadi, Rania AlAblani, Najla Bin Eid, Reyoof AlHumaidi, Amal AlMeiman, Farah AlNujaidi · 2024 · Proceedings of the 21st International Web for All Conference (W4A '24) · doi:10.1145/3677846.3678018
Summary
This paper presents Abs'arnna, a mobile application that combines serious games with eye-tracking technology to treat amblyopia (lazy eye) and astigmatism in children. The authors from Princess Nourah bint Abdulrahman University in Saudi Arabia address a significant gap in pediatric vision care: traditional treatments such as eye patching, corrective lenses, and surgical interventions (unavailable until age 18) often lack engagement, leading to poor adherence among young patients. The proposed solution uses five interactive games — Pop the Balloons, Catch the Monster, Cupcake Monster, The Maze, and Cross the Road — each designed around specific eye exercise techniques drawn from the clinical literature. Three games focus on tracking vertically or horizontally moving objects to train eye coordination and visual processing speed, while two navigation-based games strengthen the weaker eye by engaging visual perception and decision-making. The system integrates an eye-tracking algorithm built on ARKit that continuously monitors eye movement during gameplay, using image preprocessing, template matching, and edge detection to identify and track the eye's position in real time. Based on these measurements, the application dynamically adjusts game difficulty to provide a personalised treatment experience. The app also tracks performance metrics like accuracy and reaction time, generating progress reports for parents. Privacy is prioritised through on-device real-time analysis rather than cloud-based processing.
Key findings
The researchers conducted a large-scale online survey of 413 participants over 10 days to assess perceived effectiveness of their approach. 81% of respondents believed that serious games combined with eye tracking could effectively improve or maintain vision in children with amblyopia and astigmatism. Participants also expressed strong support for the usefulness of game-based training and the importance of tracking children's progress through measurable results. However, the study has not yet completed clinical validation — the planned testing protocol involves children diagnosed with amblyopia and astigmatism participating in daily supervised gameplay for 30 consecutive days, with baseline and post-intervention measurements taken at day 0 and day 20 to quantify vision improvements. The eye-tracking algorithm uses a minimum threshold score of 600 for template matching to ensure accuracy across varied conditions, and requires at least three detected edge points for circles or four for ellipses to successfully track eye position.
Relevance
This paper is relevant to accessibility practitioners interested in how gamification and assistive technology can address visual impairments, particularly in children. It demonstrates a creative approach to making vision therapy more engaging and accessible by replacing tedious traditional exercises with interactive games. The work is early-stage — the survey data shows perceived value but clinical efficacy remains unvalidated, which is a significant limitation. The on-device eye-tracking approach raises interesting possibilities for privacy-preserving assistive technology. For organisations working on accessible health technologies, this research highlights the potential of combining game design principles with clinical treatment goals, though practitioners should await the results of the planned clinical trials before drawing conclusions about therapeutic effectiveness.
Tags: serious games · eye tracking · vision therapy · assistive technology · pediatric accessibility · gamification