RT Journal Article
T1 Virtual Reality Orthoptic Interventions for Binocular Vision Disorders: A Systematic Review and Meta-Analysis
A1 Martínez Pérez, Clara
A1 Nores Palmas, Noelia
A1 García Queiruga, Jacobo
A1 Giráldez Fernández, María Jesús
A1 Yebra-Pimentel Vilar, Eva
K1 Convergence insufficiency
K1 Intermittent exotropia
K1 Stereopsis
AB Purpose: To systematically review and meta-analyze randomized controlled trials (RCTs) evaluating digital orthoptic interventions, including virtual reality (VR)–based approaches, for convergence insufficiency and intermittent exotropia. Methods: This systematic review and meta-analysis followed PRISMA 2020 guidelines and AMSTAR-2 standards and was prospectively registered in PROSPERO. PubMed, Web of Science, and Scopus were searched up to December 2025. Eligible studies were RCTs comparing VR-based or digital orthoptic interventions with conventional therapy, placebo VR, or control conditions. Primary outcomes included near point of convergence, ocular deviation, fusional reserves, and stereopsis. Risk of bias was assessed using RoB 2 and certainty of evidence with GRADE. Results: Four RCTs (184 participants) were included. In convergence insufficiency, digital orthoptic interventions, including VR-based approaches, significantly reduced near heterophoria (mean difference [MD] −1.64 prism diopters; 95% CI −3.17 to −0.12), with no significant effects on near point of convergence or positive fusional reserves. In intermittent exotropia, VR-based interventions significantly improved near point of convergence (MD −1.60 cm; 95% CI −2.64 to −0.55), although this change did not reach the ≥4 cm threshold considered clinically meaningful according to the Convergence Insufficiency Treatment Trial. Improvements were also observed in stereopsis (MD −0.19 log units; 95% CI −0.33 to −0.04), while changes in near deviation were not significant. Evidence certainty ranged from low to moderate. Conclusions: VR-based and digital orthoptic interventions may offer modest, outcome-specific benefits as adjunctive treatments for selected binocular vision disorders. Larger, well-designed RCTs with standardized outcomes are needed.
PB MDPI
YR 2026
FD 2026-04-14
LK https://hdl.handle.net/10347/46689
UL https://hdl.handle.net/10347/46689
LA eng
NO Martinez-Perez, C., Nores-Palmas, N., Garcia-Queiruga, J., Giraldez, M. J., & Yebra-Pimentel, E. (2026). Virtual Reality Orthoptic Interventions for Binocular Vision Disorders: A Systematic Review and Meta-Analysis. Journal of Eye Movement Research, 19(2), 39. https://doi.org/10.3390/jemr19020039
DS Minerva
RD 25 may 2026