It’s no secret that patching is not popular among those of us who’ve had to do it for months and even years as a part of amblyopia treatment. The way it looks, the way it feels to tear it off your face, the way it smashes your eyelashes and makes you feel blind. The good news is that there are so many alternative treatments for amblyopia with the vast technology that is available. I’ve been lucky enough to try most of them and CureSight is the latest and greatest.
So what is CureSight and does it actually work to treat amblyopia? CureSight is a binocular treatment for amblyopia or lazy eye. The patient is sent a device with eye tracking capabilities and a pair of red/blue anaglyph glasses. Their job? Watch their choice of endless streamed content on the device for an hour or more each day. While wearing the glasses, the center portion of the vision in the strong eye is blurred according to its momentary gaze position, forcing the weaker eye to work. This accomplishes the goal of strengthening a weak eye, while developing binocular vision as well. The best part is that it is research backed and covered by insurance. Win win!
There are so many details to dive into, but if you already know you are interested, visit their website and start the process HERE. For the rest of you, read on!
If you aren’t sure and would like to visit with me over zoom or check out the other resources that I offer, head over HERE.
What is Amblyopia
Let’s start with the basics, what exactly is amblyopia (lazy eye) and why is it a problem.
Amblyopia is when the vision in one or both eyes is blurry and can’t even be corrected with glasses. It’s not a glasses issue, it’s a brain neurological connection issue.
This can be a result of cataracts, strabismus, or differing, strong prescriptions in each eye. No matter how it starts, the brain’s solution usually ends up being to only use one eye and ignore the weak or amblyopic eye.
While this is actually a pretty great solution for avoiding double vision, it will reduce depth perception and the vision in the weak eye will continue to get worse.
It doesn’t matter whether you talk to an ophthalmologist, optometrist, behavioral optometrist or pediatrician, they all agree that amblyopia will create major issues and needs to be addressed. They all may have differing preferred methods of treatment, but a common thread appears. The weak eye needs to be forced to work in some way.
For the last hundred years (probably much longer), the method has always been to put a patch over the strong eye which forces the weak eye to work. This will strengthen that weaker eye, but if the eyes are not able to work together, those results don’t always last.
How Does CureSight Work?
CureSight is a device developed by the company, NovaSight. While the company is based in Israel, the main focus is within the United States where it has an office and a team. The program is geared towards children with amblyopia and is pretty simple to set up, here is how it works:
If your child has amblyopia, your ophthalmologist or optometrist simply sends a referral to CureSight and within a week or two you will receive a device in the mail. It is a pre-programmed touch screen computer with eye tracking that is extremely easy to set up.
The home screen has icons for any streaming service you can imagine from Netflix to PBS Kids to YouTube. Don’t worry, there are parental controls available to customize app availability as you see fit.
Once you pick your streaming service, the screen automatically starts the positioning process. This is when the user gets into the correct position for the eye tracking to be effective. When CureSight is happy with the position it moves to calibration. Simply follow a few little exploding balls around the screen with your eyes and then you are in.
At this point, the treatment begins. The red/blue treatment glasses are worn over the prescription glasses and the central part of what the strong eye can see is blurred out. The blur size and its density depend on the severity of the vision in the amblyopic eye and are adjusted automatically when the doctor updates your visual acuity on the CureSight cloud following an office visit.
Now, all that is left is to watch your chosen content. No matter where the eyes look on the screen, that little blurry blob follows which encourages the weak eye to fill in the central details that the strong eye is blocked from seeing.
The beautiful part is that both eyes are open and working so the fusion between the eyes is also being exercised.
I will add that it isn’t as easy and carefree as watching a normal movie. This is a workout for the brain and eyes, especially for those of us with amblyopia. Strengthening a weak eye is going to be work, no matter which way you choose to do it, but I definitely prefer doing this through movies than patching for hours.
Cost, Insurance, and Set Up
With so many new technologies that are coming out, it can be frustrating trying to figure out how to actually get the devices in your home and get them covered. They require special equipment, referrals, time and cost. The good news is that while this still may be the case, CureSight does all the work for you so you hardly even notice.
Either go to a provider that is already a referrer (list) or go to your current ophthalmologist or optometrist and ask them to give you a referral for the program. If they go HERE they can learn more about how the program works from the doctor side.
The medical codes that are billed are 0704T, 0705T and 0706T which are unique to the CureSight treatment. The first two codes are billed directly through NovaSight for the device setup, education, surveillance, and tech support. The third code can be billed through an ophthalmologist or optometrist for remote monitoring. For offices that aren’t interested in billing, this is optional.
The referral is sent to the CureSight US based Monitoring Center where they work with the insurance to determine eligibility and copays, cost, etc. Before shipping out the device, they discuss this with the patient and make sure everyone is on the same page.
Depending on the insurance, different amounts may be covered. Some insurances may cover at 100% and others will not cover so it would become a cash pay situation. The rate for cash pay is around $350 per month and discounts may apply.
It is important to remember that insurance may only cover this device if you fall within the parameters that were covered in the study.
- The child is between 4-9 years old
- Amblyopia is present
- No strabismus is present (very mild strabismus up to 5 PD is okay)
- The patient is doing the treatment with the device for a minimum of 18 hours per 30-days cycle (Note: the prescribed treatment time is 30 hours per 30-days cycle)
The device is shipped to your home and when it arrives the family receives a call from the Monitoring Center. They guide patients through the set up process, teach parents how to use parental controls, and give requirements and tips for usage.
The patient uses the device at home for at least 1 hour each day. The Monitoring Center keeps track and will call or email to check-in when needed. Doctors can also monitor the progress and usage from their own computer through a dedicated web platform. Updates to a patient’s prescription can be made on this platform by the doctor that will directly change the settings for the patient.
When the treatment is finished, the Monitoring Center schedules a pickup for the device’s return to NovaSight. As long as the device is in good condition, no charges for the device will be made.
My Experience With CureSight- Side Effects and Efficacy
I was able to use a CureSight device for 3 weeks this year. As an adult with amblyopia and strabismus, I don’t fit the criteria for use so I wasn’t using it as a treatment, more just experimenting with it for all of you who do fit the criteria.
I was expecting the eye tracking to not work because of my eye misalignment and that it would be of no help to my condition, but as it turns out, I was wrong.
There was no problem with calibration and the eye tracking worked really well. I watched several hours of videos over the course of a few weeks and I only had to redo the calibration one time when it wasn’t quite picking up my eye movements correctly.
Initially, I was mainly focusing centrally out of my strong eye, which meant that there was a central circle blurred out of the picture. It took a few treatments, but after about a week, my weak eye started filling in the central details and I started getting a better mixture of what each eye was seeing.
This is the whole goal of CureSight. To give the weaker eye an opportunity to take the lead and get stronger, while simultaneously getting the brain to combine and mix the images that each eye sees. It is patching, plus so much more.
I found that slower moving videos, like National Geographic were much easier for me to get the mixture. I also like movies that had lighter backgrounds, like cartoons and Arctic videos. It still works with other types of movies, but since I am old and less flexible in my vision, I needed those little helps to make it more effective as an exercise.
The first day that I used CureSight, I was immediately impressed. After just 15 minutes, my eyes were extremely tired. This is always a good sign to me, it means that the treatment is actually doing something. Knowing that I am prone to side effects when I overdo new treatments, I stopped at that point and took a nap. By the end of the first week, I was able to build up to doing 60-90 minutes per session without any side effects.
As someone who has spent years doing various eye exercises through vision therapy, I am very used to these side effects. Each time I try a new treatment, it takes time for my brain to get used to it.
I didn’t use the program long enough to really see if I would get lasting results, but I definitely was able to see that it could make a huge difference if used correctly for the prescribed amount of time. I could feel my eyes working together in a different way and my weak eye was becoming stronger.
I even had some extra fun moments of improved stereo and clarity after using CureSight.
Here is a quick breakdown for why I, personally, would or wouldn’t use CureSight:
|Reasons I Would Use CureSight
|Reasons I Wouldn’t Use CureSight
|Strengthens the coordination between my eyes
|I am already at 25/20 in my amblyopic eye
|Watching Movies > Wearing Eyepatch
|My insurance wouldn’t cover it
|Strengthens amblyopic eye
|I have a strabismus > 5PD at some distances
|Improves Stereoacuity and 3D Perception
After years in vision therapy, I have already gotten the acuity in my amblyopic eye to 25/20. I have many complicating factors like anomalous retinal correspondence and an angle >5 PD at some angles and distances. For these reasons, CureSight just doesn’t make sense as a main treatment for me.
That is just for me though. I think that for children with amblyopia, this is an amazing solution that checks all the important boxes. The combination of improving acuity and stereo in one tool is amazing!
How CureSight Compares to Other Amblyopia Treatments
Amblyopia is a complex problem with lots of options for treatment. I want to highlight how CureSight compares to some of the traditional treatments and why I would choose one or the other.
Patching vs CureSight
Patching can be effective at strengthening a weak eye, but it is not the most effective solution. CureSight ranks much higher with both success rates and compliance at a fraction of the time. Let’s take a look at how the two measure up to one another.
|7 hours weekly
|4-6 hours daily
|Full attention required during usage
|Can be done during normal activities
|Improves binocular fusion
|Decreases binocular fusion
|Forces weak eye to exercise
|Forces weak eye to exercise
|79% got 2 line improvement or more
|61% got 2 line improvement or more
One reason that some parents prefer patching is that their child can go on about their normal day while patching. It doesn’t require a dedicated time and is easier for parents to fit into their schedule. It can sometimes be hard to find 60-90 minutes for a child to watch a show if they are involved in a lot of extra activities.
If we compare it to exercise, patching would be the person who is on their feet all day, maybe walking around or just standing. The person using CureSight is the one who goes to the gym for an hour and lifts weights and gets the cardio. Both are much better off than the person sitting on the couch eating potato chips, but the dedicated workout is going to be more challenging and reap higher rewards.
It also requires an intentional decision to do that work.
As both a mom of 4 children, and an adult who spent years patching as a child, I can’t understand why anyone who needed to strengthen an amblyopic eye and qualified for CureSight wouldn’t at least look into and see if it was an option.
I had my 6 year old daughter try it out and even though she has no amblyopia, she still hated the patching and loved watching her movie on CureSight. Compliance is key!
For me, it’s a no-brainer. Yes, you have to make the time, but it is going to be SO much more effective and enjoyable for your child. Make the time and your child is going to experience longer lasting and better results and they won’t hate it like they hate patching. It’s worth it.
Vision Therapy vs CureSight
Vision therapy involves a much broader treatment for amblyopia than CureSight. Vision therapy includes work with acuity, fixation, saccades, pursuits, primitive reflexes, visual discrimination, stereopsis, fusion, eye-hand coordination and much more.
CureSight focuses on acuity of the weak eye, fusion between the eyes and peripheral. All so amazing and necessary, but not the full package.
In my opinion, having a patient with amblyopia spend 6 months doing a treatment through CureSight to start building the foundation of vision, followed by in-office vision therapy would be ideal.
Vision therapy can be very expensive and is generally not covered by insurance. For patients with complex conditions like amblyopia, the therapy often takes a year or more. Using a program like CureSight could be a wonderful compliment to vision therapy, hopefully decreasing the overall time needed in weekly therapy, but not necessarily replacing it all together.
This can help save money and keep the child interested in the treatments as they grow.
Virtual Reality vs CureSight
The last comparison that would be pertinent would be virtual reality. There are 3 main programs used in virtual reality that have similar concepts to CureSight are Luminopia, Vivid Vision and Optics Trainer.
Vivid Vision and Optics Trainer are generally only prescribed through a developmental optometrist. There are settings that can blur out the strong eye or make it so that only the weak eye can see specific parts of the picture. These programs have 8-12 simple games and are great. I love them both, but they are very different from CureSight.
While CureSight can be covered by insurance, the others cannot. Vivid Vision and Optics Trainer are more general programs that can be used for strabismus and/or amblyopia, while CureSight is only for Amblyopia. I love VR, as my readers know, but it’s a different program than CureSight.
Luminopia is more similar to CureSight in that it is more passive and the patient simply watches movies for the treatment instead of doing exercises and games.
|Unlimited content through any streaming service.
|Content limited to specific pre-determined shows and movies (700 hours)
|Eye Tracking provides a dynamic treatment, blurring out the section where the eyes are pointed.
|Specific parts of the screen are blurred no matter where the patient is pointing their eyes.
|Research indicates improvement in acuity of amblyopic eye AND stereoacuity
|Research indicates improvement in acuity of amblyopic eye (not stereo)
|Device is a touchscreen computer
|Device is a VR headset
|Parent can see and monitor what the child is watching
|Parent cannot see what the child is watching
I haven’t personally tried Luminopia, I am sure it is a great product so I can’t say much about it. But I will say that in my experience, VR can be challenging with younger children. The adult can’t see what they see so troubleshooting and making sure that they are using it properly and watching approved content can be a bit of a hassle.
As a mom, I’d lean towards CureSight for that reason alone.
I am not here to say that CureSight is the only treatment for amblyopia, because that simply isn’t true. With technology changing, new ideas are constantly emerging, this world is amazing. And patching isn’t going anywhere, unfortunately for amblyopic kids everywhere. The old school eye doctors will keep prescribing it because it is a habit and it’s inexpensive.
I will say that CureSight is an amazing option. It is extremely accessible, engages kids and is so effective. As a parent, I love that I can actually see what my child is seeing so that I don’t need to worry about what is happening inside a headset.
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