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Cohort studyJournal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026

Real-world effectiveness of a binocular, dual-mechanism therapy in severe amblyopia: analysis from the PUPiL Registry.

Courtney L Kraus, Alyssa A Godfrey, Eric D Gaier … Maanasa Indaram

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OphthalmologyCohort study

Binocular digital therapy linked to vision gains in severe lazy eye

Real-world effectiveness of a binocular, dual-mechanism therapy in severe amblyopia: analysis from the PUPiL Registry.

Courtney L Kraus … Maanasa Indaram

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026

Background

Occlusion therapy for severe amblyopia is challenging because of low visual function of the unoccluded eye and lengthy duration of daily therapy, which may then be hindered by low adherence.

Purpose

This study evaluates real-world effectiveness of a binocular digital treatment in patients with severe amblyopia.

Methods

The records of children <18 years with best-corrected visual acuity (BCVA) of 20/100 or worse in their amblyopic eye who were prescribed Luminopia in the PUPiL Registry were retrospectively analyzed.

n = 57 children

1.8

Results

1.8

lines

eye chart score got better after treatment, on average

n = 57 children

More results

Of the 57 patients, 26 (46%) achieved ≥2-line gains.

Treatment-naive patients showed greater improvement (n = 7; 4.4 lines [95% CI, 2.1-6.7]) versus previously treated patients (n = 50; 1.5 lines [95% CI, 0.6-2.3; P = 0.0183]).

More results

Worse baseline BCVA (Spearman r = 0.33, P = 0.013) and greater treatment hours (Spearman r = 0.51, P < 0.001), but not age or amblyopia type, were associated with greater BCVA improvement.

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Conclusion

Luminopia demonstrated significant improvements in Registry patients with severe amblyopia, particularly in treatment-naive patients, supporting its use as a viable treatment option that may address key limitations of traditional approaches.

Post

Real-world effectiveness of a binocular, dual-mechanism therapy in severe amblyopia: analysis from the PUPiL Registry.

Binocular digital therapy linked to vision gains in severe lazy eye

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