My game, Diplopia, is trying to use the Oculus Rift and Leap Motion to help people with lazy eye (amblyopia) and crossed eye (strabismus). Here is some proof. I was born with strabismus which caused my amblyopia, and had never seen anything in 3D until I made my game. Now I can see in 3D in my game, and am seeing progress in my day-to-day normal vision outside of VR.

Just over 5 weeks ago I started my crowd funding campaign hoping to raise $2,000 for a Unity Pro licence. Since then thanks to very generous people from all over the internet I have raised over 10 times that. I have spoken with so many supportive and wonderful people, from ophthalmologists to VR experts, as well as people (like me) who have amblyopia and strabismus.

AMA!

proof

Comments: 99 • Responses: 43  • Date: 

uptaman4 karma

How long did it take until you saw a noticeable difference in your day-to-day vision? How long were you playing/testing per day?

This is a really interesting application of the oculus rift and leap motion! Good luck on Diplopia!

jamesj3 karma

I was playing 15-60 minutes every other day for about 2-3 weeks before I noticed changes in my vision outside of VR.

The first time I coded and used it was the first time I had seen anything in 3D. It took some time for that to move outside of VR though.

Thanks!

goatcoat2 karma

So you're saying you had never seen the world in 3d before? What was that like?

jamesj1 karma

My whole life I would ask people what 3D vision was like, and I never got a good answer. Now that I have seen it myself I understand why it is so hard to explain.

The first time I saw something in 3D there was an extra quality to the image, depth, that I had never before experienced. I had the idea of depth, and space, but I never had the visceral sensation of it.

Things don't exactly look different, but reality now seems more real than before.

AforAnonymous1 karma

My whole life I would ask people what 3D vision was like, and I never got a good answer. Now that I have seen it myself I understand why it is so hard to explain.

I recommend reading Fixing My Gaze: A Scientist's Journey into Seeing in Three Dimensions by Susan R. Barry. Prof. Barry provides a very good description of what it was like for her to gain 3D vision.

It makes it much easier to understand what 3D vision should be like, but also makes it much easier to explain to people who have 3D vision what it is like to NOT have it - what many people don't realize is that a person capable of seeing in 3D who closes one eye does in fact NOT see the same thing as a person who lacks the ability to see in 3D and never HAD this ability sees.

This is because the visual cortex of a person capable of seeing in 3D is aware of the concept & sensation of depth, and can therefore apply an approximation of depth onto a non-stereoscopic image. If on the other hand the visual cortex has never learned this sensation, it can not apply it.

This furthermore expands into spatial thinking - the lack of having experienced the sensation of 3D vision actively inhibits the ability to imagine a situation in 3D.

Perhaps even with your limited experience with, pardon the pun, experiencing 3D vision, you have noticed a difference in the difficulty of spatial reasoning?

jamesj1 karma

Thanks, I will check that out! I've seen her TED talk, which was pretty cool. I always thought that playing a lot of 3D video games helped my spatial reasoning growing up, but I am not sure. I don't think I am any better now but I havn't done any tests.

buddythebear3 karma

Will Diplopia be available for Mac?

jamesj2 karma

I'm using Unity, so it will be available for PC, Mac, and Linux.

protestor3 karma

Did you begin development without an Oculus Rift? (I ask because your indiegogo says the funds would be used for it, but it would be hard to develop without having one..)

Also how does it help with the medical condition? Is your vision permanently better? (also, do you think this could be prescribed by doctors?)

jamesj2 karma

You can start working on a VR game without a rift. Basically it outputs the two sides, skewed for the two lenses, to a monitor. When that monitor is your Rift you see everything in 3D, but if it is a normal monitor you can still see what is going on. I got a rift before I launched the IndieGoGo, but I have since bought more and have brought more people on to the team to work on the game.

I was born with a crossed eye (strabismus). This caused the muscle in that eye to become weak (amblyopia). Since the two images from my eyes did not line up well enough, my brain learned to suppress, or disregard, information coming from my bad eye. The eye still works, but the muscle is weak.

Basically by showing some objects very brightly to the bad eye and very dimly to the good one you can temporarily break through the suppression and force the persons brain to integrate the two images (assuming their strabismus is not TOO severe). With enough practice and use the bad eye becomes stronger, and you can unlearn the suppression of it and get an image where both eyes contribute. The game is designed so you MUST use both eyes together to win.

Once you strengthen the eye and teach the brain to use it, day-to-day use of it should keep it strong. At that point you should not need to keep training the eye.

Right now, I havn't proven anything scientifically, though I have proven to myself that it can work (for me).

protestor3 karma

Once you strengthen the eye and teach the brain to use it, day-to-day use of it should keep it strong. At that point you should not need to keep training the eye.

That makes sense.

I havn't proven anything scientifically

Do you plan to work with researchers to evaluate your method (and possibly co-author papers)?

jamesj3 karma

Yes and yes.

Xunderground2 karma

If I may ask....how is it seeing the world in 3D? Much different? My strabismus caused an underdeveloped optic nerve and left me almost completely blind in my right eye.

jamesj1 karma

It isn't what I expected. It is cool. Things seem more real than before. It isn't a ''gigantic'' change, though. That said I don't have full 3D in real life yet, maybe it will get better.

Xunderground1 karma

Enjoy the changes for me. Always touches me personally when I hear about someone gaining 3D vision. I know that I'll probably never be able to so I guess it's like me living through them.

jamesj1 karma

Thanks for the kind words, and hopefully you can experience the same changes some day.

KennyFulgencio1 karma

Basically by showing some objects very brightly to the bad eye and very dimly to the good one you can temporarily break through the suppression and force the persons brain to integrate the two images (assuming their strabismus is not TOO severe).

I fucked up my eyes years ago by performing for a few weeks in a play while wearing an eyepatch. One eye saw blackness, the other saw extremely bright stage lights. Prior to that my eyes seemed to align perfectly (as far as I could tell), ever since then they've been wonked up, and that was MANY years ago. Help!!

jamesj2 karma

How did that effect your eyes? Do you have double vision?

PookaProtector3 karma

Thanks for putting your talent to good use.

Would your game be of any help to me?

2 years ago I had a blood clot that damaged my optic nerve, and now I use only one eye. My vision is wonky, though: I will often look at a crowded computer screen for far too long before finding what I'm searching for.

Would your game help improve the vision I have left?

jamesj1 karma

If you close your good eye, do you have vision in your bad eye? Is the muscle weak in that eye?

PookaProtector1 karma

I do have vision in that eye, 20/400. The muscle isn't weak, though-it's just the optic nerve is atrophied.

jamesj1 karma

I think exercising that eye wouldn't help you then.

tanxs12 karma

This thing looks cool. I'll look through more of the site when I have time

I have diplopia. I can see 3D easily (though I have trouble imagining it. Might just be my terrible imagination) but can see double of something on command.

As I get older, will my lazy eye get worse?

I also remember when I was 8 telling a teacher I could see double. This was waaaay before anybody realised I had a lazy eye (I thought it was normal to see double). The teacher kind of dismissed it. If she did something about it and I ended up going to an opticians where they found out I had diplopia at this early age, would there be a chance that they would've fixed it so that I wouldn't be able to see double right now? That has always made me curious.

(rushed this as I have to go soon. sorry for no questions on the game itself!)

jamesj2 karma

My lazy eye was diagnosed before I could speak. I can also kind of command my bad eye to show double, though not always.

It is easier to fix while young. If you had started when you are 8 there is a chance you could have fixed the problem then. Everyone thought there is nothing you can do after age 11-13 or so, but that has been proven false recently, which is one of the reasons I am now making this game.

AforAnonymous2 karma

I've read you've been accepted to LEAP.AXLR8R now.

  • So far it seems you are a single man crew, LEAP.AXLR8R seems to expect more people, is this an issue for you?
  • How do you feel about moving to San Francisco for this en endeavor?
  • Is there a company for this already?
  • Your company will have to become traded for the participation in LEAP.AXLR8R, since they require 6% of common stock, have you given this any significant amount of thought yet?
  • Have you had any contact with McGill Vision Research from Montreal? They seem to be the only major research group focusing on games as vision therapy and have developed some of the approaches you seem to be using.
  • Have you considered using a quickly alternating contrast? (i.e. swap the contrast between the eyes left/right every other frame) Strobing effects have been shown to bypass saccadic masking by Valve recently, and this bypassing has lead to issues with the Rift - however, in a therapeutically setting it MIGHT be beneficial - or catastrophic. Note that the nVidia Lightboost LCDs have a strobing backlight!

Edit:

  • Are you developing the game on a color calibrated screen to ensure you are not affected by e.g. color banding to ensure end users see the same thing you see?

jamesj1 karma

So far it seems you are a single man crew, LEAP.AXLR8R seems to expect more people, is this an issue for you?

I've brought on more people to work on the project and go to SF for the axlr8r. The main one being my co-founder, programmer, and designer, Manish Gupta.

How do you feel about moving to San Francisco for this en endeavor?

I couldn't be more excited! Michigan is cold and dreary right now, it is the ideal time to move.

Is there a company for this already?

The company is being set up now.

Your company will have to become traded for the participation in LEAP.AXLR8R, since they require 6% of common stock, have you given this any significant amount of thought yet?

This won't mean we will be traded. The kind of stock they are talking about is internal to the company.

Have you considered using a quickly alternating contrast?

I have thought about this a bit, but I am still reading about the implications of it. I will certainly test this out and see if it is better/worse.

Are you developing the game on a color calibrated screen to ensure you are not affected by e.g. color banding to ensure end users see the same thing you see?

I am currently developing the game on the dev Oculus Rift. When any new version comes out I will develop it on those as well. We will do testing (and hopefully work with Oculus directly) to determine the absolute light intensities and colors coming off the screen.

AforAnonymous1 karma

Sounds great! :)

Hope you get many testers.

jamesj1 karma

Thanks!

Lilu92 karma

I have had Amblyopia, Nystagmus and one blind eye (bout 98%) my whole life and never been able to see 3D. This sounds amazing, I hope it works out :) I would never be able to afford a rift though..

thegreatgazoo1 karma

Does it give bootstraps to lazy eyes?

I have 'normal' eyes through I'm near sighted. I can't see 3d puzzles (the ones that look like gibberish but if you look at them long enough you are supposed to see something in 3d. Would those exercises help with that?

jamesj1 karma

I would spend hours as a kid trying to see those 3D 'magic eye' puzzles, not realizing that I couldn't. If your eyes are normal, why can't you see the puzzles? If the reason is due to suppression of one of your eyes, or one (or both) of your eyes is weak, then it might help.

zeldagamerboy1 karma

Does your game work like visual therapy? Will I see an improvement in my eye movement control or eye coordination?

jamesj2 karma

I havn't proven anything, but I would like for it to fill that role for people.

socialdchic1 karma

Wow, I am very interested in this. I was born with a lazy eye, I only have 10% vision due to it being caught when I was 9. What are the odds of someone with as bad vision to be able to see this. Also, I have been told my whole life, and recently as my 5 year one was diagnosed with it at the age of 3, that once the muscles mature in early childhood, there is no fixing the muscles. I have been through one failed surgery already. I have always wanted to see 3d, especially since in 4th grade my yearbook had those magic eye things which I could never see and my husband has things like a 3ds and things my son and I cannot see... I am especially jealous over the movies, it sounds so cool to have things "pop out at you". Thank you for your time.

jamesj2 karma

I was also told that after puberty I would never get to see in 3D. That has been proven false recently. There is a chance it could work for you.

socialdchic1 karma

Could you site me something to read on any recent studies?

Migratory_Locust1 karma

I have the same issue with my left eye, though I got it trained to about 70% "seeing power", not sure the right term. I can kinda see 3D but I suspect it is not as impressive as for people with properly working eyes.

Anyway: Curious about those kind of therapy for a while now.

How much would it cost me to get a rift and everything to get started with the "therapy"?

jamesj2 karma

300 for a rift, 20 for the game.

Migratory_Locust2 karma

that seems quite affordable. Can you buy a rift anywhere (Living in europe)? And would you say the Rift is fully developed or would you wait as an end-user until the bumpy start is over?

Edit: according to wikipedia, the Rift will be available for consumers end of 2014. So it would probably make sense to wait until then instead of trying to get a developers kit or whatever you need to buy at the moment to get it?

jamesj2 karma

I would wait for the consumer version. The development kit is much lower resolution and lacks some other key features.

powder11 karma

Is your game available to the public yet? I have an acute lazy eye but am always trying ways to strengthen it. Thank you for your efforts sometimes it really makes me feel self-conscious. I would want to check the game out.

jamesj2 karma

Not yet. Backers will get first access to the closed beta. I won't be releasing the game until there is a consumer Oculus Rift out for people to purchase.

Hdloser1 karma

Not really asking you anything but I am left handed and had lazy eye. Was corrected when I was 4 or 5, pretty sure it made my lazy eye the dominant eye due to the patches. I also only see in 2D but will once in a blue moon gain 3D vision for a half an hour to a hour

jamesj1 karma

Interesting! I havn't heard of anyone whose dominant eye was their lazy eye.

Hdloser1 karma

Former lazy eye but it affects life in weird ways,due to my right eye being the dominant eye I shoot right handed even though I am left handed.

jamesj1 karma

I always thought growing up that your dominant eye was the same side as your dominant hand. I later learned there is absolutely no correlation.

wtfudgery1 karma

[deleted]

jamesj1 karma

If you are able to see the movies in 3D, it should strengthen your weak eyes and promote cooperation. Why are you not able to have depth perception? If it isnt due to lazy eye (amblyopia, weak eye muscle), then I am not sure if it will help.

suparuss1 karma

What science go you have backing your claim that you can improve these conditions with your game?

What impact have these conditions had on your life?

jamesj1 karma

Depth is a quality to my vision I didn't know I was lacking. Things just seem more real now. I am more likely to notice movement of objects that are close to me than before. I have better peripheral vision on my bad eye than before I started.

Right now I have no proof that it works except for my own personal story, though I am working on having research done on the game.

I have been reading all the studies that have been coming out about the plasticity of the adult brain when it comes to unlearning suppression. I have also been looking at studies which discuss measuring and treating amblyopia in adults. If you want links to studies PM me and I can send you some links. The method used in the game takes what has been proven to work from these studies and builds on it. I can't say it will work for sure but I will certainly find out.

jamesj1 karma

Right, but whether my specific method is better, worse, or the same is still not known.

ParadiseCity19951 karma

I'm late to this thread, but do you think your game could help me?

Lazy right eye, 17 years old. No surgery, but doctors said I'm hopeless. Any chance?

jamesj1 karma

If your right eye is being suppressed then our software may be able to help. We aren't yet testing it on people younger than 18 though.

ParadiseCity19951 karma

Any plans to bring this to Project Morpheus?

jamesj1 karma

Yes, absolutely.

RegularWhiteShark1 karma

Will this work for adults? I'm twenty and refused to wear my patch when I was little (due to bullying) and was told if it's not fixed by the time you're seven, it can't be fixed.

Sucks because if anything happens to my good eye, I won't be able to see anything. :(

jamesj2 karma

This does work in adults. I was also told it couldn't be fixed, but there have been studies coming out in the last few years proving that idea incorrect.

CuzinMike1 karma

I just want to say that this is very, very cool. I have amblyopia, and remember as a young kid how much I hated eye patching. I've always loved to mountain bike and ride motorcycles, but struggle a bit as my dominant eye has a tough time reading the road/terrain. If something like this could improve my vision I'd absolutely want to try it.

jamesj1 karma

I also hated patching as a kid, and would always peek out the side to watch tv.

LadyRedditrix1 karma

Have you consulted with any developmental optometrists that work with vision therapy? I can see this being a great supplement, but at the same time I would be cautious using such a system without the involvement of one with expertise in the area.

jamesj1 karma

I am talking with optometrists. I won't release anything until I am sure what the risks are.

Guttermouth111111 karma

I have a lazy eye that I can move, but when I am sleepy or something is far away my eye moves to allow me to focus and becomes lazy. Does your training help with that at all?

jamesj1 karma

I think it probably would.

Just_18_characters1 karma

Am I understanding correctly, that I need an Oculus Rift to play the game? It's not possible to buy one where I am living. What other options do I have?

jamesj1 karma

Currently if you want to use it to help with your eyes and you can't get a Rift you can use nVidia 3D vision or you can apply for a free rift here.

urbster11 karma

Will it be possible to use with nVidia 3d vision anaglyph glasses?

jamesj1 karma

I will support nVidia 3D vision, although I suspect the experience will not be as good as the Rift.

FaxCelestis1 karma

As a designer, and specifically one already dealing with users with optical defects, how have you attempted to make your game colorblind-user-friendly, if at all?

jamesj1 karma

I want to add tests for color blindness, and we will make sure to add various color blindness modes, though we havn't yet.

FaxCelestis2 karma

That puts you ahead of most of the other game designers these days. It never ceases to amaze me that companies are perfectly willing to alienate 15% of their market share by making their end product somewhere between user-unfriendly (team fortress 2) and literally unplayable (puzzle quest).

jamesj1 karma

I agree! My friend, who is color blind and I game with quite a bit, always runs into problems when we are playing.

chocki3051 karma

How old are you? As I have a lazy eye (about 10% vision), but have always been told "you are to old to correct it".

jamesj1 karma

I am 26. The fact that it could be corrected in adults was discovered and confirmed over the last few years.

aswokei1 karma

Do you have full stereo ability now? Are you able to do those hidden autostereograms (Magic Eye)?

If so, is it your game that allowed you to rehabilitate your vision?

Did you always have strabismus/amblyopia?

btw, I have strabismus. I've been doing vision therapy for about three years and I'm very close to having achieved my goal of stereopsis. Great work on the game. Your work is very appreciated! I've donated and I'm going to be getting the game.

jamesj1 karma

I do not have full stereo yet. I get it more easily in game and see some things at certain distances in 3D.

Playing and working on the game has improved my vision. I always had amblyopia and strabismus. I was diagnosed before I could speak.

Thanks for supporting the project!

JamesTiberiusChirp1 karma

I realize I'm very late to this thread, but I have some questions for you, as a fellow individual with strabismus and amblyopia. I had realignment surgery very young but I cannot see in 3D.

1) How bad is/was your strabismus? Did you require surgery for eye re-alignment? Also, did you see double images when you had strabismus? How did your vision change while you were playing your game? Did you ever experience double vision or degradation in your eye sight?

2) Have any side effects been reported with the use of your game? I went to an opthalmologist to request a referral to vision therapy to see in 3D (after being inspired by Sue Barry's book), and she gave me the impression that for every strabismus success story, most people start and fail vision therapy with dire consequences, permanently altering their vision for the worse. I fall into some sort of "sweet spot" where I generally don't have double vision. She implied that if I were to mess with vision therapy and not follow through, I could end up with double vision, and worse vision than before I started. I'm curious if you've heard of this, and how your game prevents that possible outcome. Or is your game just meant for people with very mild strabismus who are at low risk for that kind of outcome?

3) The possibility of poor outcomes aside, is it worth it? Does the ability to see binocular depth cues actually make the world look all that different? Further, if you can see in 3D now, can you "unsee" it? One of the fears I have about the possibility of learning to see in 3D is losing my unique perception of the world around me. Will I fail to see detail that I noticed (and relied upon for monocular depth) in absence of binocular depth cues? Will I become mediocre at art? (doctors have accredited my artistic skill to my ability to translate 3D objects on to 2D paper). Will I be able to switch back to 2D if I decide I don't like it, or switch back and forth at will? Or, will I never be able to go back once my brain learns how to see binocular depth cues?

jamesj2 karma

1) I had almost total suppression of my weak eye, but my strabismus wasn't super severe. My eye was actually crossed up. I never had surgery and I had double vision some of the time, but I could usually kind of "shake it off" when I got it by looking at something else.

2) No one has reported any negative side effects yet. I've asked a bunch of optometrists and ophthalmologists about this issue as I am very worried about harming anyone and they seem to think that if the brain is plastic enough to gain diplopia it is probably plastic enough to lose it if you stop practicing. That being said, it could be a risk, and I am not a doctor. The risk would be higher the more severe your strabismus is. That is why we are only testing it on people without very severe strabismus at the moment.

3) It is as different as you might expect. I have 3D in about a 1-20 foot range now. Reality seems more real than it did before, like there is another layer I didn't know existed. I don't think I've lost anything, only gained. Your better than normal perception of the 2d information has already been learned, and I think you will keep it. I think I also am better than normal at perceiving monocular depth cues, and I don't think that ability has diminished at all. I think once you see it, you see it. I can't turn it on and off. But that doesn't mean you don't still have the skills you learned while you saw in 2d.

If you have any more questions please let me know!

startin-over-4 karma

AMA's that focus on crowd funding are frowned upon, and you also did not post proof.

jamesj3 karma

A link to a post on the official site isn't proof? I can remove the post if I've broken a rule.

protestor3 karma

A lot of AMAs include some form of crowfunding.

startin-over-1 karma

a large percentage get nuked. Depends on how much there is in it. When OP first posted, it was front and center. Mods asked him to edit to tone it down, which he did.

jamesj2 karma

Mods didn't contact me, I just saw your post and didn't realize so I changed it around a bit. I'm not trying to spam it, but I obviously would like to give it some exposure.

startin-over2 karma

ah. they were discussing PM'ing you but you beat them to it. That's always a good thing.

jamesj1 karma

thanks for letting me know!