If you were diagnosed with lazy eye – otherwise known as amblyopia – as a child, there are only a few options available to you. You can wear an eye patch, you can take eye drops, or you can wear corrective lenses. Or, in the future (while waiting for FDA clearance) you will be able to watch TV.
This is the central idea behind Luminopia, a four-person startup led by Scott Xiao and Dean Travers. Xiao and Travers started Luminopia six years ago as undergraduates at Harvard University, and first heard about the disease from a classmate who had struggled with amblyopia in his childhood. childhood. Lazy eye is the most common form of vision loss in children and affects approximately three in 100 children.
Amblyopia can develop early in life when something causes one eye to struggle to keep up with the other. There may be muscle strength imbalances between the eyes, resulting in one eye being delayed, one eye may be much stronger than the other, or one eye may be deprived of clear vision, due to a cataract or other obstacle. Overtime, the brain learns to depend on the vision of one eye, while the other weakens, eventually, in severe cases, leading to permanent vision loss.
Common treatments for lazy eyes involve eye drops, corrective lenses, or eye patches, which strengthen the weaker eye. Luminopia’s solution is different; kids watch TV through a VR headset with the show’s settings slightly changed (the company has made deals with Sesame Workshop, Nickelodeon, DreamWorks, and NBC to deliver over 100 hours of content). The contrast can be increased or decreased, or parts of each image can be removed to encourage the weaker eye to follow the stronger.
“We’re actually changing the image settings in real time, with the goal of promoting lower eye utilization and encouraging patients’ brains to combine inputs from both eyes,” Xiao explains.
In September, the company released the results of a randomized controlled trial out of 105 children. All of the children wore glasses full-time, but 51 of them also watched an hour of Luminopia’s software-modified TV shows six days a week for 12 weeks.
Overall, children in the treatment group improved their eyesight by 1.8 lines on a standard eye chart, compared with 0.8 lines in the comparison group (although some children saw improvements of two or more lines during the 12-week follow-up visit).
The study was published in “Ophthalmology.”
Luminopia is still a small business – there are only four employees. But the company has raised around $ 12 million so far thanks to investments from Sesame Ventures (the venture capital arm of Sesame Workshop) and angel investors like Robert Langer, co-founder of Moderna (now director of the Luminopia Board of Directors) and Jeffrey Dunn, the former President and CEO of Sesame Workshop.
The company stood out for its unique approach to a problem common to amblyopia and general health: treatment adherence.
There is some evidence that lazy eye treatments are difficult to follow. A study conducted at a Saudi Arabian hospital interviewed 37 families with children who used eye patches to treat amblyopia. The children in the study only completed about 66% of the prescribed patch time. Families cited social stigma, discomfort, and outright refusal to wear the patch as common reasons they struggled to follow eye patch recommendations.
A 2013 study in “Investigative Ophthalmology & Visual Science” analyzed how well 152 children complied with eye patch treatments and found that on about 42% of days, children failed to get patched altogether.
The founders of Luminopia created their treatment for the lazy eye by first addressing the problem of adhesion – a strategy borrowed from the world of consumer products.
“We’ve always seen such a huge gap in the experience of things in the consumer world, where things are so thoughtful and so delicious, and in healthcare where so often we see bad experiences that lead to a loss. low adhesion, ”says Travers.
As for children, there is nothing more attractive to do than watch TV, notes Xiao. And the test seems to prove this thesis: the children in the study spent 88% of the television minutes that were asked of them. And 94% of parents said they were likely or very likely to use the treatment on an eye patch.
The key, however, is to have the data and FDA approval to prove that these “delicious” treatment experiences actually work and overcome the stickiness problem. Luminopia’s most recently published essay follows a single-arm pilot test, who evaluated the technology at nine sites and a total of 84 participants. During the first phase of this pilot trial, conducted on 10 children, the team found that the children completed 78% of the prescribed treatment minutes. They also saw improvements in their vision that were equivalent to about three lines on a standard eye chart. These results have been published in the “Scientific Reports”.
Luminopia isn’t the first company to start evaluating gambling or, for lack of a better word, fun treatments for disease. The FDA has already somewhat supported other proposals in this direction.
Another company, Akili Interactive, obtained FDA approval in June 2020 through the De Novo lane for a video game used to treat ADHD in children. The approval marked the first time the agency had approved a video game to treat a disease. In total, Akili Interactive has raised approximately $ 301.1 million in funding, by Crunchbase.
Akili’s game, called EndeavorRx, shows a path of approval that Luminopia might be able to emulate. Luminopia, like EndeavorRx, is a prescription therapy service that has no predecessor. Luminopia, Xiao says, will also follow the De Novo path as it seeks FDA approval this year. Data from its most recent pivotal trial was submitted to the FDA last March.
“We anticipate a decision by the end of the year, and provided it is a positive decision, we plan to launch the product early this year,” he said.