Manchester eye consultant invents computer game to improve ophthalmology testing on young children

Tariq Aslam, who works at Manchester Royal Eye Hospital and is a senior lecturer at the University of Manchester, created the pioneering solution after finding it was difficult to get very young children to sit still and concentrate while machines, primarily designed for adults, measured what they could see at the edge of their vision. This problem was having an impact on diagnosis and treatment options.

He said: "I realised the ideal way to overcome a short attention span and lack of co-operation ws to get children involved in playing a computer game, which would automatically measure their peripheral vision depending on exactly how they played."

Parents do sometimes worry about their children spending too much time looking at computer screens, but in this case it could potentially help to save a child's sight or give valuable information to help treat their medical condition

Aslam wrote the software himself after researching game theory and psychology, as well as taking advice from the children who tried out each version. He also designed and built electronically-controlled equipment to encourage the children to position themselves correctly as part of the whole gaming experience. The 'Crazy Castle' apparatus was assessed with the help of Waheeda Rahman and Peng Tee Khaw at Moorfields Eye Hospital in London, and his university colleague, David Henson.

He said: "We built a large toy castle, roughly a metre high. A pair of magic glasses is set into the front wall, and when the child looks right through them we know they are in the right position and so a drawbridge in the castle wall electronically opens to allow the child to see and play a game on a screen within. The aim of the game is to track a wizard inside the castle and press a button to help squash rogue tomatoes. While concentrating on the wizard in the centre of the screen, they then press a different button if they spot a ghost appearing at the corners. Their reactions are recorded automatically using a laptop attached to the game screen."

The system has shown great promise in this feasibility study to provide clinically-useful information in a way that is accessible and enjoyable for the child with no discomfort or potential for harm

He added: "Parents do sometimes worry about their children spending too much time looking at computer screens, but in this case it could potentially help to save a child's sight or give valuable information to help treat their medical condition."

The console has now been piloted among 17 young people aged between four and 14 at Moorfields Eye Hospital and proved popular, achieving measurements that seem accurate.

Aslam told HES: "The system has shown great promise in this feasibility study to provide clinically-useful information in a way that is accessible and enjoyable for the child with no discomfort or potential for harm. Based on the pilot, we aim to develop the programme and the hardware and to prove it has a greater diagnostic precision and sensitivity to identify visual field loss than existing tests. Our test would be quicker and more reliable and therefore require fewer hospital resources, as well as being more fun for the children.

This is a good example of an innovation that will directly benefit patients

"Crazy Castle' does not require expensive equipment, so it could be adopted by most hospitals in the UK and is affordable for use in developing countries, too. The game-based approach could also be adapted to carry out other eye tests such as checking contrast sensitivity and the sharpness of a child's vision."

The pilot study was funded by the National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital; the hospital's Special Trustee board; and the University College London's Institute of Ophthalmology. It was supported by the NIHR Manchester Biomedical Research Centre and the findings were published in the British Journal of Ophthamology.

Professor Khaw said: "This is a good example of an innovation that will directly benefit patients, which arose as a result of collaboration between two NIHR biomedical research centres."