Original Investigation

Virtual Reality–Based Vision Therapy for Intermittent Exotropia

JAMA Network Open 10.1001/jamanetworkopen.2026.0631

March 09, 2026 at 11:00 AM EDT

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Is virtual reality–based vision therapy (VRVT) effective for treating intermittent exotropia (IXT) in children?In this randomized clinical trial involving 177 children with IXT, there was a statistically significant difference in the change of distance exotropia control score at 12 weeks, favoring the VRVT program over observation (control). Greater benefits were observed in participants with greater than 75% VRVT training adherence.The findings of this study suggest that VRVT may have a therapeutic value for IXT, particularly in children able to maintain high training adherence.

Corresponding Authors: Hui Zhu, MD, PhD (zhny1125@njmu.edu.cn); Hu Liu, MD, PhD (liuhu@njmu.edu.cn), Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Rd, Nanjing 210029, China.

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