IoT-Enabled Patch to Improve Adherence to Occlusion Therapy

Amblyopia and strabismus are largely treatable during early childhood, but become difficult to treat in adulthood. Occlusion therapy—patching the better-seeing eye to force use of the amblyopic/strabismic eye—is a noninvasive, nonpharmacologic intervention that is often more effective than drug-based approaches and remains the preferred modality among pediatric ophthalmologists; however, its success critically depends on adherence (i.e., daily wear time), which recent studies suggest is frequently below 50%. To address this adherence measurement gap, we designed, developed, and evaluated an Internet-of-Things–enabled ocular patch (IoT patch) that provides objective, real-time, remote monitoring of wear time for pediatric clinical trials. The device integrates two temperature microsensors and a wireless module; by positioning one sensor closer to the skin than the other, the system infers on-skin wear from the resulting temperature differential and transmits data to a cloud server via a mobile application. In evaluations with 30 healthy adults and 40 children with amblyopia, the IoT patch demonstrated excellent temporal accuracy (mean delay 0.4 min in adults and 0.5 min in children) and wearability comparable to conventional patches. We also developed a companion Android tracking and intervention application and a clinician-facing web portal that visualizes adherence data in real time. Consequently, these components constitute a practical system capable of improving adherence and measurement fidelity in occlusion therapy, thereby supporting more precise and timely treatment adjustments.