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Turning Tough Amblyopia Training into a “Fun VR Game”: A Practicing Doctor Develops a “Prescribable Treatment App”【2025 ICT Startup League Member Interview: InnoJin Inc.】
"Childhood amblyopia" is a condition that impairs the development of a child's vision. The standard treatment involves full correction with eyeglasses and patching the "good" eye, but this is often difficult to continue as children resist it, placing a significant burden on both the child and their parents.
InnoJin Inc., founded by Dr. Takenori Inomata, who is also an ophthalmologist at Juntendo University, is working to transform this "tough training" into a "fun VR game," and in doing so, revolutionize the very nature of medical care.
A therapeutic app 'prescribed' by doctors is being developed as a VR-based Software as a Medical Device (SaMD). How was this product, born from the urgent needs of clinical practice, created, and what future will it bring to medicine? We spoke with Dr. Inomata, who champions "challenge" as his personal theme, about the development process and his vision.
A VR Solution Born from Unmet Needs in Clinical Practice
Could you briefly tell us about your current research?
Inomata: Our primary focus is the development of Software as a Medical Device (SaMD). One of our most advanced products, and the one selected for this program, is a SaMD for pediatric amblyopia training using VR (this product) (Fig. 1). This app uses VR for amblyopia training, and we are now at the stage of initiating a multicenter specified clinical study to verify its efficacy, starting in mid-October.
Fig 1. SaMD for pediatric amblyopia training using VRFirst, please tell us about the "problem" that the SaMD for pediatric amblyopia training using VR aims to solve.
Inomata: Yes. First, there's "childhood amblyopia," a condition where a child's vision fails to develop properly. It's said to affect 1-5% of children, and early treatment before the age of 7 or 8, when vision is still developing, is crucial.
The standard treatment until now has been full correction with eyeglasses, combined with "occlusion therapy," which involves covering the eye with better vision with an eyepatch to force the weaker eye to be used. However, as you can imagine, children strongly dislike this, making it difficult to continue treatment and placing a significant psychological burden on both the child and parents. We doctors also faced the problem of not being able to accurately track how much training the patient was actually completing.
How does the VR program solve that problem?
Inomata: Our program uses a head-mounted display to transform this "tough training" into "fun VR games" like kendama, table tennis, and tennis. It's designed with a function within the VR that makes objects invisible to the stronger eye, forcing the child to track them using only their weaker eye. This way, children can get the necessary training naturally while they are engrossed in playing the game.
When using both eyes, people inevitably rely on the stronger eye, leaving the weaker eye unused. Intervening, as our program does, by forcing the weaker eye to see objects and stimulating its retina with light, constitutes the training.
I see. So there are benefits for the patients, their families, and the doctors.
Inomata: That's right. Children can actively engage in their treatment while playing, which significantly reduces the burden on parents. And doctors can accurately monitor the training progress through digital logs, enabling them to provide more personalized, precise treatment and improve overall therapeutic efficiency.
How will this program reach patients?
Inomata: This is "Software as a Medical Device (SaMD)," and we aim for it to be a therapeutic app that is "prescribed" by a doctor at an ophthalmology clinic, much like medication is today. We are planning to provide this product as a SaMD.
What led you to develop this pediatric amblyopia training program?
Inomata: It stemmed from the unmet need I saw in my daily clinical practice—children with amblyopia were truly struggling with the existing treatment challenges. I developed this product to address that gap.
What is your timeline for implementation?
Inomata: We will start the specified clinical study in the latter half of October. Based on those results, we will conduct a pivotal clinical trial. After that, we will file for medical device approval and aim for insurance reimbursement. This will take a certain amount of time. Realistically, I believe we are targeting around 2029.
Creating New Value in Ophthalmology, a Field Ripe for Innovation
Please tell us what led you to start your own company.
Inomata: From 2012, I spent three and a half years studying abroad at Harvard University in Boston, researching ocular immunology related to corneal transplantation and dry eye. During that time, as I had always wanted to attend business school, I also enrolled at Boston University's business school to study management alongside my ophthalmology research. My motivation was the belief that leadership and management skills would become essential for doctors in the future, and I thought it would be a way to contribute back to my home institution, Juntendo University Hospital.
So you weren't thinking about starting a company when you went to study abroad?
Inomata: Correct. It was through my exposure to Boston's startup ecosystem that I truly felt the necessity of translating research results into real-world applications. After returning to Japan in 2016, I began research into app development, and once I had accumulated sufficient data, I founded InnoJin Inc. in 2020.
Was there anything during your time abroad that served as a hint?
Inomata: Through my exposure to Boston's startup ecosystem, I came to believe that even for those in academia, it's necessary to create entities like startups to deliver our research to the world. In Boston, it was commonplace for startups to collaborate with academia to drive social implementation. This was still underdeveloped in Japan at the time, which is precisely why I felt it was a challenge we needed to take on. It wasn't so much a shock as a realization that this approach would be necessary in Japan's future.
What inspired you to become a doctor?
Inomata: It was a desire to help patients, and also my own personal experience being treated with such kindness by ophthalmologists and nurses when I had myopia (nearsightedness). By the time I was in junior high, I knew clearly that I wanted to become a doctor.
And have you been unwavering on that path to becoming an ophthalmologist ever since?
Inomata: After entering medical school, I explored many different clinical specialties. They were all wonderful, and it was a difficult choice. But ultimately, ophthalmology was my original inspiration. When I did my rotation, I found it fascinating because it's a field where you can handle everything from diagnosis all the way through to treatment.
Above all, it's a specialty where you can be deeply involved in innovation. The eye is a field where new things happen frequently. For example, iPS cells were first applied to an eye disease. Because it's an external organ, you can visually assess the situation, making it easier to test new approaches. I decided it was a unique opportunity to be involved in a field so ripe for innovation.
Motto: "Challenge." The Positive Power to Overcome Walls
Where does this attitude of "taking on new challenges" come from?
Inomata: My favorite word is "challenge." I especially noticed this in the U.S. In Japan, when we hit a wall, we tend to say, "This is painful," or "This is terrible." But there, they say, "That's a challenging problem." It feels so positive, like any wall can be overcome. So, I've made "challenge" my life's theme and I always try to take on new things. I even named my lab the "Inomata Challenging Lab" to remind us all to never forget that spirit of challenge.
How you think when you hit a wall is extremely important. Could you briefly tell us about the process of starting your company after returning from abroad?
Inomata: When I took on this challenge, there wasn't really a culture of supporting startups at the university yet, so I was truly feeling my way in the dark. Some people would even say, "What is this startup? Isn't that risky?" Being the "first penguin" in any field is difficult, and it required persistent dialogue to gain the understanding of those around me.
Is it difficult for doctors to build careers outside of working at a hospital or in private practice?
Inomata: Most doctors work in hospitals or private practice, but there's also the path of a researcher. For example, Dr. Shimon Sakaguchi, who won the Nobel Prize in Physiology or Medicine, is both a doctor and a researcher. Beyond that, many doctors now go into consulting firms or pharmaceutical companies.
What I believe is that the current trend of people leaving academia might be because it lacks a compelling "dream." We hear about people drifting away from research, but I think it's crucial to show that there's an interesting future where, for example, you can work hard on research at a university and then achieve success through a startup. That's the area where I want to make my challenge.
Have you faced any particular difficulties in your research?
Inomata: The field of SaMD development is extremely cutting-edge, so the regulatory landscape is also constantly changing and being updated. We have to adapt to those changes as we go, which can be very challenging.
For example, new approval systems (like the two-stage approval system) are introduced, and we have to decide whether to use them. Also, because our product is novel, there's no precedent for its clinical trial protocol, which makes it difficult to finalize. We face challenges like that.
Right now, medical DX is a major trend in the healthcare industry. With various domestic issues like doctor shortages in depopulated areas and regional disparities in care, InnoJin's products could help solve these social problems. From a broader perspective, what are InnoJin's goals?
Inomata: Our vision is to make healthcare more "ubiquitous." Ubiquitous means "present, everywhere, all the time." In other words, our goal is to cause a paradigm shift from "facility-based medicine," where you had to go to a hospital for care, to "lifelong medicine" that is more integrated into patients' daily lives. Of course, many procedures must be done at a hospital, but there are also many things that don't. We believe this will make life more convenient for everyone, and that's the challenge we want to tackle.
As someone on the front lines, do you often feel there are many challenges in the healthcare industry?
Inomata: Yes. The maldistribution of physicians is a definite problem, and I believe we need to correct it in a way that better serves patients. I have experience providing care in underserved regions as part of my university work. In those areas, it's common for people to travel an hour just to get to a hospital. They can't rush in for an emergency, and if they can't drive, they have to rely on help from others. This is very common. By using digital tools effectively, we can help determine if a condition warrants such a trip, and I believe we can make the whole system more efficient.
To Remote Islands, Doctorless Villages, and Busy Professionals... Reaching the People Who Truly Need Medical Care
This is your second selection for the ICT Startup League, following 2024. Including last year's program, what benefits or takeaways have you gained from the league itself?
Inomata: Last year, we received support for our organizational development, for instance, assistance in formulating our hiring strategy. Our team has grown considerably since then, and we've matured as a company. This year, we're receiving further support in exposure and marketing—like this interview today—which we hope to translate into tangible business results.
At the same time, the league is providing opportunities to discuss our business and connecting us with parties we couldn't access on our own, such as fostering collaborations with local governments we are already in discussions with. I have high expectations for these opportunities.
Please tell us your medium- to long-term vision.
Inomata: In addition to the VR amblyopia training program, we have a diagnostic aid for dry eye (Fig. 2) and a dedicated platform for online ophthalmology care. The online platform has already been implemented at "Tenohira Ganka" (Palm-of-your-hand Ophthalmology) and is fully operational. We want people to use these tools to help us achieve the ubiquitous healthcare I mentioned earlier.
We are particularly focused on regions facing challenges, such as remote islands and doctorless villages suffering from physician maldistribution. Another focus is the workplace. There are many people who are too busy at work to visit a doctor. For them, we want to partner with corporations and the Japan Health Insurance Association (Kyokai Kenpo) to provide care. In the field of ophthalmology especially, corporate surveys show eye fatigue is a top complaint, yet it often goes unaddressed, leading to reduced productivity. We believe this is an area where we can intervene.
Fig 2. Smartphone app-based SaMD for dry eye diagnosis supportEditor's Note
Before the interview, I wondered why a practicing ophthalmologist would launch a startup and challenge the forefront of medical DX. But as I listened to Dr. Inomata, the reason became clear.
"Ophthalmology is a field ripe for innovation, and from here, we can change medicine as a whole." Behind these words lies a strong conviction to tackle clinical challenges head-on and make future healthcare "more accessible."
Like the VR that turns arduous training into a fun experience—Dr. Inomata's challenge may just be the first step in transforming healthcare itself into something "kinder and more positive."
■ICT Startup League
A support program launched in FY2023, originating from the Ministry of Internal Affairs and Communications' "Support Program for Startup-driven, Seed-stage R&D."
The ICT Startup League supports startups through four pillars.
①R&D Funding / Hands-on Support
Provides up to 20 million JPY in R&D funding as a subsidy. Additionally, for hands-on support, the selection committee members who participated in selecting the league members stay on to foster their growth. For companies that a committee member "absolutely wanted to select," that member provides continuous support, offering advice on business plans and providing growth opportunities, creating a "fan-like" support system.
②Discovery & Development
We provide opportunities for learning and networking to promote the business growth of league members. We also work to discover aspiring entrepreneurs to expand the base.
③Competition & Co-creation
It serves as a place for positive competition, much like a sports league, where startups learn together and challenge each other, competing to win the funding they truly need (up to 20 million JPY). We also provide a venue for co-creation, where league members can collaborate and expand their businesses through various opportunities, such as sessions with selection committee members.
④Promotion
We promote the initiatives of league members in collaboration with the media! By sharing their work with many people, we aim to expand opportunities for new matching and chances.
■Related Websites
InnoJin Inc.
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InnoJin Inc. (LEAGUE MEMBER)
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ICT Startup League
