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3D Vision Syndrome:A Technologically Induced Visual Impairment


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3D Vision Syndrome is a technologically induced visual impairment that typically involves binocular vision dysfunctions that result in many symptoms including but not limited to blurred vision, diplopia, asthenopia, eye strain, headache, dizziness, and vision induced motion sickness. Dr. Dominick Maino, the American Optometric Association's spokesman on this syndrome presented this lecture at the American Academy of Optometry and Vision Institute of Canada meetings.

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3D Vision Syndrome:A Technologically Induced Visual Impairment

  1. 1. 10/14/2011 Disclosure Statement: Nothing to disclose” Please silence all mobile devices. Unauthorized recording of this session is prohibited. Dominick M. Maino, OD, MEd, FAAO, FCOVD-A FAAO, FCOVD- AOA National Spokesperson on 3 D Vision Syndrome Lecture Rules: AOA Classroom 3D Project Team Member Professor, 1.) Yes, you may ask questions. Pediatrics/Binocular Vision Service 2.) But only if I know the answer! Illinois College of Optometry Illinois E I tit t Illi i Eye Institute 3.) My answer is always right! ) y y g 3241 S. Michigan Ave. Chicago, Il. 60616 312-949- 312-949-7280 (Voice) 312-949-7358 (fax) 312-949- 4.) An updated version of this presentation can be found at nw.optometry.netPhoto credit: 1
  2. 2. 10/14/2011 Virtual 3 D: Why Now? 3 D Tipping Point A 3D TV Tipping Point? htt // b /id/41591929/A 3D TV Ti i P i t Stereoscopic 3D Technologies Reach Tipping Point on PC Market – JPR. _Reach_Tipping_Point_on_PC_Market_JPR.html ESPN: 3D Is at the Tipping Point 3D Printing Technology Nearing Tipping Point Will you one day print yourself a new bowl or even a new house using 3D + printing technology? 3D printers are nearing a tipping point according to one expert cited in a TechWeb article. Sharp’s New Cellphone Video May Be a Tipping Point for 3D may-be-a-tipping-point-for-3d/315 3-D reaches a tipping point in Europe Dr. Karl Kapp: "the tipping point for 3D will be in the healthcare industry“ 3D Medical Education activities including: The Public Health Implications of Virtual 3D Michael Duenas, ODSymposia, 3D Users Experience Tech The Visual System and Virtual 3D Jim Sheedy, O.D., Ph.D.Summit, The 3Ds of 3D Viewing 3D: The User Experience StoryAOA YouTube Videos Philip J. Corriveau3D in the Classroom: See Well, Learn Well Exploring a New Dimension Chris Haws Ch i H Do You Know if the Kids are OK? Maureen Powers, PhD com/watch?v=9U4Ao Improving Binocular Vision- DWPEQ0 Creating a Better 3D Audience 3D Vision Syndrome Dominick M. Maino, OD, MEd, FAAO, FCOVD-A 2
  3. 3. 10/14/2011 The Public Health Implications of The Visual System and Virtual 3D - Virtual 3D - Michael Duenas Jim Sheedy, O.D., Ph.D. ( ( =player_embedded&v=howdZm-d7Z0) ZLpwCC5yxlo&feature=related) Exploring a New Dimension 3D: The User Experience Story - - Chris Haws Philip J. Corriveau ( ( qZw98mkIhI&feature=related ) 1IiHNit3RPM&feature=related) Available from: AOA 3D@Home MainosMemosBrock String Debuts at the Consumer Electronics ShowKids@Play Summit at CES 2011Dominick M. Maino, OD, MEd, FAAO, FCOVD-A( 3
  4. 4. 10/14/2011 Binocular Vision Improving Binocular Vision - Creating a Better Audience Dysfunction as a Medical & Public Health Issue Maybe Mike, from "Monsters, Inc.," looks so sad because he realizes 3- D doesnt do you any good if you dont have binocular vision.)....For the 3D Movie, Television, Video- Improving 3D Television Technologygaming and 3D in the Classroom but Not CreatingTechno-Industrial Complex….nothaving binocular vision is the 800lbs a Better 3D Viewing AudienceCyclops in the room! 1920’s Image Credit : Baird Television Today Improving 3D Movie Improving 3D Gaming Technology but Technology but Not Creating a Better 3D Not Creating a Better Viewing Audience Gamer Image Credit: Daily Motion 3D Image Credit: Nintendo 1953 Image Credit: Mystic Cinema Today Image Credit: Joystiq 4
  5. 5. 10/14/2011 History of 3D Improving Classroom Technology but Have Not Created a Better 3D Viewing Student 3D in the Classroom: See Well, Learn Well 3D Timeline Image Credit: American Optometric AssociationImage Credit: mkrstovic.edublogs.org3 D Stereo Scopes1844Scottish inventorand writer DavidBrewster introduced theStereoscope1862USA jurist, author, j , ,inventor OliverWendell Holmesmakes it possiblefor all to enjoy 3D! Some of the first 3D Movies included: House of Wax (1953) starring Vincent Price Bwana Devil (1952 ) starring Robert Stack ?v=4oGl_KqTw-M&NR=1 5
  6. 6. 10/14/2011 The Mask (1961) 13 Ghosts (1960) 3D Television3D Television Stereoscopic television was first demonstrated by John Stereoscopic television was first demonstrated by Logie Baird in 1928 John Logie Baird in 1928 Stereo TV Stereo Receiver 3D Education 3D Education VRMagic Digital BIO VRMagic Digital BIO 6
  7. 7. 10/14/2011 3D Education 3D Video-games vertebrae/ 3D Tech - NASA Uses Video Games for Visualization & Engineering NASA Video Game Brain Training for ADHD ueWjQ&feature=related M i Brothers 3D Mario B h 3D in the Classroom: See Well, Learn Well Passive 3D glasses technology Linearly polarized glasses Two images are projected superimposed onto the same Use a silver screen so that polarization is preserved. Can’t tilt head 7
  8. 8. 10/14/2011 Passive 3D glasses technology Circularly polarized glasses Circularly polarized glasses Light that is left-circularly polarized is extinguished by the right-handed analyzer, while right-circularly polarized light is extinguished by the left-handed analyzer. The viewer can tilt their head and still maintain left/right separation. RealD Cinema system uses an Dolby 3D theatres electronically driven circular polarizer Complementary color Infitec glasses anaglyphs (use red and cyan) Infitec (interference filter technology.) Lenticular printing used to Filters divide the visible color produce images with an spectrum into six narrow bands illusion of depth, or the ability "super-anaglyph” to change or move as the Dolby uses a form of this technology in its image is viewed from different angles 3D glasses technology Active 3D Glasses Active small LCD screensActive when voltage applied lens goes darkLCD shutter glasses synced with screen showing 3DA liquid crystal glasses stop q y gor allow light in thru p content then alternates imagesynchronization with the viewedimages seen on the screen each eye different angle of viewRed eye shutterglassesThe Red Eye Method creates 3D effectreduces the ghosting 8
  9. 9. 10/14/2011 Active 3D Glasses Active 3D Glasses 3D Personal Display Spectaclesthis method of 3D cuts refresh rate in halfKnown to cause headaches two small screens in the glasses display separate images to each eye. Does not require a television Autostereoscopic displays Auto 3D Autostereoscopic displays Auto 3D Almont Green 3D Photography Nintendo 3DS Nintendo 3DS is hazardous to the eyes of children (Nope!) ( How Does Nintendo 3D Vision Syndrome 3DS Work? two separate What constitutes a syndrome? outputs at slightly different angles g one for your left A group of symptoms that eye and the other collectively indicate or characterize a for your right disease, psychological disorder, or other abnormal condition /features/How_th e_3DS_Works/ 9
  10. 10. 10/14/2011 So is the 3D Vision Syndrome The 3D’s of 3D Viewing: Really a Syndrome? Discomfort, Dizziness and Lack of Depth Yes. Discomfort: The symptoms and signs consistently Since 3D viewing is based include: headaches, nausea, dizziness, a on the eyes converging in vision induced sense of motion, front of or beyond the diplopia, blurred vision and eyestrain; screen, viewing 3D images as well as a disconnect between can potentially create accommodation and vergence. eyestrain and headaches The 3D’s of 3D Viewing: The 3D’s of 3D Viewing: Discomfort, Dizziness and Lack of Depth Discomfort, Dizziness and Lack of Depth Dizziness: Lack of Depth: 3D technology can A viewer lacking binocular exaggerate visually vision, simply won’t see 3D. i i i l ’t 3D induced motion sickness While this doesn’t pose any …causing consumers to feel problem viewing the screen, dizzy or nauseous during or it serves as a “vision after viewing 3D content. screening” that something is abnormal with the viewer’s binocular vision. Photo credit: PhotobucketSymptoms of 3D Vision Syndromeasthenopia, headaches, blurred vision, Symptoms of 3D Vision Syndromeeyestrain, diplopia, dizziness/nausea and …a happy, actively engaged users of 3Dvision induced motion sickness …..or …. content? Image credit: Credit: American Optometric Association animated-gif Image Credit: American Optometric Association 10
  11. 11. 10/14/20113D Vision Syndrome … Scope of The Problem… is comprised of a group of symptoms and Amblyopia 2% (6,239,043 US)physical signs that collectively indicate or Strabismus 2-5% (15,597,609 UScharacterize a functional vision and/or eye Accommodation 2.5-9.2% (28,699,600 US)health disorder that manifests when viewing Eye Coordination (CI 7%)simulated 3D technology These signs and technology. Up to 25% (77 988 195 US) (77,988,195symptoms include but are not limited to Vertical Misalignment 7-52%headaches, blurred vision, eyestrain, double (162,215,135 US)vision, dizziness/nausea, decreased depth US Census Bureau: U.S. 311,952,183perception and vision induced motion World 6,954,459,463sickness. AOA Clinical Guidelines: US Census: How to Dx an Individual with How to Dx an Individual with 3D Vision Syndrome 3D Vision Syndrome Examination SequenceComprehensive Case HxVisual Efficiency/Strabismus/AmblyopiaVi l Effi i /St bi /A bl iSpecial Testing (Visagraph, TOVA, etc) Salient Findings How to Tx an Individual with How to Tx an Individual with 3D Vision Syndrome 3D Vision SyndromeWe really don’t Use what we do knowknow the b tk th bestmethodology/approach. Rx/Prism Optometric Vision Therapy 11
  12. 12. 10/14/2011 These are your patient’s eyes…. 3D Vision Syndrome Single Subject Design Research Study Patient #1 Symptoms: blurred vision, bl d i iThese are double vision,your patient’s nausea, headache,eyes dizziness whileOn 3D! watching 3D movie 3D Vision Syndrome 3D Vision Syndrome Patient #1 Patient #1 27 y/o white female Initial Findings College educated VA’s CLS RE/LE 20/20 Athletic trainer OR RE -.25, LE PL Acceptable Fit , p MR RE -4.25-50X175 20/15,Hx of reading problems since 5th grade LE -4.00-.50X175 20/15 Remedial reading class in college Pursuits/Saccades +4 Seasonal allergies CT 18 XOP @ near Nephrectomy 2nd Degree Fusion Variable 3D Vision Syndrome 3D Vision Syndrome Patient #1 Patient #1 Initial Findings Initial Findings Random Dot 100” (?) Accommodative Facility diplopia NPC 2/6/4” MEM variable After 5 attempts pain noted Ocular health mild allergic conjunctivitis PFV/NFV @ near could not do/diplopia - Lens amplitudes could not do NRA +2.00 diplopia PRA -1.00 12
  13. 13. 10/14/2011 3D Vision Syndrome 3D Vision Syndrome Patient #1 Patient #1 Diagnosis Plan Convergence insufficiency Obtain past records Accommodative dysfunctions y Start Optometric Vision Therapy p py Headache Diplopia Allergic conjunctivitis 3D Vision Syndrome 3D Vision Syndrome Patient #1 Patient #1 Previous Eye Examination (10/09) Optometric Vision Therapy “No Binocular Testing Done!” Phase 1 Phase 2 Phase 3 Phase 4 Mono Biocular Binocular Integration Hx “General Exam”, health “good”, Aided VAs General Exam good Oculo- O l add anti- dd ti add dd Stabilization St bili ti 20/20 RE/LE, SLE unremarkable, Non-dilated Motor, suppression vergence fundus evaluation unremarkable, Ret -4.00 Sph RE/LE, MR -4.00-50X175 RE, -4.00-.50X180 LE, CT HE, Acc 2XO dist/Ortho near, BI 20/8, BO 24/12 near 3 month post OVT maintenance Tx and Dx Myopia, Astigmatism final progress evaluation 3D Vision Syndrome 3D Vision Syndrome Patient #1 Optometric Vision Therapy Patient #1 Optometric Vision TherapyOVT #1HC Saccades OVT #2HC Rock Reviewed HVT R i dHTS (saccades, pursuits, Vision Builderaccommodation (saccadesBrockstring Franzblau Red RockHVT BrockstringSent Home all of the above 13
  14. 14. 10/14/2011 3D Vision Syndrome Patient #1 Optometric 3D Vision Syndrome Vision Therapy Patient #1 Optometric Vision OVT #3 Therapy Reviewed HVT OVT #4 Minus lens dips Mi l di Reviewed HVT HC accom rock Vision Builder Vision Builder Randot vergence (binoc reading) Eccentric Circles Quoits Quoits Photo credit VisionHelpBlog 3D Vision Syndrome 3D Vision Syndrome Patient #1 Optometric Patient #1 Optometric Vision Therapy Vision Therapy OVT #5 OVT #6 Reviewed HVT +/- Flippers (mono) Review HVT Eccentric Circles E t i Ci l ECC HTS autoslide vergence Vectogram Jump Jump vergences (vectos) Vergence Brockstring (bug on a string) HVT Lifesaver Cards ECC BO/Brockstring, HTS jump vergences 3D Vision Syndrome 3D Vision Syndrome Patient #1 Optometric Vision Therapy Patient #1 Optometric Vision Therapy Progress evaluation #1 OVT #7 20/15 BVA, RE/LE NPC TN no pain CL OR RE +1.00-.50X180 BI 12/9 near Clown vectograms (push BI) 20/20 BO > 45 LE +1.25 20/20 Amps 7 D RE/LE Chicago Skyline (jump)MR RE -3.25-.25X175 20/20 3 25 25X175 Facility F ilit 8 CPM RE, 11 CPM LE, 10 RE LE LE -3.250.75X005 20/20 CPM OUPursuits +4 Saccades +3 CT 2EP (near) MEM +.75 each eye W4D 4 at all distances Random dot 20 ‘ During evaluation no diplopia, pain, suppression stable findings Symptoms improving, not all resolved 14
  15. 15. 10/14/2011 3D Vision Syndrome 3D Vision SyndromePatient #1 Optometric Vision Therapy Patient #1 Optometric Vision Therapy OVT #8 Progress Evaluation #2 Clown vectograms (push 1 month later BI) with +/-1.00 Majority of symptoms resolved Tranaglyph BC 601 BVA 20/20 RE, LE Slight + CL OR Amps 8.33 RE/LE NRA +2.50 Brockstring B k t i CT ortho/2 EXO PRA -2.25 NPC TN Facility 6 RE, 7LE, 8 OU CPM no Aperture Rule After 5 trials TN suppression NPC with RL 7/10 cm MEM +.50 RE, LE Vergence dist BI x/14/10 BO Switch to HVT only due to X/30/25 RTO 6 mos CEE, intermittently do Near BI 16/12 BO 35/25 HVT change in work schedule W4D 4 all distancesSaw 3D movie…no problems! Random Dot 25’ Pur/Sac +4 Started Here: Ended Here: Convergence insufficiency, Accommodative dysfunctions, Headache, Diplopia, VA’s CLS RE/LE 20/20 Majority of symptoms Blurred vision, Double vision, Nausea, Dizziness OR RE -.25, LE PL Acceptable Fit resolved MR RE -4.25-50X175 20/15, BVA 20/20 RE, LE LE -4.00-.50X175 20/15 Slight + CL OR Pursuits/Saccades +4 Pur/Sac +4 All resolved in 8 OVT visits and HVT CT 18 XOP @ near CT ortho/2 EXO, NPC TN NPC 2/6/4” After 5 trials TN After 5 attempts pain noted NPC with RL 7/10 cm Last Progress Evaluation on 7/10 PFV/NFV @ near could not Vergence dist BI x/14/10 do/diplopia BO X/30/25 W4D Fusion Variable Near BI 16/12 BO 35/25 On 8/1/10 the patient texted me and Random Dot 100” (?) W4D 4 all distances, Random - Lens amplitudes could not Dot 25’ said, “Just saw a 3D movie. It didn’t do Amps 8.33 RE/LE hurt! It was an awesome experience!” NRA +2.00 diplopia NRA +2.50, PRA -2.25 PRA -1.00 Facility 6 RE, 7LE, 8 OU CPM no suppression MEM +.50 RE, LE Computer Programs Used in Optometric Vision Therapy 3D as a Public Information and Marketing Tool 3D in the News-Print Media-Internet Computer Aided Home Therapy Solutions Vision Therapy In Your Office-3D Pictures-Newsletters Website/Blog/Facebook/SOVOTO/LinkedIn Media Awareness! 15
  16. 16. 10/14/20113D in the News ABC Chicago tory?section=news/health&i d=7298893 NBC News Broadcast oryid=145741&catid=9 AOA TV Diagnosis Maino D. Brock String Debuts at 2011 Consumer Electronics Show. Optom Vis Dev 2011;42(1):6-9. Blogs Print /Digital Media 16
  17. 17. 10/14/ Radio Pacific Eye Clinic Beaverton Opens 3D Performance Eye Clinic 17
  18. 18. 10/14/2011 The 3D’s of 3D Viewing:Discomfort, Dizziness and Lack of Depth The 4th D of 3D Viewing Discomfort The fourth “D” of 3D Viewing should be Dizziness to call your…. Lack of Depth Doctor of Optometry 3D Resources 3D in the Classroom: AOA See Well, Learn Well American Academy of Optometry 3D Eye COVD OEPF Optometrists Network Berezin Stereo Photography Products Questions? Dominick M. Maino, O.D., M.Ed., F.A.A.O., F.C.O.V.D-A. F.A.A.O., F.C.O.V.D- Professor, Pediatrics/Binocular Vision Service Illinois College of Optometry Illinois Eye Institute 3241 S. Michigan Ave. Chicago, Il. 60616 312-949- 312-949-7280 (Voice) 312-949-7358 (fax) 312-949- 18