ICO Lecture 3 D Vision Syndrome

4/9/2011

Dominick M. Maino, OD, MEd, FAAO, FCOVD-A
FAAO, FCOVD-
AOA National Spokesperson on 3 D Vision Syndrome
AOA Classroom 3D Project Team Member

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-

dmaino@ico.edu MainosMemos.blogspot.com
www.ico.edu nw.optometry.net

1

4/9/2011

Virtual 3 D: Why Now?

3 D Tipping Point
A 3D TV Tipping Point?

http://www.cnbc.com/id/41591929/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.

http://www.xbitlabs.com/news/video/display/20100526234951_Stereoscopic_3D_Technologies

_Reach_Tipping_Point_on_PC_Market_JPR.html

2

4/9/2011

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
http://www.bnet.com/blog/gadget-guy/sharp-8217s-new-cellphone-video-
may-be-a-tipping-point-for-3d/315

3-D reaches a tipping point in Europe
http://www.variety.com/article/VR1118004886

Dr. Karl Kapp: "the tipping point for 3D will be in the healthcare
industry“

3D Medical Education
http://medical-animation-studio.com/

3D Vision & Eye Health.org
The 3Ds of Stereoscopic 3D Viewing
AOA YouTube Videos

The Public Health Implications of Virtual 3D - Michael Duenas
The Visual System and Virtual 3D - Jim Sheedy, O.D., Ph.D.
3D: The User Experience Story - Philip J. Corriveau
Exploring a New Dimension - Chris Haws

The Public Health Implications of
Virtual 3D - Michael Duenas
(http://www.youtube.com/watch?feature
=player_embedded&v=howdZm-d7Z0)

3

4/9/2011

The Visual System and Virtual 3D -
Jim Sheedy, O.D., Ph.D.
(http://www.youtube.com/watch?v=
ZLpwCC5yxlo&feature=related)

3D: The User Experience Story -
Philip J. Corriveau
(http://www.youtube.com/watch?v=
1IiHNit3RPM&feature=related)

Exploring a New Dimension
- Chris Haws
(http://www.youtube.com/watch?v=4
qZw98mkIhI&feature=related )

4

4/9/2011

http://www.next-
gen.biz/features/a-
brief-history-3d
http://www.newyorker.com/a
rts/critics/atlarge/2010/03/0
8/100308crat_atlarge_lane

3 D Stereo Scopes

1844
Scottish inventor and writer David Brewster
introduced the Stereoscope

5

4/9/2011

Some of the first 3D Movies included:

Bwana Devil (1952 ) starring Robert Stack

House of Wax (1953) starring Vincent Price

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4/9/2011

13 Ghosts (1960)

The Mask (1961)

Current and Future 3D Movies:
2011
Pirates of the Caribbean: on Stranger Tides
The Green Hornet
2010
Gulliver's Travels
Yogi Bear
Tron Legacy
The Chronicles of Narnia: The Voyage of the Dawn Treader
Harry Potter and the Deathly Hallows: Part 1
SAW 3D (aka: SAW 7)
Legend of the Guardians: The Owls of Ga'Hoole 3D
Alpha and Omega
Piranha 3D
Beauty and the Beast in 3D
The Last Airbender
King Kong 360 3D
Toy Story 3 in 3D
Clash of the Titans
How to Train Your Dragon
Hubble 3D
Alice in Wonderland 3D

7

4/9/2011

3D Television
Stereoscopic television was first demonstrated by
John Logie Baird in 1928

Stereo TV
Stereo Receiver

3D Television
Stereoscopic television was first demonstrated by John
Logie Baird in 1928

3D Education
AOA
Classroom 3D Project Team
Dominick Maino Barry Barresi
Jim Brocato
Ji B t Barb Horn
Danette Miller Nancy Cope
Reggie Swanigan
Linda Boyland
Chris Haws
Michael Duenas Len Scrogan
Renee Brauns Jim Sheedy
Greg Wolfe

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4/9/2011

3D Education
VRMagic Digital BIO

3D Education
http://www.3dmedicaleducation.co.uk/index.php/anatomy/lumbar_
vertebrae/

3D Video-games

9

4/9/2011

3D Tech - NASA Uses Video Games for
Visualization & Engineering
http://www.youtube.com/watch?v=v-mFx6blZK8

NASA Video Game Brain Training for ADHD
http://www.youtube.com/watch?v=S26Kk-
ueWjQ&feature=related

Mario B h
M i Brothers 3D
http://www.youtube.com/watch?v=0U0ZDjnQiXQ

3D glasses technology
Active & Passive
Active
LCD shutter glasses
A liquid crystal glasses stop
q y g p
or allow light in thru
synchronization with the
images seen on the screen

Red eye shutterglasses
The Red Eye Method
reduces the ghosting

10

4/9/2011

Active 3D Glasses

most commonly used
Active 3D glasses
small LCD screens
when voltage applied lens goes dark
synced with screen showing 3D
content then alternates image
viewed
each eye different angle of view
creates 3D effect

Active 3D Glasses

this method of 3D cuts refresh rate in half

Known to cause headaches
http://www.3d-tvbuyingguide.com/3dtv/3d-glasses.html

Active 3D Glasses

Display spectacles
two small screens in the glasses
display separate images to each eye.
Does not require a television

http://www.3d-tvbuyingguide.com/3dtv/3d-glasses.html

11

4/9/2011

Passive
Linearly polarized glasses
Two images are projected superimposed onto the same
Use a silver screen so that polarization is preserved.
Can’t tilt head

Passive

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.

Circularly polarized glasses

12

4/9/2011

RealD Cinema system uses an
electronically driven circular polarizer
Infitec glasses
Infitec (interference filter technology.)
Filters divide the visible color
spectrum into six narrow bands
"super-anaglyph”
Dolby uses a form of this technology
in its

Dolby 3D theatres
Complementary color
anaglyphs (use red and cyan)
Lenticular printing used to
produce images with an
illusion of depth, or the ability
to change or move as the
image is viewed from
different angles

Autostereoscopic displays Auto 3D

Almont Green 3D Photography

(http://almontgreen.wordpress.com/)

See photographs on easels

13

4/9/2011

Autostereoscopic displays Auto 3D
Nintendo 3DS
Nintendo 3DS is hazardous to the
eyes of children

http://www.digitaltrends.com/gaming/nintendo-3ds-is-hazardous-to-kids-eyes/

How Does
Nintendo
3DS Work?
two separate
outputs at slightly
different angles
g
one for your left
eye and the other
for your right

http://kombo.com
/features/How_th
e_3DS_Works/

3D Vision Syndrome

What constitutes a syndrome?

A group of symptoms that
collectively indicate or characterize a
disease, psychological disorder, or
other abnormal condition

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4/9/2011

So is the 3D Vision Syndrome
Really a Syndrome?

Yes.

The symptoms and signs consistently
y p g y
include: headaches, nausea, dizziness, a
vision induced sense of motion,
diplopia, blurred vision and eyestrain;
as well as a disconnect between
accommodation and vergence.

How to Dx an Individual with
3D Vision Syndrome
Examination Sequence
Comprehensive
Visual Efficiency/Strabismus/Amblyopia
Special Testing (Visagraph, TOVA, etc)

How to Dx an Individual with
3D Vision Syndrome

Case Hx

Salient Findings

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4/9/2011

How to Tx an Individual with
3D Vision Syndrome

We really don’t know the best
methodology/approach.
th d l / h

How to Tx an Individual with
3D Vision Syndrome

Use what we do know

Rx/Prism
Optometric Vision Therapy

3D Vision Syndrome
Patient #1

Symptoms:

blurred vision, double
vision
vision, nausea, headache,
dizziness

16

4/9/2011

3D Vision Syndrome
Patient #1

27 y/o white female
College educated
Athletic trainer
Hx of reading problems since 5th grade
Remedial reading class in college
Seasonal allergies
Nephrectomy

3D Vision Syndrome
Patient #1

Initial Findings
VA’s CLS RE/LE 20/20
OR RE -.25, LE PL Acceptable Fit
, p
MR RE -4.25-50X175 20/15,
LE -4.00-.50X175 20/15
Pursuits/Saccades +4
CT 18 XOP @ near
2nd Degree Fusion Variable

3D Vision Syndrome
Patient #1

Initial Findings
Random Dot 100” (?)
NPC 2/6/4”
After 5 attempts pain noted
PFV/NFV @ near could not do/diplopia
- Lens amplitudes could not do
NRA +2.00 diplopia
PRA -1.00

17

4/9/2011

3D Vision Syndrome
Patient #1

Initial Findings
Accommodative Facility diplopia
MEM variable
Ocular health mild allergic conjunctivitis

3D Vision Syndrome
Patient #1

Diagnosis
Convergence insufficiency
Accommodative dysfunctions
y
Headache
Diplopia
Allergic conjunctivitis

3D Vision Syndrome
Patient #1

Plan
Obtain past records
Start Optometric Vision Therapy
p py

18

4/9/2011

3D Vision Syndrome
Patient #1

Previous Eye Examination (10/09)
“No Binocular Testing Done!”
Hx “General Exam”, health “good”, Aided VAs
20/20 RE/LE, SLE unremarkable, Non-dilated
RE/LE unremarkable Non dilated
fundus evaluation unremarkable, Ret -4.00 Sph
RE/LE, MR -4.00-50X175 RE, -4.00-.50X180 LE, CT
2XO dist/Ortho near, BI 20/8, BO 24/12 near

Dx Myopia, Astigmatism

3D Vision Syndrome
Patient #1

Optometric Vision Therapy
Phase 1 Phase 2 Phase 3 Phase 4
Mono Biocular Binocular Integration
Oculo-
O l add anti-
dd ti add
dd Stabilization
St bili ti
Motor, suppression vergence
HE, Acc

3 month post OVT maintenance Tx and
final progress evaluation

3D Vision Syndrome
Patient #1 Optometric Vision Therapy

OVT #1
HC Saccades
HC Rock
HTS (saccades, pursuits,
( d it
accommodation
Brockstring

HVT
Sent Home all of the above

19

4/9/2011

3D Vision Syndrome

OVT #2

Reviewed HVT
Vision B ild (saccades
Vi i Builder ( d
Franzblau Red Rock
Brockstring

3D Vision Syndrome

OVT #3

Reviewed HVT
Minus lens dips
Mi l di
HC accom rock
Vision Building
(binoc reading)
Quoits

3D Vision Syndrome

OVT #4

Reviewed HVT
Vision Builder Randot
Vi i B ild R d t vergence
Eccentric Circles
Quoits

20

4/9/2011

3D Vision Syndrome
OVT #5
Reviewed HVT
+/- Flippers (mono)
Eccentric Circles
HTS autoslide vergence
Jump vergences (vectos)
Brockstring (bug on a string)
HVT
ECC BO/Brockstring, HTS jump vergences

3D Vision Syndrome
OVT #6

Review HVT
ECC
Vectogram Jump Vergence
Lifesaver Cards

3D Vision Syndrome
Progress evaluation #1
20/15 BVA, RE/LE NPC TN no pain
CL OR RE +1.00-.50X180 BI 12/9 near
20/20 BO > 45
LE +1.25 20/20 Amps 7 D RE/LE
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 OU
Pursuits +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 resolved

21

4/9/2011

3D Vision Syndrome
OVT #7

Clown vectograms (push BI)
Chicago Skyline (jump)

3D Vision Syndrome
OVT #8

Clown vectograms (push BI) with +/-1.00
Tranaglyph BC 601
Brockstring
Aperture Rule

Switch to HVT only due to change in work
schedule
Saw 3D movie…no problems!

3D Vision Syndrome
Progress Evaluation #2
1 month later

Majority of symptoms resolved Amps 8.33 RE/LE
BVA 20/20 RE, LE NRA +2.50
Slight + CL OR PRA -2.25
2 25
CT ortho/2 EXO Facility 6 RE, 7LE, 8 OU CPM no
NPC TN suppression
After 5 trials TN MEM +.50 RE, LE
NPC with RL 7/10 cm RTO 6 mos CEE, intermittently do HVT
Vergence dist BI x/14/10 BO X/30/25
Near BI 16/12 BO 35/25
W4D 4 all distances
Random Dot 25’
Pur/Sac +4

22

4/9/2011

Started Here: Ended Here:
VA’s CLS RE/LE 20/20 Majority of symptoms
OR RE -.25, LE PL resolved
Acceptable Fit BVA 20/20 RE, LE
MR RE -4.25-50X175 Slight + CL OR
20/15, CT ortho/2 EXO, NPC TN
LE -4.00-.50X175 20/15 After 5 trials TN
Pursuits/Saccades +4 NPC with RL 7/10 cm
CT 18 XOP @ near Vergence dist BI x/14/10 BO
2 nd Degree Fusion Variable
d X/30/25
Random Dot 100” (?) Near BI 16/12 BO 35/25
NPC 2/6/4” W4D 4 all distances, Random
After 5 attempts pain noted Dot 25’
PFV/NFV @ near could not Pur/Sac +4
do/diplopia Amps 8.33 RE/LE
- Lens amplitudes could not NRA +2.50, PRA -2.25
do Facility 6 RE, 7LE, 8 OU CPM
NRA +2.00 diplopia no suppression
PRA -1.00 MEM +.50 RE, LE

Convergence insufficiency, Accommodative dysfunctions, Headache, Diplopia,
Blurred vision, Double vision, Nausea, Dizziness

All resolved in 8 OVT visits and HVT

Last Progress Evaluation on 7/10

On 8/1/10 the patient texted me and
said, “Just saw a 3D movie. It didn’t
hurt! It was an awesome experience!”

Computer Programs Used in Optometric Vision Therapy

An example of
vision training? Computer Aided
Home Therapy Solutions Vision Therapy

23

4/9/2011

3D as a Public Information and
Marketing Tool
3D in the News
Print Media
Internet
In Y
I Your Office
Offi
3D Pictures
Newsletters
Website/Blog/Facebook/SOVOTO/LinkedIn

Media Awareness

3D in the News ABC Chicago

NBC Broadcast

24

4/9/2011

AOA TV

Consumer Electronics Show

Print Media

25

4/9/2011

Blogs

MainosMemos.blogspot.com

Radio

26

4/9/2011

3D Resources
AOA
http://www.aoa.org
3D Eye Health.org
http://www.3deyehealth.org/
COVD
http://www.covd.org

OEPF
http://www.oepf.org

Optometrists Network
http://www.vision3d.com/

Berezin Stereo Photography Products
http://www.berezin.com/3d/

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-

dmaino@ico.edu MainosMemos.blogspot.com
www.ico.edu nw.optometry.net

27

ICO Lecture 3 D Vision Syndrome

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