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Disclosure Statement:Disclosure Statement:

Nothing to disclose”Nothing to disclose”Please silence all mobile devices.Unauthorized recording of this session is prohibited.

Dominick M. Maino, OD, MEd, FAAODominick M. Maino, OD, MEd, FAAO, , FCOVDFCOVD--AAAOA National Spokesperson on 3 D Vision Syndrome

AOA Classroom 3D Project Team Member

Professor, Professor,

Pediatrics/Binocular Vision ServicePediatrics/Binocular Vision Service

Illinois College of OptometryIllinois College of OptometryIlli i E I tit tIlli i E I tit tIllinois Eye InstituteIllinois Eye Institute

3241 S. Michigan Ave. Chicago, Il. 606163241 S. Michigan Ave. Chicago, Il. 60616

312312--949949--7280 (Voice) 3127280 (Voice) 312--949949--7358 (fax)7358 (fax)

dmaino@ico.edudmaino@ico.edu

MainosMemos.blogspot.com MainosMemos.blogspot.com

www.ico.edu nw.optometry.netwww.ico.edu nw.optometry.net

Photo credit: http://science.howstuffworks.com/3-d-glasses2.htm

Virtual Virtual 3 D: Why Now?3 D: Why Now?

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3 D Tipping Point3 D Tipping PointA 3D TV Tipping Point?A 3D TV Tipping Point?

htt // b /id/41591929/A 3D TV Ti i P i thtt // b /id/41591929/A 3D TV Ti i P i thttp://www.cnbc.com/id/41591929/A_3D_TV_Tipping_Pointhttp://www.cnbc.com/id/41591929/A_3D_TV_Tipping_Point

Stereoscopic 3D Technologies Reach Tipping Point on PC Market Stereoscopic 3D Technologies Reach Tipping Point on PC Market –– JPR.JPR.

http://www.xbitlabs.com/news/video/display/20100526234951_Stereoscopic_3D_Technologieshttp://www.xbitlabs.com/news/video/display/20100526234951_Stereoscopic_3D_Technologies

_Reach_Tipping_Point_on_PC_Market_JPR.html_Reach_Tipping_Point_on_PC_Market_JPR.html

ESPN: 3D Is at the Tipping Point

3D Printing Technology Nearing Tipping PointWill 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 3Dhttp://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 Europehttp://www.variety.com/article/VR1118004886

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

3D Medical Educationhttp://medical-animation-studio.com/

+

Many activities including:

Symposia, 3D Users Experience Tech Summit, The 3Ds of 3D ViewingAOA YouTube Videos3D in the Classroom: See Well, Learn Well

http://www.youtube.com/watch?v=9U4AoDWPEQ0

The Public Health Implications of Virtual 3D Michael Duenas, OD

The Visual System and Virtual 3D Jim Sheedy, O.D., Ph.D.

3D: The User Experience Story Philip J. Corriveau

Exploring a New Dimension Ch i HChris Haws

Do You Know if the Kids are OK?Maureen Powers, PhD

Improving Binocular Vision-Creating a Better 3D Audience

3D Vision Syndrome Dominick M. Maino, OD, MEd, FAAO, FCOVD-A

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

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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=4qZw98mkIhI&feature=related )

Brock String Debuts at the Consumer Electronics ShowKids@Play Summit at CES 2011Dominick M. Maino, OD, MEd, FAAO, FCOVD-A

(http://mainosmemos.blogspot.com/2011/04/dr-dominick-maino-at-consumer.html)

Available from:

AOA3D@Home

3deyehealth.orgMainosMemos

Binocular Vision Binocular Vision Dysfunction as a Dysfunction as a

Medical & Medical & Public Health IssuePublic Health IssuePublic Health IssuePublic Health Issue

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Improving Binocular Vision Improving Binocular Vision -- Creating a Better AudienceCreating a Better Audience

Improving 3D Television Technology Improving 3D Television Technology

but Not Creating but Not Creating

a Better 3D Viewing Audiencea Better 3D Viewing Audience

1920’s Image Credit : Baird Television Today

Improving 3D Movie Improving 3D Movie Technology but Technology but

Not Creating a Better 3D Not Creating a Better 3D Viewing AudienceViewing Audience

1953 Image Credit: Mystic Cinema Today Image Credit: Joystiq

Improving 3D Gaming Improving 3D Gaming Technology but Technology but

Not Creating a Better Not Creating a Better GamerGamerGamerGamer

Image Credit: Daily Motion 3D Image Credit: Nintendo

Improving Classroom Technology but Improving Classroom Technology but

Have Not Created Have Not Created

a Better 3D Viewing Studenta Better 3D Viewing Student

Image Credit: American Optometric AssociationImage Credit: mkrstovic.edublogs.org

History of 3D

3D in the Classroom: See Well, Learn Well3D Timeline

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3 D Stereo Scopes1844Scottish inventor and writer David Brewsterintroduced the Stereoscope1862USA jurist, author, j , ,inventor Oliver Wendell Holmes makes it possible for all to enjoy 3D!

Some of the first 3D Movies included:

Bwana Devil (1952 ) starring Robert Stack

http://www youtube com/watchhttp://www.youtube.com/watch?v=4oGl_KqTw-M&NR=1

House of Wax (1953) starring Vincent Price

13 Ghosts (1960)

http://www.youtube.com/watch?v=Zdwq3jdvZDI

The Mask (1961)

http://www.youtube.com/watch?v=xGTApr_SAts

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3D TelevisionStereoscopic television was first demonstrated by

John Logie Baird in 1928

Stereo TVStereo Receiver

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

http://www.youtube.com/watch?v=O5ZSXPMlumc

3D EducationVRMagic Digital BIO

3D Educationhttp://www.3dmedicaleducation.co.uk/index.php/anatomy/lumbar_vertebrae/

3D Video-games 3D Tech - NASA Uses Video Games for Visualization & Engineering

http://www.youtube.com/watch?v=v-mFx6blZK8

NASA Video Game Brain Training for ADHDhttp://www.youtube.com/watch?v=S26Kk-

ueWjQ&feature=related

M i B h 3DMario Brothers 3Dhttp://www.youtube.com/watch?v=0U0ZDjnQiXQ

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3D in the Classroom: See Well, Learn Well

3D glasses technology

Linearly polarized glassesTwo images are projected superimposed onto the same

Use a silver screen so that polarization is preserved.

Can’t tilt head

Passive3D glasses technology

Circularly polarized glassesLight that is left-circularly polarized is extinguished by the right-handed

Passive

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

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

3D glasses technology

Active

ActiveLCD shutter glassesA liquid crystal glasses stop q y g por allow light in thru synchronization with the images seen on the screen

Red eye shutterglassesThe Red Eye Method reduces the ghosting

Active 3D Glasses

small LCD screens

when voltage applied lens goes darksynced with screen showing 3D content then alternates image content then alternates image

viewed

each eye different angle of viewcreates 3D effect

Active 3D Glasses

this method of 3D cuts refresh rate in half

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

Active 3D Glasses

3D Personal Display Spectacles

two small screens in the glasses display separate images to each eye.

Does not require a television

http://www.trendhunter.com/trends/head-mounter-3d

Autostereoscopic displays Auto 3D

Almont Green 3D Photography

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

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Autostereoscopic displays Auto 3D

Nintendo 3DSNintendo 3DS is hazardous to the

eyes of children (Nope!)

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

How Does Nintendo

3DS Work?two separate

outputs at slightly different angles gone 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 A group of symptoms that collectively indicate or characterize a disease, psychological disorder, or other abnormal condition

So is the 3D Vision Syndrome Really a Syndrome?

Yes.

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

The 3D’s of 3D Viewing: Discomfort, Dizziness and Lack of Depth

Discomfort:

Since 3D viewing is based Since 3D viewing is based on the eyes converging in front of or beyond the screen, viewing 3D images can potentially create eyestrain and headaches

The 3D’s of 3D Viewing: Discomfort, Dizziness and Lack of Depth

Dizziness:

3D technology can exaggerate visually induced motion sickness …causing consumers to feel dizzy or nauseous during or after viewing 3D content.

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The 3D’s of 3D Viewing: Discomfort, Dizziness and Lack of Depth

Lack of Depth:

A viewer lacking binocular i i i l ’t 3D vision, simply won’t see 3D.

While this doesn’t pose any problem viewing the screen, it serves as a “vision screening” that something is abnormal with the viewer’s binocular vision. Photo credit: Photobucket

Symptoms of 3D Vision Syndromeasthenopia, headaches, blurred vision, eyestrain, diplopia, dizziness/nausea and vision induced motion sickness …..or ….

Image Credit: American Optometric Association Image credit: squidoo.com/3d-a i ated if

Symptoms of 3D Vision Syndrome

…a happy, actively engaged users of 3D content?

Image Credit: American Optometric Association

3D Vision Syndrome …

… is comprised of a group of symptoms and physical signs that collectively indicate or characterize a functional vision and/or eye health disorder that manifests when viewing simulated 3D technology These signs and simulated 3D technology. These signs and symptoms include but are not limited to headaches, blurred vision, eyestrain, double vision, dizziness/nausea, decreased depth perception and vision induced motion sickness.

How to Dx an Individual with3D Vision Syndrome

Examination SequenceComprehensiveVi l Effi i /St bi /A bl iVisual Efficiency/Strabismus/AmblyopiaSpecial Testing (Visagraph, TOVA, etc)

How to Dx an Individual with3D Vision Syndrome

Case Hx

Salient Findings

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How to Tx an Individual with3D Vision Syndrome

We really don’t k th b t know the best methodology/approach.

How to Tx an Individual with3D Vision Syndrome

Use what we do know

Rx/PrismOptometric Vision Therapy

These are your eyes….

These are your eyesOn 3D!

3D Vision Syndrome Single Subject Design

Research Study Patient #1

Symptoms:

bl d i i blurred vision, double vision, nausea, headache, dizziness while watching 3D movie

3D Vision Syndrome Patient #1

27 y/o white female College educated

Athletic trainerAthletic trainerHx of reading problems since 5th grade

Remedial reading class in collegeSeasonal allergies

Nephrectomy

3D Vision Syndrome Patient #1

Initial FindingsVA’s CLS RE/LE 20/20

OR RE -.25, LE PL Acceptable Fit, pMR RE -4.25-50X175 20/15,

LE -4.00-.50X175 20/15Pursuits/Saccades +4

CT 18 XOP @ near2nd Degree Fusion Variable

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3D Vision Syndrome Patient #1

Initial FindingsRandom 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 diplopiaPRA -1.00

3D Vision Syndrome Patient #1

Initial FindingsAccommodative Facility diplopia

MEM variableOcular health mild allergic conjunctivitis

3D Vision Syndrome Patient #1

DiagnosisConvergence insufficiency

Accommodative dysfunctionsyHeadacheDiplopia

Allergic conjunctivitis

3D Vision Syndrome Patient #1

PlanObtain past records

Start Optometric Vision Therapyp py

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 20/20 RE/LE, SLE 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 TherapyPhase 1 Phase 2 Phase 3 Phase 4Mono Biocular Binocular IntegrationO l dd ti dd St bili tiOculo- add anti- add StabilizationMotor, suppression vergenceHE, Acc

3 month post OVT maintenance Tx and final progress evaluation

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3D Vision Syndrome Patient #1 Optometric Vision Therapy

OVT #1

HC SaccadesHC RockHTS (saccades, pursuits, accommodationBrockstring

HVTSent Home all of the above

3D Vision Syndrome Patient #1 Optometric

Vision Therapy

OVT #2

R i d HVTReviewed HVT

Vision Builder (saccades

Franzblau Red RockBrockstring

3D Vision Syndrome Patient #1 Optometric

Vision Therapy

OVT #3

Reviewed HVT

Mi l diMinus lens dipsHC accom rockVision Builder

(binoc reading)Quoits

3D Vision Syndrome Patient #1

Optometric Vision Therapy

OVT #4

Reviewed HVT

Vision Builder Randot vergenceEccentric Circles

QuoitsPhoto credit VisionHelpBlog

3D Vision Syndrome Patient #1 Optometric Vision Therapy

OVT #5Reviewed HVT

+/- Flippers (mono)E t i Ci lEccentric Circles

HTS autoslide vergenceJump vergences (vectos)Brockstring (bug on a string)

HVTECC BO/Brockstring, HTS jump vergences

3D Vision Syndrome Patient #1 Optometric

Vision Therapy

OVT #6

Review HVT

ECCVectogram Jump

VergenceLifesaver Cards

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3D Vision Syndrome Patient #1 Optometric Vision Therapy

Progress evaluation #1

20/15 BVA, RE/LECL OR RE +1.00-.50X180

20/20LE +1.25 20/20

MR RE 3 25 25X175 20/20

NPC TN no painBI 12/9 near

BO > 45 Amps 7 D RE/LE

F ilit 8 CPM RE 11 CPM LE 10 MR RE -3.25-.25X175 20/20LE -3.250.75X005 20/20

Pursuits +4 Saccades +3CT 2EP (near)

W4D 4 at all distancesRandom dot 20 ‘

Facility 8 CPM RE, 11 CPM LE, 10 CPM OU

MEM +.75 each eye

During evaluation no diplopia, pain, suppressionstable findings

Symptoms improving, not all resolved

3D Vision Syndrome Patient #1 Optometric Vision Therapy

OVT #7

Clown vectograms (push BI)Chicago Skyline (jump)

3D Vision Syndrome

Patient #1 Optometric Vision Therapy

OVT #8

Clown vectograms (push BI) with +/-1.00

Tranaglyph BC 601B k t iBrockstring

Aperture Rule

Switch to HVT only due to change in work schedule

Saw 3D movie…no problems!

3D Vision Syndrome Patient #1 Optometric Vision Therapy

Progress Evaluation #21 month later

Majority of symptoms resolvedBVA 20/20 RE, LE

Slight + CL ORAmps 8.33 RE/LE

NRA +2.50CT ortho/2 EXO

NPC TNAfter 5 trials TN

NPC with RL 7/10 cmVergence dist BI x/14/10 BO

X/30/25Near BI 16/12 BO 35/25

W4D 4 all distancesRandom Dot 25’

Pur/Sac +4

PRA -2.25Facility 6 RE, 7LE, 8 OU CPM no

suppressionMEM +.50 RE, LE

RTO 6 mos CEE, intermittently do HVT

Ended Here:

Majority of symptoms resolved

BVA 20/20 RE, LESlight + CL OR

Pur/Sac +4

CT ortho/2 EXO, NPC TNAfter 5 trials TN

NPC with RL 7/10 cmVergence dist BI x/14/10

Started Here:VA’s CLS RE/LE 20/20

OR RE -.25, LE PL Acceptable FitMR RE -4.25-50X175 20/15,

LE -4.00-.50X175 20/15Pursuits/Saccades +4

CT 18 XOP @ nearNPC 2/6/4”

After 5 attempts pain notedPFV/NFV @ near could not

BO X/30/25Near BI 16/12 BO 35/25

W4D 4 all distances, Random Dot 25’

Amps 8.33 RE/LENRA +2.50, PRA -2.25

Facility 6 RE, 7LE, 8 OU CPM no suppression

MEM +.50 RE, LE

do/diplopiaW4D Fusion VariableRandom Dot 100” (?)

- Lens amplitudes could not do

NRA +2.00 diplopiaPRA -1.00

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!”

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Computer Programs Used in Optometric Vision Therapy

Home Therapy SolutionsComputer Aided Vision Therapy

3D as a Public Information and Marketing Tool

3D in the News-Print Media-Internet

In Your Office-3D Pictures-NewslettersIn Your Office-3D Pictures-Newsletters

Website/Blog/Facebook/SOVOTO/LinkedIn

Media Awareness

3D in the News ABC Chicago

http://abclocal.go.com/wls/story?section=news/health&id=7298893

NBC News Broadcast

http://www.wlbz2.com/news/local/story.aspx?storyid=145741&catid=9

AOA TV

http://www.iwantmyaoatv.com/

Diagnosis

Maino D. Brock String Debuts at 2011 Consumer Electronics Show. Optom Vis Dev 2011;42(1):6-9.

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Print /Digital Media

Blogs

MainosMemos.blogspot.com Radio

The 3D’s of 3D Viewing: Discomfort, Dizziness and Lack of Depth

Discomfort

Dizziness

Lack of Depth

The 4th D of 3D Viewing

The fourth “D” of 3D Viewing should be to call your….

Doctor of Optometry

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3D in the Classroom: See Well, Learn Well

3D Resources

AOA http://www.aoa.org

American Academy of Optometryhttp://www.aaopt.org

3D Eye Health.orghttp://www.3deyehealth.org/

COVD COVD http://www.covd.org

OEPF http://www.oepf.org

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

Berezin Stereo Photography Productshttp://www.berezin.com/3d/

Dominick M. Maino, O.D., M.Ed., F.A.A.ODominick M. Maino, O.D., M.Ed., F.A.A.O., ., F.C.O.V.DF.C.O.V.D--AA..Professor, Professor,

Pediatrics/Binocular Vision ServicePediatrics/Binocular Vision Service

Illi i C ll f O t tIlli i C ll f O t t

Questions?

Illinois College of OptometryIllinois College of OptometryIllinois Eye InstituteIllinois Eye Institute

3241 S. Michigan Ave. Chicago, Il. 606163241 S. Michigan Ave. Chicago, Il. 60616

312312--949949--7280 (Voice) 3127280 (Voice) 312--949949--7358 (fax)7358 (fax)

dmaino@ico.edudmaino@ico.edu MainosMemos.blogspot.com MainosMemos.blogspot.com

www.ico.edu nw.optometry.netwww.ico.edu nw.optometry.net