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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
     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
                                       312-949-7280 (Voice) 312-949-7358 (fax)




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

1.) Yes, you may ask questions.
2.) But only if I know the answer!
3.) My answer is always right!
4.) An updated version of this
presentation can be found at
www.slideshare.net/DMAINO/
Photo credit: http://science.howstuffworks.com/3-d-glasses2.htm
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

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

http://www.xbitlabs.com/news/video/display/20100526234951_Stereoscopic_3D_Technologies_Rea


                                                  ch_Tipping_Point_on_PC_Market_JPR.html


                                                                     10/114
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 Cell        phone 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/
+
Many activities including:       http://www.youtube.com/watch?v=9U4
                                 AoDWPEQ0

Symposia, 3D Users Experience Tech Summit, The 3Ds of
3D Viewing, AOA YouTube Videos
3D in the Classroom: See Well, Learn Well
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
            Chris 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)
Public Health Model
3D Movies Have a New Dimension: Protecting Eye Health

                      1850 Snellen Eye Chart
          Snellen eye chart has a 27% sensitivity (OMG!!)
                   High rate of FALSE Negatives.
   Children that are referred because they fail the eye chart ….
                    Have a distance VA problem
         Pediatrician screening? School nurse screening?
          Only 3 states have mandatory vision screening.
  Only a small percentage of children ever get the care they need
    25% of school children have one or more vision problems
    Undiagnosed untreated vision disorders are very prevalent
           Cost of untreated vision problems staggering

           All BV are treatable and preventable:
                Great Public Health Model
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 Show
                 Kids@Play Summit at CES 2011
         Dominick M. Maino, OD, MEd, FAAO, FCOVD-A




(http://mainosmemos.blogspot.com/2011/04/dr-dominick-maino-at-consumer.html)
                                                         20/114
Available from:


      AOA
   3D@Home
 3deyehealth.org
  MainosMemos
Binocular Vision
  Dysfunction as a
         Medical &
Public Health Issue
Improving Binocular Vision - Creating a Better Audience




Maybe Mike, from "Monsters, Inc.,"
looks so sad because he realizes
3-D doesn't do you any good if you
don't have binocular vision.)....
For the 3D Movie, Television, Video-
gaming and 3D in the Classroom
Techno-Industrial Complex….not having
binocular vision is the 800lbs Cyclops in
the room!
Improving 3D Television Technology
                                 but Not Creating
             a Better 3D Viewing Audience




1920‟s   Image Credit : Baird Television            Today
Improving 3D Movie
         Technology but
     Not Creating a Better 3D
        Viewing Audience




1953 Image Credit: Mystic Cinema   Today   Image Credit: Joystiq
Improving 3D Gaming
         Technology but
       Not Creating a Better
              Gamer



Image Credit: Daily Motion 3D   Image Credit: Nintendo
Improving Classroom Technology but
                             Have Not Created
                a Better 3D Viewing Student




                                       30/128
                                                Image Credit: American Optometric Association
Image Credit: mkrstovic.edublogs.org
History of 3D




          3D in the Classroom: See Well, Learn Well
                         3D Timeline
3 D Stereo Scopes
1844
Scottish inventor
and writer David
Brewster
 introduced the
Stereoscope
1862
USA jurist, author,
inventor Oliver
Wendell Holmes
makes it possible
for all to enjoy 3D!




                       30/114
Some of the first 3D Movies included:

Bwana Devil (1952 ) starring Robert Stack




                                   http://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=Zdwq3jdvZD I
The Mask (1961)




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




         http://www.youtube.com/watch?v=O5ZSXPMlumc
3D Education
VRMagic Digital BIO




                      40/128
3D Education
VRMagic Digital BIO
3D Education
http://www.3dmedicaleducation.co.uk/index.php/anatomy/lumbar_verte
brae/




                                                            40/114
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 ADHD
             http://www.youtube.com/watch?v=S26Kk-
                      ueWjQ&feature=related
Mario Brothers
      3D
http://www.youtube.com/wat
    ch?v=0U0ZDjnQiXQ
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
Passive
        3D glasses technology


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
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 3D theatres
Complementary color
anaglyphs (use red and cyan)
3D glasses technology
                   Active
Active
LCD shutter glasses
A liquid crystal glasses stop
or allow light in thru
synchronization with the
images seen on the screen

Red eye shutterglasses
The Red Eye Method
reduces the ghosting
                                 50/114
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
  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/)
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
3D Printing
Autostereoscopic displays Auto 3D
                           Nintendo 3DS
                Nintendo 3DS is hazardous to the
                     eyes of children (Nope!)




http://www.digitaltrends.com/gaming/nintendo-3ds-is-hazardous-to-kids-eyes/
Remember we want 6 y/olds
   using Nintendo 3DS!

      3D Vision as

   Public Health Model



         60/128
How Does
 Nintendo
3DS Work?
  two separate
outputs at slightly
 different angles
 one for your left
eye and the other
  for your right

http://kombo.com/f
eatures/How_the_
   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
So is the 3D Vision Syndrome
          Really a Syndrome?

                  Yes.

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 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.
The 3D’s of 3D Viewing:
Discomfort, Dizziness and Lack of Depth
Lack of Depth:
A viewer lacking binocular
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
               Syndrome
asthenopia, headaches, blurred vision,
eyestrain, diplopia, dizziness/nausea and
vision induced motion sickness …..or ….




                                                Image credit: squidoo.com/3d-
Image Credit: American Optometric Association   animated-gif
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
symptoms include but are not limited to
headaches, blurred vision, eyestrain, double
vision, dizziness/nausea, decreased depth
perception and vision induced motion sickness.
So….is this
really a public
health issue?
      70/128
Scope of The Problem
     Amblyopia 2% (6,239,043 US)
    Strabismus 2-5% (15,597,609 US
Accommodation 2.5-9.2% (28,699,600 US)
        Eye Coordination (CI 7%)
       Up to 25% (77,988,195 US)
       Vertical Misalignment 7-52%
             (162,215,135 US)

     US Census Bureau: U.S. 311,952,183
            World 6,954,459,463
  AOA Clinical Guidelines: http://www.aoa.org/x4813.xml US Census:
           http://www.census.gov/main/www/popclock.html
According to Statistics Canada, the
population of Canada, as of January 1,
2011, is estimated to be 34,278,400.

     Amblyopia 2% (686,568)
   Strabismus 2-5% (1,713,920)
Accommodation 2.5-9.2% (3,085,056)
     Eye Coordination (CI 7%)
      Up to 25% (8,569,600)
    Vertical Misalignment 7-52%
             (17,842,768)
Toronto, has a
population of 2.48 million
people (5.5 million in the
GTA - Greater Toronto
Area)
Chicago is only a bit
more than an hour
plane ride from
Toronto…so if you don‟t
want to care for these
folks….
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
How to Tx an Individual with
     3D Vision Syndrome

We really don‟t
know the best
methodology/approach.
How to Tx an Individual with
   3D Vision Syndrome

   Use what we do know

       Rx/Prism
Optometric Vision Therapy
These are your patient‟s eyes….




These are
your patient‟s
eyes
On 3D!
3D Vision Syndrome
  Single Subject Design
     Research Study
        Patient #1
Symptoms:

blurred vision, double
vision, nausea,
headache, dizziness
while watching 3D
movie                     80/128
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
       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
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
                Headache
                 Diplopia
          Allergic conjunctivitis
3D Vision Syndrome
                Patient #1

Plan
             Obtain past records
       Start Optometric Vision Therapy
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 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
Optometric Vision Therapy

Evidence Based Medicine
Randomized clinical trial of treatments for symptomatic convergence
insufficiency in children. Arch Ophthalmol. 2008 Oct;126(10):1336-49.
Convergence Insufficiency Treatment Trial Study Group.

CONCLUSIONS:
Twelve weeks of OBVAT results in a significantly
greater improvement in symptoms and clinical
measures of near point of convergence and
positive fusional vergence and a greater
percentage of patients reaching the predetermined
criteria of success compared with HBPP,
HBCVAT+, and OBPT. Application to Clinical
Practice Office-based vergence accommodative
therapy is an effective treatment for children with
symptomatic convergence insufficiency.
Scheiman M, Cotter S, Kulp MT, Mitchell GL, Cooper J, Gallaway M, Hopkins
KB, Bartuccio M, Chung I; the Convergence Insufficiency Treatment Trial Study
Group. Treatment of Accommodative Dysfunction in Children: Results
from a Randomized Clinical Trial. Optom Vis Sci. 2011 Nov;88(11):1343-
1352.


CONCLUSIONS: Vision
therapy/orthoptics is effective in
improving accommodative
amplitude and accommodative
facility in school-aged children with
symptomatic CI and
accommodative dysfunction.
90/128
Long-term effectiveness of treatments for symptomatic convergence
insufficiency in children. Optom Vis Sci. 2009 Sep;86(9):1096-103.
Convergence Insufficiency Treatment Trial Study Group.


CONCLUSIONS: Most    children aged 9 to
17 years who were asymptomatic after
a 12-week treatment program of
OBVAT for convergence insufficiency
maintained their improvements in
symptoms and signs for at least 1 year
after discontinuing treatment. ….
Scheiman M, Mitchell GL, Cotter S, Kulp MT, Cooper J, Rouse M, Borsting E,
London R, Wensveen J. A randomized clinical trial of vision
therapy/orthoptics versus pencil pushups for the treatment of
convergence insufficiency in young adults. Optom Vis Sci. 2005
Jul;82(7):583-95.

DISCUSSION:
 In this study, vision therapy/orthoptics was the only
treatment that produced clinically significant
improvements in the near point of convergence and
positive fusional vergence. ……


         Pencil Push ups do not work very well!
Ciuffreda KJ. The scientific basis for and efficacy of optometric vision
therapy in nonstrabismic accommodative and vergence disorders.
Optometry. 2002 Dec;73(12):735-62.

BACKGROUND:
For nearly 75 years, optometric vision therapy has been an important mode of
therapy for both children and adults who manifested a range of nonstrabismic
accommodative and vergence disorders.
METHODS:
In this article, the scientific basis for, and efficacy of, optometric vision therapy
in such patients will be discussed. Using bio-engineering models of the
oculomotor system as the conceptual framework, emphasis will be focused on
studies that used objective recording techniques to directly assess
therapeutically related changes in oculomotor responsivity.
RESULTS AND CONCLUSIONS:
The findings clearly support the validity of
optometric vision therapy. Furthermore, the
results are consistent with the tenets of general
motor learning.
Maino D. The number of placebo controlled,
double blind, prospective, and randomized
strabismus surgery outcome clinical trials:
None! Optom Vis Dev 2011;42(3):134-136.

http://www.covd.org/Portals/0/OVD/42-3/Editorials/OVD%2042-
3%20Journal_Editorial_Maino_web.pdf
3D Vision Syndrome
                 Patient #1

         Optometric Vision Therapy
Phase 1 Phase 2      Phase 3 Phase 4
Mono    Biocular     Binocular Integration
Oculo-  add anti-      add      Stabilization
Motor,  suppression vergence
HE, Acc

    3 month post OVT maintenance Tx and
           final progress evaluation
Use principles of neuro-plasticity therapy:




Maino D. Neuroplasticity: Teaching an Old
Brain New Tricks. Rev Optom 2009. 46(1):62-
64,66-70
3D Vision Syndrome
    Patient #1   Optometric Vision Therapy

OVT #1
HC Saccades
HC Rock
HTS (saccades, pursuits,
accommodation
Brockstring
HVT
Sent Home all of the above
3D Vision Syndrome
Patient #1    Optometric
     Vision Therapy

       OVT #2

    Reviewed HVT
   Vision Builder
     (saccades
Franzblau Red Rock
    Brockstring
3D Vision Syndrome
Patient #1    Optometric
     Vision Therapy

       OVT #3
    Reviewed HVT
  Minus lens dips
  HC accom rock
   Vision Builder
  (binoc reading)
       Quoits
3D Vision Syndrome
    Patient #1
 Optometric Vision
      Therapy

     OVT #4
  Reviewed HVT
 Vision Builder
Randot vergence
Eccentric Circles
     Quoits          100/128   Photo credit   VisionHelpBlog
3D Vision Syndrome
 Patient #1   Optometric Vision Therapy
              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
Patient #1    Optometric
     Vision Therapy
       OVT #6

     Review HVT
       ECC
 Vectogram Jump
     Vergence
 Lifesaver Cards
3D Vision Syndrome
   Patient #1   Optometric Vision Therapy
                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     Facility 8 CPM RE, 11 CPM LE,
  LE -3.250.75X005 20/20                 10 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 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 601
       Brockstring
      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 #2
                  1 month later
Majority of symptoms resolved
      BVA 20/20 RE, LE                   Amps 8.33 RE/LE
        Slight + CL OR                      NRA +2.50
       CT ortho/2 EXO                       PRA -2.25
            NPC TN              Facility 6 RE, 7LE, 8 OU CPM no
        After 5 trials TN                  suppression
    NPC with RL 7/10 cm                  MEM +.50 RE, LE
 Vergence dist BI x/14/10 BO
            X/30/25             RTO 6 mos CEE, intermittently do
  Near BI 16/12 BO 35/25                    HVT
     W4D 4 all distances
       Random Dot 25‟
          Pur/Sac +4
Started Here:                     Ended Here:
     VA‟s CLS RE/LE 20/20          Majority of symptoms resolved
OR RE -.25, LE PL Acceptable Fit          BVA 20/20 RE, LE
 MR RE -4.25-50X175 20/15,                 Slight + CL OR
    LE -4.00-.50X175 20/15                   Pur/Sac +4
     Pursuits/Saccades +4            CT ortho/2 EXO, NPC TN
    CT 18 XOP @ near                       After 5 trials TN
         NPC 2/6/4”                     NPC with RL 7/10 cm
After 5 attempts pain noted           Vergence dist BI x/14/10
PFV/NFV @ near could not                     BO X/30/25
         do/diplopia                 Near BI 16/12 BO 35/25
   W4D Fusion Variable             W4D 4 all distances, Random
   Random Dot 100” (?)                     Random Dot 25‟
- Lens amplitudes could not               Amps 8.33 RE/LE
             do                        NRA +2.50, PRA -2.25
    NRA +2.00 diplopia             Facility 6 RE, 7LE, 8 OU CPM
         PRA -1.00                          no suppression
                                          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




                                                    Computer Aided
Home Therapy Solutions                              Vision Therapy
3D as a Public Information
    and Marketing Tool

 3D in the News-Print Media-Internet
In Your Office-3D Pictures-Newsletters

Website/Blog/Facebook/SOVOTO/LinkedIn

      Media Awareness!
                                110/128
3D in the News ABC Chicago

                  http://abclocal.go.com/wls/stor
                  y?section=news/health&id=72
                  98893
NBC News Broadcast




http://www.wlbz2.com/news/local/story.aspx?storyi
d=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.
Print /Digital Media
Blogs
MainosMemos.blogspot.com
Radio
http://prescription3dglasses.com/
120/128


http://prescription3dglasses.com/
Pacific Eye Clinic Beaverton Opens 3D Performance
                     Eye Clinic
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
3D in the Classroom:
See Well, Learn Well
3D Resources
                  AOA
          http://www.aoa.org
  American Academy of Optometry
         http://www.aaopt.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/
Chris Haws




 3D@Home
Questions?




Dominick M. Maino, O.D., M.Ed.,
         F.A.A.O., F.C.O.V.D-A.
                              Professor,
     Pediatrics/Binocular Vision Service

         Illinois College of
                 Optometry
                        Illinois Eye Institute
         3241 S. Michigan Ave. Chicago, Il. 60616
          312-949-7280 (Voice) 312-949-7358 (fax)

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

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3 D Vision Syndrome: Toronto

  • 1. Disclosure Statement:  Nothing to disclose” Please silence all mobile devices. Unauthorized recording of this session is prohibited.
  • 2.
  • 3.
  • 4.
  • 5. Dominick M. Maino, OD, MEd, FAAO, FCOVD-A 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 312-949-7280 (Voice) 312-949-7358 (fax) dmaino@ico.edu MainosMemos.blogspot.com www.ico.edu nw.optometry.net
  • 6. Lecture Rules: 1.) Yes, you may ask questions. 2.) But only if I know the answer! 3.) My answer is always right! 4.) An updated version of this presentation can be found at www.slideshare.net/DMAINO/
  • 8.
  • 9. Virtual 3 D: Why Now?
  • 10. 3 D Tipping Point A 3D TV Tipping Point? http://www.cnbc.com/id/41591929/A_3D_TV_Tipping_Point Stereoscopic 3D Technologies Reach Tipping Point on PC Market – JPR. http://www.xbitlabs.com/news/video/display/20100526234951_Stereoscopic_3D_Technologies_Rea ch_Tipping_Point_on_PC_Market_JPR.html 10/114
  • 11. 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 Cell phone 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/
  • 12. +
  • 13. Many activities including: http://www.youtube.com/watch?v=9U4 AoDWPEQ0 Symposia, 3D Users Experience Tech Summit, The 3Ds of 3D Viewing, AOA YouTube Videos 3D in the Classroom: See Well, Learn Well
  • 14. 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
  • 15. Exploring a New Dimension Chris 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
  • 16. The Public Health Implications of Virtual 3D - Michael Duenas (http://www.youtube.com/watch?feature=player_embedded&v=howdZm-d7Z0)
  • 17. Public Health Model 3D Movies Have a New Dimension: Protecting Eye Health 1850 Snellen Eye Chart Snellen eye chart has a 27% sensitivity (OMG!!) High rate of FALSE Negatives. Children that are referred because they fail the eye chart …. Have a distance VA problem Pediatrician screening? School nurse screening? Only 3 states have mandatory vision screening. Only a small percentage of children ever get the care they need 25% of school children have one or more vision problems Undiagnosed untreated vision disorders are very prevalent Cost of untreated vision problems staggering All BV are treatable and preventable: Great Public Health Model
  • 18.
  • 19. The Visual System and Virtual 3D - Jim Sheedy, O.D., Ph.D. (http://www.youtube.com/watch?v=ZLpwCC5yxlo&feature=related)
  • 20. 3D: The User Experience Story - Philip J. Corriveau (http://www.youtube.com/watch?v=1IiHNit3RPM&feature=related)
  • 21. Exploring a New Dimension- Chris Haws (http://www.youtube.com/watch?v=4qZw98mkIhI&feature=related )
  • 22. Brock String Debuts at the Consumer Electronics Show Kids@Play Summit at CES 2011 Dominick M. Maino, OD, MEd, FAAO, FCOVD-A (http://mainosmemos.blogspot.com/2011/04/dr-dominick-maino-at-consumer.html) 20/114
  • 23. Available from: AOA 3D@Home 3deyehealth.org MainosMemos
  • 24. Binocular Vision Dysfunction as a Medical & Public Health Issue
  • 25. Improving Binocular Vision - Creating a Better Audience Maybe Mike, from "Monsters, Inc.," looks so sad because he realizes 3-D doesn't do you any good if you don't have binocular vision.)....
  • 26. For the 3D Movie, Television, Video- gaming and 3D in the Classroom Techno-Industrial Complex….not having binocular vision is the 800lbs Cyclops in the room!
  • 27. Improving 3D Television Technology but Not Creating a Better 3D Viewing Audience 1920‟s Image Credit : Baird Television Today
  • 28. Improving 3D Movie Technology but Not Creating a Better 3D Viewing Audience 1953 Image Credit: Mystic Cinema Today Image Credit: Joystiq
  • 29. Improving 3D Gaming Technology but Not Creating a Better Gamer Image Credit: Daily Motion 3D Image Credit: Nintendo
  • 30. Improving Classroom Technology but Have Not Created a Better 3D Viewing Student 30/128 Image Credit: American Optometric Association Image Credit: mkrstovic.edublogs.org
  • 31. History of 3D 3D in the Classroom: See Well, Learn Well 3D Timeline
  • 32. 3 D Stereo Scopes 1844 Scottish inventor and writer David Brewster introduced the Stereoscope 1862 USA jurist, author, inventor Oliver Wendell Holmes makes it possible for all to enjoy 3D! 30/114
  • 33.
  • 34. Some of the first 3D Movies included: Bwana Devil (1952 ) starring Robert Stack http://www.youtube.com/watch?v =4oGl_KqTw-M&NR=1
  • 35. House of Wax (1953) starring Vincent Price
  • 38. 3D Television Stereoscopic television was first demonstrated by John Logie Baird in 1928 Stereo TV Stereo Receiver
  • 39. 3D Television Stereoscopic television was first demonstrated by John Logie Baird in 1928 http://www.youtube.com/watch?v=O5ZSXPMlumc
  • 44. 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 Brothers 3D http://www.youtube.com/wat ch?v=0U0ZDjnQiXQ
  • 45.
  • 46. 3D in the Classroom: See Well, Learn Well
  • 47. 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
  • 48. Passive 3D glasses technology 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.
  • 50. 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”
  • 51. Dolby 3D theatres Complementary color anaglyphs (use red and cyan)
  • 52. 3D glasses technology Active Active LCD shutter glasses A liquid crystal glasses stop or allow light in thru synchronization with the images seen on the screen Red eye shutterglasses The Red Eye Method reduces the ghosting 50/114
  • 53. 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
  • 54. 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
  • 55. 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
  • 56. Autostereoscopic displays Auto 3D Almont Green 3D Photography (http://almontgreen.wordpress.com/)
  • 57. 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
  • 59. Autostereoscopic displays Auto 3D Nintendo 3DS Nintendo 3DS is hazardous to the eyes of children (Nope!) http://www.digitaltrends.com/gaming/nintendo-3ds-is-hazardous-to-kids-eyes/
  • 60. Remember we want 6 y/olds using Nintendo 3DS! 3D Vision as Public Health Model 60/128
  • 61. How Does Nintendo 3DS Work? two separate outputs at slightly different angles one for your left eye and the other for your right http://kombo.com/f eatures/How_the_ 3DS_Works/
  • 62. 3D Vision Syndrome What constitutes a syndrome? A group of symptoms that collectively indicate or characterize a disease, psychological disorder, or other abnormal condition
  • 63. So is the 3D Vision Syndrome Really a Syndrome? Yes. 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.
  • 64. The 3D’s of 3D Viewing: Discomfort, Dizziness and Lack of Depth Discomfort: 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
  • 65. 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.
  • 66. The 3D’s of 3D Viewing: Discomfort, Dizziness and Lack of Depth Lack of Depth: A viewer lacking binocular 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
  • 67. Symptoms of 3D Vision Syndrome asthenopia, headaches, blurred vision, eyestrain, diplopia, dizziness/nausea and vision induced motion sickness …..or …. Image credit: squidoo.com/3d- Image Credit: American Optometric Association animated-gif
  • 68. Symptoms of 3D Vision Syndrome …a happy, actively engaged users of 3D content? Image Credit: American Optometric Association
  • 69. 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 symptoms include but are not limited to headaches, blurred vision, eyestrain, double vision, dizziness/nausea, decreased depth perception and vision induced motion sickness.
  • 70. So….is this really a public health issue? 70/128
  • 71. Scope of The Problem Amblyopia 2% (6,239,043 US) Strabismus 2-5% (15,597,609 US Accommodation 2.5-9.2% (28,699,600 US) Eye Coordination (CI 7%) Up to 25% (77,988,195 US) Vertical Misalignment 7-52% (162,215,135 US) US Census Bureau: U.S. 311,952,183 World 6,954,459,463 AOA Clinical Guidelines: http://www.aoa.org/x4813.xml US Census: http://www.census.gov/main/www/popclock.html
  • 72. According to Statistics Canada, the population of Canada, as of January 1, 2011, is estimated to be 34,278,400. Amblyopia 2% (686,568) Strabismus 2-5% (1,713,920) Accommodation 2.5-9.2% (3,085,056) Eye Coordination (CI 7%) Up to 25% (8,569,600) Vertical Misalignment 7-52% (17,842,768)
  • 73. Toronto, has a population of 2.48 million people (5.5 million in the GTA - Greater Toronto Area)
  • 74. Chicago is only a bit more than an hour plane ride from Toronto…so if you don‟t want to care for these folks….
  • 75. How to Dx an Individual with 3D Vision Syndrome Examination Sequence Comprehensive Visual Efficiency/Strabismus/Amblyopia Special Testing (Visagraph, TOVA, etc)
  • 76. How to Dx an Individual with 3D Vision Syndrome Case Hx Salient Findings
  • 77. How to Tx an Individual with 3D Vision Syndrome We really don‟t know the best methodology/approach.
  • 78. How to Tx an Individual with 3D Vision Syndrome Use what we do know Rx/Prism Optometric Vision Therapy
  • 79. These are your patient‟s eyes…. These are your patient‟s eyes On 3D!
  • 80. 3D Vision Syndrome Single Subject Design Research Study Patient #1 Symptoms: blurred vision, double vision, nausea, headache, dizziness while watching 3D movie 80/128
  • 81. 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
  • 82. 3D Vision Syndrome Patient #1 Initial Findings VA‟s CLS RE/LE 20/20 OR RE -.25, LE PL Acceptable Fit MR RE -4.25-50X175 20/15, LE -4.00-.50X175 20/15 Pursuits/Saccades +4 CT 18 XOP @ near 2nd Degree Fusion Variable
  • 83. 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
  • 84. 3D Vision Syndrome Patient #1 Initial Findings Accommodative Facility diplopia MEM variable Ocular health mild allergic conjunctivitis
  • 85. 3D Vision Syndrome Patient #1 Diagnosis Convergence insufficiency Accommodative dysfunctions Headache Diplopia Allergic conjunctivitis
  • 86. 3D Vision Syndrome Patient #1 Plan Obtain past records Start Optometric Vision Therapy
  • 87. 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 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
  • 89. Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol. 2008 Oct;126(10):1336-49. Convergence Insufficiency Treatment Trial Study Group. CONCLUSIONS: Twelve weeks of OBVAT results in a significantly greater improvement in symptoms and clinical measures of near point of convergence and positive fusional vergence and a greater percentage of patients reaching the predetermined criteria of success compared with HBPP, HBCVAT+, and OBPT. Application to Clinical Practice Office-based vergence accommodative therapy is an effective treatment for children with symptomatic convergence insufficiency.
  • 90. Scheiman M, Cotter S, Kulp MT, Mitchell GL, Cooper J, Gallaway M, Hopkins KB, Bartuccio M, Chung I; the Convergence Insufficiency Treatment Trial Study Group. Treatment of Accommodative Dysfunction in Children: Results from a Randomized Clinical Trial. Optom Vis Sci. 2011 Nov;88(11):1343- 1352. CONCLUSIONS: Vision therapy/orthoptics is effective in improving accommodative amplitude and accommodative facility in school-aged children with symptomatic CI and accommodative dysfunction. 90/128
  • 91. Long-term effectiveness of treatments for symptomatic convergence insufficiency in children. Optom Vis Sci. 2009 Sep;86(9):1096-103. Convergence Insufficiency Treatment Trial Study Group. CONCLUSIONS: Most children aged 9 to 17 years who were asymptomatic after a 12-week treatment program of OBVAT for convergence insufficiency maintained their improvements in symptoms and signs for at least 1 year after discontinuing treatment. ….
  • 92. Scheiman M, Mitchell GL, Cotter S, Kulp MT, Cooper J, Rouse M, Borsting E, London R, Wensveen J. A randomized clinical trial of vision therapy/orthoptics versus pencil pushups for the treatment of convergence insufficiency in young adults. Optom Vis Sci. 2005 Jul;82(7):583-95. DISCUSSION: In this study, vision therapy/orthoptics was the only treatment that produced clinically significant improvements in the near point of convergence and positive fusional vergence. …… Pencil Push ups do not work very well!
  • 93. Ciuffreda KJ. The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders. Optometry. 2002 Dec;73(12):735-62. BACKGROUND: For nearly 75 years, optometric vision therapy has been an important mode of therapy for both children and adults who manifested a range of nonstrabismic accommodative and vergence disorders. METHODS: In this article, the scientific basis for, and efficacy of, optometric vision therapy in such patients will be discussed. Using bio-engineering models of the oculomotor system as the conceptual framework, emphasis will be focused on studies that used objective recording techniques to directly assess therapeutically related changes in oculomotor responsivity. RESULTS AND CONCLUSIONS: The findings clearly support the validity of optometric vision therapy. Furthermore, the results are consistent with the tenets of general motor learning.
  • 94. Maino D. The number of placebo controlled, double blind, prospective, and randomized strabismus surgery outcome clinical trials: None! Optom Vis Dev 2011;42(3):134-136. http://www.covd.org/Portals/0/OVD/42-3/Editorials/OVD%2042- 3%20Journal_Editorial_Maino_web.pdf
  • 95. 3D Vision Syndrome Patient #1 Optometric Vision Therapy Phase 1 Phase 2 Phase 3 Phase 4 Mono Biocular Binocular Integration Oculo- add anti- add Stabilization Motor, suppression vergence HE, Acc 3 month post OVT maintenance Tx and final progress evaluation
  • 96. Use principles of neuro-plasticity therapy: Maino D. Neuroplasticity: Teaching an Old Brain New Tricks. Rev Optom 2009. 46(1):62- 64,66-70
  • 97. 3D Vision Syndrome Patient #1 Optometric Vision Therapy OVT #1 HC Saccades HC Rock HTS (saccades, pursuits, accommodation Brockstring HVT Sent Home all of the above
  • 98. 3D Vision Syndrome Patient #1 Optometric Vision Therapy OVT #2 Reviewed HVT Vision Builder (saccades Franzblau Red Rock Brockstring
  • 99. 3D Vision Syndrome Patient #1 Optometric Vision Therapy OVT #3 Reviewed HVT Minus lens dips HC accom rock Vision Builder (binoc reading) Quoits
  • 100. 3D Vision Syndrome Patient #1 Optometric Vision Therapy OVT #4 Reviewed HVT Vision Builder Randot vergence Eccentric Circles Quoits 100/128 Photo credit VisionHelpBlog
  • 101. 3D Vision Syndrome Patient #1 Optometric Vision Therapy 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
  • 102. 3D Vision Syndrome Patient #1 Optometric Vision Therapy OVT #6 Review HVT ECC Vectogram Jump Vergence Lifesaver Cards
  • 103. 3D Vision Syndrome Patient #1 Optometric Vision Therapy 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 Facility 8 CPM RE, 11 CPM LE, LE -3.250.75X005 20/20 10 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 all resolved
  • 104. 3D Vision Syndrome Patient #1 Optometric Vision Therapy OVT #7 Clown vectograms (push BI) Chicago Skyline (jump)
  • 105. 3D Vision Syndrome Patient #1 Optometric Vision Therapy 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!
  • 106. 3D Vision Syndrome Patient #1 Optometric Vision Therapy Progress Evaluation #2 1 month later Majority of symptoms resolved BVA 20/20 RE, LE Amps 8.33 RE/LE Slight + CL OR NRA +2.50 CT ortho/2 EXO PRA -2.25 NPC TN Facility 6 RE, 7LE, 8 OU CPM no After 5 trials TN suppression NPC with RL 7/10 cm MEM +.50 RE, LE Vergence dist BI x/14/10 BO X/30/25 RTO 6 mos CEE, intermittently do Near BI 16/12 BO 35/25 HVT W4D 4 all distances Random Dot 25‟ Pur/Sac +4
  • 107. Started Here: Ended Here: VA‟s CLS RE/LE 20/20 Majority of symptoms resolved OR RE -.25, LE PL Acceptable Fit BVA 20/20 RE, LE MR RE -4.25-50X175 20/15, Slight + CL OR LE -4.00-.50X175 20/15 Pur/Sac +4 Pursuits/Saccades +4 CT ortho/2 EXO, NPC TN CT 18 XOP @ near After 5 trials TN NPC 2/6/4” NPC with RL 7/10 cm After 5 attempts pain noted Vergence dist BI x/14/10 PFV/NFV @ near could not BO X/30/25 do/diplopia Near BI 16/12 BO 35/25 W4D Fusion Variable W4D 4 all distances, Random Random Dot 100” (?) Random Dot 25‟ - Lens amplitudes could not Amps 8.33 RE/LE do NRA +2.50, PRA -2.25 NRA +2.00 diplopia Facility 6 RE, 7LE, 8 OU CPM PRA -1.00 no suppression MEM +.50 RE, LE
  • 108. 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!”
  • 109. Computer Programs Used in Optometric Vision Therapy Computer Aided Home Therapy Solutions Vision Therapy
  • 110. 3D as a Public Information and Marketing Tool 3D in the News-Print Media-Internet In Your Office-3D Pictures-Newsletters Website/Blog/Facebook/SOVOTO/LinkedIn Media Awareness! 110/128
  • 111. 3D in the News ABC Chicago http://abclocal.go.com/wls/stor y?section=news/health&id=72 98893
  • 114. Diagnosis Maino D. Brock String Debuts at 2011 Consumer Electronics Show. Optom Vis Dev 2011;42(1):6-9.
  • 116. Blogs
  • 118. Radio
  • 121. Pacific Eye Clinic Beaverton Opens 3D Performance Eye Clinic
  • 122.
  • 123. The 3D’s of 3D Viewing: Discomfort, Dizziness and Lack of Depth Discomfort Dizziness Lack of Depth
  • 124. The 4th D of 3D Viewing The fourth “D” of 3D Viewing should be to call your…. Doctor of Optometry
  • 125. 3D in the Classroom: See Well, Learn Well
  • 126. 3D Resources AOA http://www.aoa.org American Academy of Optometry http://www.aaopt.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/
  • 128. Questions? Dominick M. Maino, O.D., M.Ed., F.A.A.O., F.C.O.V.D-A. Professor, Pediatrics/Binocular Vision Service Illinois College of Optometry Illinois Eye Institute 3241 S. Michigan Ave. Chicago, Il. 60616 312-949-7280 (Voice) 312-949-7358 (fax) dmaino@ico.edu MainosMemos.blogspot.com www.ico.edu nw.optometry.net