The Circle of Least Confusion


Charlie Fitzpatrick, President of NJSOP, sent an email with news from Ophthalmology Times that the AAO (American Academy of Ophthalmology) has figured out that headache and tired eyes associated with with 3-D games may indicate “eye disorder”.  The item was based on a consumer alert issued by the AAO through its eyeSmart portal regarding children’s vision and eye health and 3-D digital products.  The alert concludes that children who have conditions such as amblyopia and strabismus, or “other conditions that persistently inhibit focusing, depth perception or normal 3-D vision” (though we’re not told what those conditions might be) would have difficulty seeing digital 3-D images. Individuals who have these vision disorders may be more likely to experience headaches and/or eye fatigue when viewing 3-D digital images. If such problems occur, the Academy recommends that the child be given a comprehensive exam by an ophthalmologist.

What’s the logic behind the AAO release, other than as a reaction to the release issued by the American Optometric Association (AOA) two weeks prior?

In fact, if I’m a consumer, I might be just a bit confused.  Looking at the AAO eyeSmart site, I’d see the following information about 3D media:

“Some people complain of headaches or motion sickness when viewing 3-D, which may indicate that the viewer has a problem with focusing or depth perception. Also, the techniques used to create the 3-D effect can confuse or overload the brain, causing some people discomfort even if they have normal vision. Taking a break from viewing usually relieves the discomfort.”

See the circular logic here?  According to the AAO, if you experience problems viewing 3D media, it may signal that you have an eye disorder.  If you have strabismus, you simply won’t see 3D – but you won’t have any discomfort.  If you experience blur, headaches, fatigue or motion sickness, you or your child should see an ophthalmologist.  But what’s the ophthalmologist going to tell you?  That’s right:  Taking a break from viewing usually relieves the discomfort.

But gee, couldn’t I have figured that out by myself?  How much more insightful is that than “If it hurts when you laugh, take breaks from laughing.”  More importantly, what if I’m one of those for whom taking a break doesn’t relieve the discomfort?  If this turns out to be a sign that I have one of those conditions that “persistently inhibits focusing, depth perception or normal 3-D vision”, what can I do about it?

You see where I’m going with this.  Nowhere is the possibility raised by the AAO that the symptoms associated with 3D viewing might be alleviated with vision therapy.  Ironically, under Eye Smart Tips, under the item “Know Your Eye Care Team”, the AAO writes:  Make sure you are seeing the right eye care provider for your condition or treatment.

Here’s a thought question for you:  If you have 3D viewing symptoms not relieved by taking breaks, how would you know if you’re seeing the right eye care provider for your condition or treatment?  Perhaps the easiest clue would be that the guidance you’re given doesn’t have you running around in circles, or resigned to just having to live with it.

– Leonard J. Press, O.D. FCOVD, FAAO

3 thoughts on “The Circle of Least Confusion

  1. I am blesses to have Dr. Nancy Torgerson as my vision therapy Doctor in Lynnwood WA. She is an amazing Doctor and woman It was through her recommendation I found this site. SHE IS A LONG TIme FRIEND, NEIGHBOR AND COLLEIGUE OF Dr. Etting the origionator of Vision Therapy.

  2. The growing issue of 3-D technology development/viewing is certainly the newest opportunity for those of us in the Vision Therapy business to educate consumers about 3-D issues. We are uniquely positioned for outreach and are the best equipped from my perspective. One could say it is also our responsibility to help eliminate confusion, and we have a big job ahead of us to not only educate consumers but to clearly define our place and elevate our profession as service providers amongst eyecare professionals. Behavioral Optometry needs to be offered by the AAO as a viable option for evaluation of 3-D viewing issues. Behavioral OD’s need to get busy communicating with the AAO and request inclusion into their analysis, as we include them. Everyone needs to acknowledge our clearly defined specialties, and we need develop sensible referral relationships.
    Here is what we are doing to educate the public about Vision Therapy at our clinic. As part of my job as a Certified Vision Therapist, I visit the teachers of our young patients with the doctor’s report; give talks to teacher teams, PTA’s, parent and homeschool groups; and put fingers to keyboard writing newsletters and letters to editors as 3-D viewing/technology continues to be discussed in the mainstream press. I welcome others to consider a position such as mine as part of their business model, and to offer other suggestions for outreach that I have not thought of. All outreach efforts make a difference to grow our profession in the collective consciousness.

    • I love your enthusiasm, Lisa! Couldn’t agree with you more. Regarding the AAO (Ophthalmology) being inclusive of Optometry, I remain open-minded and receptive, but also very pragmatic. In a perfect world, ophthalmologists when asked about these issues would simply say: “It’s not my field. Ask the Optometrists about it – they are the visual expects in visual performance as related to binocular dysfunction.”

      Perhaps one day someone can explain to me satisfactorily why the AAO in particular, and Ophthalmology in general (not to mention pediatricians and other select professionals under their influence) is so intent on trying to discredit our work and contributions to the public welfare, beyond all the obvious “cats and dogs” reasons that I’ve referred to previously (see https://visionhelp.wordpress.com/author/pressvision/page/6/). I would gladly beat my sword into a ploughshare if the AAO/Ophthalmology can get over its paranoia and insecurity about Optometry. At every opportunity, at the local level, when my patient benefit from collaboration with OMDs an other MDs I do whatever is in the patient’s best interest without hesitation. I acknowledge that I don’t have a monopoly on ocular or visual knowledge.

      Regarding your thoughts on being proactive about getting the word out on 3D, I would encourage all AOA members to join AOA Connect, and then sign up for the 3D group. Dr Dominick Maino has gotten it off to a great start by posting his blog info on the subject.
      http://connect.aoa.org/forums/Topic4457282-7783-1.aspx

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