{Authors note: Coincidently today, just before I was about to publish this blog article, I examined a 5th grade (11 year old) girl who has been struggling to concentrate in school for the last 3 years.  Her teachers thought she had ADHD since she could not concentrate on reading or paper pencil activities for more than a couple minutes. When asked about her interest in the new 3-D movies her mother reported that they just give her a headache and she shuts her eyes! Until recently, her mother never suspect a vision problem since she had always passed the school vision screening with 20/20 eye sight. But, the frustration and headaches with reading prompted her to make an appointment for her daughter to see an optometrist. The primary care optometrist recognized this little girl’s poor attention and concentration was due to a binocular vision problem called convergence insufficiency and referred her to see me for a specific diagnosis and treatment. This article was written for her and the millions of other children who continue to struggle with treatable binocular vision problems (like convergence insufficiency) that causes poor attention, concentration and reduced ability for near-centered visual tasks, such as reading and paper pencil activities. These kids also typically do not enjoy the new 3-D movies because of a condition known as 3-D Vision Syndrome… dizziness, discomfort and poor depth perception  while watching a 3-D movie.}

A link between 3-D Vision Syndrome and a treatable binocular vision problems associated with “ADD-like” behaviors in children is being recognized. Not only has the advent of 3-D technology hit the bit screen, but  soon will become common place in the home as the next wave of 3-D televisions. However, for children to enjoy the 3-D visual experience requires that they have developed an essential visual function called binocular vision. Binocular vision involves the ability to effectively coordinate, focus and move the eyes effortlessly. This eye coordination function develops normally in early childhood for most kids however, research shows that as many as 10-15% of children will have difficulty in binocular function. Some children (3-5%) will have a total lack of binocular ability due to a complete failure of binocular vision known as strabismus. These children will have no appreciation for 3-D movies or 3-D television because these children are completely stereo blind.

On the other hand, another more common form of binocular vision failure affects 7-10% of the population and has more serious symptoms. Stereo blindness is less severe in these cases because these children have the general ability to coordinate their two eyes, however they just do it very poorly! As a result, instead of having fun with the three dimensional entertainment experience, these children will often experience dizziness, visual discomfort and reduced depth perception while watching the 3-D movie; what is now being called the 3-D Vision Syndrome. A look into the cause of this “visual stress”, optometrists will often find that the patient who complains of 3-D Vision Syndrome will have a diagnosis of a binocular vision problem called convergence insufficiency (CI).

It is no strange coincidence that convergence insufficiency (CI) which has been linked with 3-D Vision Syndrome is also associated  with “ADD-like” behaviors in children due to the inability for the CI individual to sustain binocular alignment and focus of the two eyes for near-centered visual tasks such as reading. As a result parents whose children experience dizziness or discomfort associated with a 3-D movie or TV should seek a Doctor of Optometry for a comprehensive vision examination. Don’t forget to mention your child’s symptoms to the doctor as routine eye health and eye sight testing will not identify a child with convergence insufficiency (CI). Rather a battery of specialized tests are necessary to properly diagnose problems with binocular vision such as convergence insufficiency.

When diagnosed with CI a patient can be effectively treated with office-based vision therapy which has been found, though double-blind research, as the only effective treatment yielding an effective “cure” in most individuals. While outcomes can vary, the usual result of office-based vision therapy for CI is complete remediation of the binocular vision dysfunction and improved ability to visually attend and participate in near centered visually demanding tasks. That translates to better concentration and ability to stay on task improving competency for completing reading and homework…and enjoyment of the 3-D movie or TV experience!

Dan L. Fortenbacher, O.D., FCOVD

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