CLINICAL

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3D and Binocular Vision Dysfunction

How you can raise awareness of this common, yet often undiagnosed, problem

IRVING BENNETT, O.D., BEAVER FALLS, PA., AND FLOYD MIZENER, O.D., DOWNERS GROVE, ILL.

The excitement of the early years of optometry when workable contact lenses were first introduced, when a scratch-resistant plastic material replaced glass in ophthalmic lenses and when designer frames became profit centers for many practices is now being replicated in today’s fast-moving society with an old optometric mainstay: binocular dysfunction.

The AOA estimates that nearly 25% of the American public has binocular vision dysfunction. However, many cases go undiagnosed because O.D.s do not always test for and, therefore, do not discover and correct problems of fusion due to inadequately compensated phorias. What’s more, patients rarely complain about this because they have never seen binocularly, so they do not know what they are missing — or what to complain about.

However, the re-emergence of 3D entertainment is shining a new light on this problem. Optometrists are in a unique and exceptional position to revive the century-old skill of making sure patients not only see with their two eyes, but that they use their two eyes at the same time.

The time is now to help raise awareness in your practices and in your communities. Here are a few ideas to consider:

A sample 3D poster from Classic Cinemas.

Test for binocularity

A comprehensive eye exam includes measuring phorias or testing for binocularity. Although a significant number of patients with binocular vision dysfunction can be corrected with ophthalmic lenses and prism, some patients need a referral for additional care. If you do not offer vision therapy in your practice, refer patients for further treatment. The College of Optometrists in Vision Development (www.covd.org) provides the names of optometrists who offer vision therapy in your area.

Educate your patients and community

Talk to your patients — and your community — about the importance of testing for binocular vision dysfunction. Let them know that you test for it not only because it is an impediment to seeing and appreciating 3D movies, but the condition also hinders reading and learning and affects good, safe driving.

Hanging 3D posters in high-traffic areas, such as at check-in, is an effective icebreaker and will help create interest among your patients and their family and friends who accompany them to your practice. Classic Cinemas, in Downers Grove, Ill., offers a free colorful sample poster with a blank space to add your logo. (Contact Classic Cinemas for more information: wjohnson@classiccinemas.com.)

To help facilitate the binocular vision dysfunction conversation both in and out of the office, we developed two educational handouts, with cooperation from the Illinois Optometric Association. You can acquire these by contacting the Illinois Optometric Association (ioaed@ioaweb.org).

The first handout was developed specifically for theatre patrons. It explains that the discomfort, dizziness and lack of depth that those who attend a 3D movie may experience can be the result of binocular vision dysfunction. It also suggests how to find an eye doctor. Talk with local theatres, and ask them to pass this handout to patrons.

The second handout was developed for optometrists to give to patients after their eye examinations. This leaflet fortifies the message of the one given out at cooperating theaters and goes into a bit more detail.

Both handouts should be placed in your reception area for patients to take. Also, the information can be included in a patient newsletter or shared online via your practice website or social media pages. Not only will these handouts create interest among your patients, they will elicit questions and open up the subject for discussion.

Train your staff

It’s important your staff understands that 20/20 means only that someone sees a sized 20 letter at 20 feet and does not mean that that person sees with both eyes together at the same time. The same resources designed for patient use can be employed for staff training and education as well. In addition, the AOA has contributed significantly to public awareness regarding binocular vision dysfunction. You can access this information at www.3deyehealth.org.

Remember, an educated staff can often do more than you can in getting prospective patients to understand how both eyes must work together to see depth.

Spread the word

Binocular dysfunction is a common problem, but is uncommonly diagnosed. But with the popularity of 3D technology, the time is now to increase awareness. The more often you spread the word on the need for comprehensive eye exams, the better job you do for the public, for your profession and, of course, for yourself. OM

	Dr. Bennett is an author and the former editor of OM and the Journal of the American Optometric Association. He practiced optometry in Beaver Falls, Pa., for 45 years.
	Dr. Mizener practiced in Downers Grove, Ill. He received the Eye Care Professional of Year award from the International 3D and Advanced Imaging Society in 1948. Send comments to optometricmanagement@gmail.com.