The Effect of 3D Visual Simulator on Children’s Visual Acuity - A Pilot Study Comparing Two Different Modalities

Purpose : To evaluate the efficacy of two non-surgical interventions of vision improvement in children. Methods : A prospective, randomized, pilot study to compare fogging method and the use of head mounted 3D display. Subjects were children, between 5 to 15 years old, with normal best corrected visual acuity (BCVA) and up to -3D myopia. Subjects played a video game as near point work, and received one of the two methods of treatments. Measurements of uncorrected far visual acuity (UCVA), refraction with autorefractometer, and subjective accommodative amplitude were taken 3 times, at the baseline, after the near work, and after the treatment. Results : Both methods applied after near work, improved UCVA. Head mounted 3D display group showed significant improvement in UCVA and resulted in better UCVA than baseline. Fogging group showed improvement in subjective accommodative amplitude. While 3D display group did not show change in the refraction, fogging group’s myopic refraction showed significant increase indicating the eyes showed myopic change of eyes after near work and treatment. Discussion : Despite our lack of clear knowledge in the mechanisms, both methods improved UCVA after the treatments. The improvement in UCVA was not correlated to measured refraction values. Conclusion : UCVA after near work can be improved by repeating near and distant accommodation by fogging and 3D image viewing, although at the different degrees. Further investigation on mechanisms of improvements and their clinical significance are warranted.

[1]  N. Mcbrien,et al.  The M1 muscarinic antagonist pirenzepine reduces myopia and eye enlargement in the tree shrew. , 1996, Investigative ophthalmology & visual science.

[2]  A. Sjølie,et al.  The importance of genes and environment for ocular refraction and its determiners: a population based study among 20–45 year old twins , 2001, The British journal of ophthalmology.

[3]  H. Price,et al.  Aberration control and vision training as an effective means of improving accommodation in individuals with myopia. , 2009, Investigative ophthalmology & visual science.

[4]  E. G. D. L. Cera,et al.  Longitudinal changes of optical aberrations in normal and form-deprived myopic chick eyes , 2006, Vision Research.

[5]  D. Azar,et al.  Myopia and models and mechanisms of refractive error control. , 2002, Ophthalmology clinics of North America.

[6]  Yingfeng Zheng,et al.  Prevalence of Myopia in Urban and Rural Children in Mainland China , 2009, Optometry and vision science : official publication of the American Academy of Optometry.

[7]  S. Saw,et al.  Myopia: attempts to arrest progression , 2002, The British journal of ophthalmology.

[8]  C. Cedrone,et al.  Standardized measurement of visual acuity. , 1998, Ophthalmic epidemiology.

[9]  Tae-Sun Choi,et al.  Depth Map and 3D Imaging Applications: Algorithms and Technologies , 2011 .

[10]  J. Atkinson,et al.  Infant Hyperopia: Detection, Distribution, Changes and Correlates—Outcomes From the Cambridge Infant Screening Programs , 2007, Optometry and vision science : official publication of the American Academy of Optometry.

[11]  D. Mutti,et al.  Interventions to slow progression of myopia in children. , 2011, The Cochrane database of systematic reviews.

[12]  T. Degtyarenko,et al.  Changes in visual evoked potentials after phosphene electrostimulation in children suffering from myopia , 2008, Neurophysiology.

[13]  Mark J Elder,et al.  A systematic review of the applicability and efficacy of eye exercises. , 2005, Journal of pediatric ophthalmology and strabismus.

[14]  B. Gilmartin A REVIEW OF THE ROLE OF SYMPATHETIC INNERVATION OF THE CILIARY MUSCLE IN OCULAR ACCOMMODATION , 1986, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[15]  B Gilmartin,et al.  Adaptation of Tonic Accommodation to Sustained Visual Tasks in Emmetropia and Late-Onset Myopia , 1991, Optometry and vision science : official publication of the American Academy of Optometry.

[16]  N. Mcbrien,et al.  Pressure-induced changes in axial eye length of chick and tree shrew: significance of myofibroblasts in the sclera. , 2004, Investigative ophthalmology & visual science.

[17]  J T Holladay,et al.  Proper method for calculating average visual acuity. , 1997, Journal of refractive surgery.

[18]  Tomoki Shiomi,et al.  Simultaneous measurement of lens accommodation and convergence in natural and artificial 3D vision , 2013 .

[19]  Hiroki Takada,et al.  Effect of Accommodation Training on Visual Function of Visual Inspection Workers and Middle-Aged People , 2012 .

[20]  Susan Vitale,et al.  Prevalence of refractive error in the United States, 1999-2004. , 2008, Archives of ophthalmology.

[21]  T. Ho,et al.  Effects of different concentrations of atropine on controlling myopia in myopic children. , 1999, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[22]  Hiroki Takada,et al.  Effect of strategic accommodation training by wide stereoscopic movie presentation on myopic young people of visual acuity and asthenopia , 2011, Displays.

[23]  M. F. Wesner,et al.  Instrument myopia conceptions, misconceptions, and influencing factors , 1986, Documenta Ophthalmologica.

[24]  T T Norton,et al.  Animal models of emmetropization: matching axial length to the focal plane. , 1995, Journal of the American Optometric Association.

[25]  Hiroki Takada,et al.  Effectiveness of New Technology to Compose Stereoscopic Movies , 2012 .

[26]  A. Kuo,et al.  Distribution of refractive error in healthy infants. , 2003, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[27]  N. Mcbrien,et al.  Atropine reduces experimental myopia and eye enlargement via a nonaccommodative mechanism. , 1993, Investigative ophthalmology & visual science.

[28]  Yu-Chen Lee,et al.  A combined therapy using stimulating auricular acupoints enhances lower-level atropine eyedrops when used for myopia control in school-aged children evaluated by a pilot randomized controlled clinical trial. , 2008, Complementary therapies in medicine.

[29]  C. Westall,et al.  Time courses for maturation of electroretinogram responses from infancy to adulthood , 1998, Documenta Ophthalmologica.

[30]  Pamela J Blade,et al.  Validation of the PowerRefractor for Measuring Human Infant Refraction , 2006, Optometry and vision science : official publication of the American Academy of Optometry.

[31]  M. Devoto,et al.  Genetic linkage study of high-grade myopia in a Hutterite population from South Dakota , 2007, Molecular vision.

[32]  Paul Mitchell,et al.  Outdoor activity reduces the prevalence of myopia in children. , 2008, Ophthalmology.

[33]  Ann Nour,et al.  Visual Psychophysics and Physiological Optics The Effect of Simultaneous Negative and Positive Defocus on Eye Growth and Development of Refractive State in Marmosets , 2012 .

[34]  H. Taylor,et al.  A myopic shift in Australian Aboriginals: 1977-2000. , 2003, Transactions of the American Ophthalmological Society.

[35]  George Mcmahon,et al.  Time outdoors and physical activity as predictors of incident myopia in childhood: a prospective cohort study. , 2012, Investigative ophthalmology & visual science.

[36]  Dependence of the Curative Effects of Phosphene Electrostimulation on Its Frequency in Patients with Myopia , 2002, Neurophysiology.

[37]  V. Sreenivas,et al.  Refractive Status at Birth: Its Relation to Newborn Physical Parameters at Birth and Gestational Age , 2009, PloS one.

[38]  C. S. Lam,et al.  The epidemiology of myopia in Hong Kong. , 2004, Annals of the Academy of Medicine, Singapore.

[39]  D. Mutti To emmetropize or not to emmetropize? The question for hyperopic development. , 2007, Optometry and vision science : official publication of the American Academy of Optometry.

[40]  A. Gorkovenko,et al.  Effect of cold stimulation of the arm fingers on the spectral/coherent EEG characteristics in humans , 2008, Neurophysiology.

[41]  J T Holladay,et al.  The relationship of visual acuity, refractive error, and pupil size after radial keratotomy. , 1991, Archives of ophthalmology.

[42]  Hema Radhakrishnan,et al.  Peripheral refraction and the development of refractive error: a review , 2010, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[43]  Y. Cheung,et al.  Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2). , 2012, Ophthalmology.

[44]  J. Gwiazda Treatment options for myopia. , 2009, Optometry and vision science : official publication of the American Academy of Optometry.

[45]  B. Gilmartin,et al.  The relationship between tonic accommodation and ciliary muscle innervation. , 1985, Investigative ophthalmology & visual science.