Visual Discomfort While Viewing Three-dimensional Television as a Screening Tool for Pediatric Eye Diseases in Children

Purpose: To investigate the efficacy of evaluating 3D asthenopia and 3D perception difficulty for screening of binocular vision abnormalities in children. Methods: Patients aged 6–12 years with abnormal binocularity, including strabismus, amblyopia, and anisometropia, were included. Age-matched normal subjects without any ophthalmologic abnormality other than a refractive error were also recruited. The best-corrected visual acuity, refractive error, angle of strabismus, and stereopsis were measured. Presenting visual acuity (PVA) was measured as the uncorrected visual acuity for subjects without glasses and spectacle-corrected visual acuity for those with glasses. After watching 3D TV for 30 min, a survey was administered to evaluate the 3D perception and 3D asthenopia. Receiver operation characteristic (ROC) curve analysis was conducted to evaluate the efficacy of the survey for detecting abnormal binocularity and poor PVA. Results: One hundred subjects were enrolled in this study. Among them, 59 had abnormal binocularity (strabismus, anisometropia, or amblyopia), and 41 were normal control. Among the entire subjects, the number of subjects with a PVA of 20/40 or worse in one or both eyes was 24 (7 from the normal control and 17 with abnormal binocularity). ROC curve analysis revealed that the survey did not effectively detect strabismus, anisometropia, or amblyopia. However, for detection of PVA 20/40 or worse in the subjects with abnormal binocularity, the total score of the survey yielded an area of 0.714 under the ROC curve (p = 0.010). The sensitivity was 88.2% and specificity was 61.9% with a cutoff at 0.50. Conclusion: The degree of 3D asthenopia and 3D perception while watching 3D TV were not effective for screening of abnormal binocularity. However, evaluation of the severity of 3D asthenopia and the quality of 3D perception can help screen of decrease in PVA that requires correction.