Research has shown that up to 56% of those 18 to 38 years of age have one or more problems with binocular vision and therefore could have difficulty seeing 3-D.[i] In addition, about five percent of the population have amblyopia (lazy eye) and/or strabismus (eye turn) which makes 3-D viewing impossible.

Unfortunately, not all people are able to see 3 dimensional images (stereovision, stereopsis), or 3D. Many people see a 2 dimensional, or flat world, and don’t know it because they have never experienced the pleasure of seeing in 3D. Vision problems such as strabismus (eye turn), amblyopia (lazy eye), or poor binocular skills (eyes drift apart) can interfere with the ability to see true 3D. In order to see in 3D, your eyes need to work together as a team to align the images from each eye, then the brain fuses the images into a 3 dimensional image.

For example, the 3-D version of the movie Avatar has two images projected on the screen, each image seen by one eye. The images are then merged into one by your brain. If your eyes don’t work together, it will be very difficult to merge or fuse the images into 3-D. The technology behind the Avatar 3-D effects is based on the premise that the viewer has the ability to see 3-D. If you have poor eye coordination, or a lazy eye, 3D television will also look flat to you (2 dimensional), and objects will not “pop off the screen”.

These vision problems affect more than just your ability to see 3D movies. They also impair depth perception, your ability to know where objects are located in space, eye hand and eye body coordination for driving and sports, and reading efficiency and comfort. Over time, if the eyes do not coordinate and work together, the brain ignores one image to avoid seeing double vision. This results in seeing a flat or 2D world.

But there is hope. Thanks to Optometric Vision Therapy, people who previously could not see 3-D are enjoying every special effect 3-D movies such as Avatar, and 3-D TV has to offer. There are methods to teach people to see in 3D. Using Vision Therapy and physical aids (lenses and prisms) as “training wheels,” you can eventually learn how to point both eyes to focus on the same space. Visual skills are definitely trainable, so you can learn better eye control and coordination through special Vision Therapy techniques.

This is the number one question I receive regarding strabismus. Most surgeons or ophthalmologists will recommend eye muscle surgery, but cannot guarantee their results.

Most optometrists will recommend Vision Therapy or a type of physical therapy to work on eye muscle coordination and control.

The truth is that there are several options depending on how much you, or your child’s eye is deviating, which direction, how often it drifts, and the age of onset. It’s also important to consider if there are any co-existing neurological factors such as a traumatic brain injury, or acquired brain injury (such as stroke or craniotomy) to determine the potential for improvement.

Surgery alone is never the best option. If you cut the eye muscle, but the brain doesn’t learn how to coordinate the eyes and use them together, the eyes will drift apart again, and another surgery will be necessary. The brain needs to be trained to function as a two eyed system and use the eyes as a team. This will minimize the likelihood of the eyes drifting apart after surgery, and will maximize cosmetic alignment as well as visual function (such as depth perception/stereopsis).

Doing nothing is also not a good option. A patient with strabismus has little to no depth perception which will affect their ability to judge depth and distances such as while driving a car or catching a ball. It will also diminish your reading skills because the brain must ignore or suppress the eye that is deviating to prevent from seeing double vision. This wastes energy and attention is drawn away from the task at hand. Also, when one visual pathway is not stimulated and developed, that side of the brain doesn’t develop, and amblyopia usually occurs where the eye is not correctable to 20/20 vision, even with glasses, contact lenses or LASIK.

Usually the best option is Vision Therapy if the amount of eye drift is small, or intermittent. A combination of surgery and Vision Therapy is best if the deviation is larger.

I am often asked if LASIK or refractive surgery is right for a patient. The answer is, it depends on your eyes, and your lifestyle. Overall, LASIK is very safe. With today’s technology, there are very, very few post-surgical complications  so I can recommend it to my patients. I am very conservative in my treatment, and would only recommend a procedure to my patients that I would recommend to my own family.

That having been said, LASIK is still surgery, and we need to do a pre-operative exam to make sure that your eyes are healthy and suitable for LASIK.
Before you see the surgeon, we evaluate the following aspects of your eyes such as:
* Ultrasound to measure the thickness of your cornea for creation of the flap
* Tear analysis
* Cycloplegic refraction (prescription analysis under dilation)
* Topography (map of corneal surface)
* Pupil measurement
* Lifestyle analysis (to determine the target post surgical prescription goal i.e. monovision, under correction, full distance correction, etc.)

If everything looks good, you’ll meet the surgeon and schedule your procedure.

We will see you after surgery over the next several months to make sure that your eyes have healed properly.

LASIK or refractive surgery can be life changing for some patients as they wake up every morning seeing clearly. It is important to do it correctly, and choose the best surgeon after we’ve determined that your eyes are suited for LASIK.

This is the number one question that I receive from parents. The answer is YES, by 6 months old, and yearly thereafter. The reason is because 80% of the information taken in while reading and writing is through the visual system, so vision problems can interfere significantly with learning. Early vision problems can also delay development in areas such as eye hand and eye body coordination which affect walking, reaching, crawling, and balance for infants and toddlers.
The vision exam needs to evaluate more than the need for glasses and eye health. Developmental or Behavioral Optometrists, such as myself, evaluate for age-appropriate visual motor and visual perceptual skills that affect learning and sports. Visual motor skills that important to learning include eye tracking, teaming and focusing. Visual Perceptual skills include visual memory, visual sequential memory, visual closure, and visual motor integration.

I did a post-doctorate Fellowship in Developmental Optometry or Pediatric Optometry, and serve as a consultant to over 40 schools in Los Angeles. I evaluated my own son at 6 months old, and often play games with him to develop his visual motor and visual perceptual skills since vision is the dominant sense and extremely important to learning and sports.