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      Comparison of Objective and Subjective Changes Induced by Multiple-Pinhole Glasses and Single-Pinhole Glasses

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          Abstract

          Multiple-pinhole (MPH) glasses are currently sold in many countries with unproven advertisements; however, their objective and subjective effects have not been investigated. Therefore, to investigate the effects of MPH glasses excluding the single-pinhole (SPH) effect, we compared the visual functional changes, reading speed, and ocular discomfort after reading caused by MPH and SPH glasses. Healthy 36 participants with a mean age of 33.1 years underwent examinations of pupil size, visual acuity (VA), depth of focus (DOF), and near point accommodation (NPA); tests for visual field (VF), contrast sensitivity (CS), stereopsis, and reading speed; and a survey of ocular discomfort after reading. Both types of pinhole glasses enlarged pupil diameter and improved VA, DOF, and NPA. However, CS, stereopsis, and VF parameters deteriorated. In comparison with SPH glasses, MPH glasses induced smaller pupil dilation (5.3 and 5.9 mm, P < 0.001) and showed better VF parameters with preserved peripheral VF. However, no significant difference was observed for VA, DOF, NPA, stereopsis, and CS. Reading speed using pinhole glasses was significantly slower than baseline; SPH glasses showed the slowest reading speed. Both types of glasses caused significant ocular discomfort after reading compared with baseline, and symptoms were worst with MPH glasses. In conclusion, both types of pinhole glasses had positive effects due to the pinhole effect; however, they had negative effects on VF, CS, stereopsis, reading speed, and ocular discomfort. In spite of the increased luminance and preserved peripheral VF with MPHs, these glasses caused more severe ocular discomfort than SPH glasses. This clinical trial was registered at www.ClinicalTrials.gov (Identifier: NCT02572544).

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          The development of a symptom questionnaire for assessing virtual reality viewing using a head-mounted display.

          Virtual reality devices, including virtual reality head-mounted displays, are becoming increasingly accessible to the general public as technological advances lead to reduced costs. However, there are numerous reports that adverse effects such as ocular discomfort and headache are associated with these devices. To investigate these adverse effects, questionnaires that have been specifically designed for other purposes such as investigating motion sickness have often been used. The primary purpose of this study was to develop a standard questionnaire for use in investigating symptoms that result from virtual reality viewing. In addition, symptom duration and whether priming subjects elevates symptom ratings were also investigated. A list of the most frequently reported symptoms following virtual reality viewing was determined from previously published studies and used as the basis for a pilot questionnaire. The pilot questionnaire, which consisted of 12 nonocular and 11 ocular symptoms, was administered to two groups of eight subjects. One group was primed by having them complete the questionnaire before immersion; the other group completed the questionnaire postviewing only. Postviewing testing was carried out immediately after viewing and then at 2-min intervals for a further 10 min. Priming subjects did not elevate symptom ratings; therefore, the data were pooled and 16 symptoms were found to increase significantly. The majority of symptoms dissipated rapidly, within 6 min after viewing. Frequency of endorsement data showed that approximately half of the symptoms on the pilot questionnaire could be discarded because <20% of subjects experienced them. Symptom questionnaires to investigate virtual reality viewing can be administered before viewing, without biasing the findings, allowing calculation of the amount of change from pre- to postviewing. However, symptoms dissipate rapidly and assessment of symptoms needs to occur in the first 5 min postviewing. Thirteen symptom questions, eight nonocular and five ocular, were determined to be useful for a questionnaire specifically related to virtual reality viewing using a head-mounted display.
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            Effect of size of pupil on visual acuity.

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              Effects of aniseikonia, anisometropia, accommodation, retinal illuminance, and pupil size on stereopsis.

              The sensitivity of clinical measures of stereoacuity in the detection of interocular differences in retinal images was examined in 50 adults with normal binocularity. Interocular differences in retinal image size (aniseikonia), clarity (anisometropia) and brightness, as well as differences in absolute and relative pupil size (anisocoria) were created in small steps over a large range to determine their effect on threshold levels of stereopsis. Their effect on stereoacuity was measured in both contour (Titmus test) and random dot (Randot test) stereograms. Stereoacuity measured by both types of stereograms decreased in a curvilinear manner for aniseikonic and anisometropic test conditions. Monocular blur caused a more rapid decrease in stereoacuity than induced aniseikonia. Stereoacuity measured by the contour stereogram decreased about 1.8 times faster than that measured by the random dot stereogram during induced aniseikonia and anisometropia. This differential sensitivity suggests that the Titmus test would detect small interocular differences in retinal images more effectively than the Randot test in clinical screening procedures for vision abnormalities. However, both tests can miss clinically significant amounts of aniseikonia and anisometropia, and fail to differentiate the cause of reduced stereopsis. Interocular differences in retinal image brightness and pupil size within a normal physiologic range did not reduce stereopsis to clinically unacceptable levels.
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                Author and article information

                Journal
                J Korean Med Sci
                J. Korean Med. Sci
                JKMS
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                1011-8934
                1598-6357
                May 2017
                17 March 2017
                : 32
                : 5
                : 850-857
                Affiliations
                [1 ]Department of Ophthalmology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea.
                [2 ]Department of Ophthalmology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Korea.
                [3 ]YK Eye Clinic, Seoul, Korea.
                Author notes
                Address for Correspondence: Yeoun Sook Chun, MD. Department of Ophthalmology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea. yschun100@ 123456hanmail.net
                Author information
                http://orcid.org/0000-0002-4416-2197
                http://orcid.org/0000-0003-1266-1693
                http://orcid.org/0000-0001-9887-9620
                http://orcid.org/0000-0002-2752-8185
                Article
                10.3346/jkms.2017.32.5.850
                5383620
                28378561
                738a18c0-e031-4060-b0d7-d3f233abb206
                © 2017 The Korean Academy of Medical Sciences.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 September 2016
                : 03 February 2017
                Funding
                Funded by: Korean Optometry Society;
                Award ID: 20140001
                Categories
                Original Article
                Ophthalmology

                Medicine
                pinhole glasses,reading speed,visual function
                Medicine
                pinhole glasses, reading speed, visual function

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