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      Is Open Access

      Can the Three-Dimensional Heads-Up Display Improve Ergonomics, Surgical Performance, and Ophthalmology Training Compared to Conventional Microscopy?

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          Abstract

          Purpose

          To explore ophthalmic surgeons’ opinions regarding three-dimensional heads-up display (3D HUD) use and investigate musculoskeletal (MSK) complaints among ophthalmologists.

          Methods

          Physicians were invited to complete an online questionnaire. Musculoskeletal complaints and data of the HUD system use were correlated with demographic information. We explored surgeons’ feedback on image quality, depth perception, and the educational value of 3D microscopy.

          Results

          In this study, the prevalence of self-reported MSK pain was 82.6% (n=132). The pain started after joining ophthalmology practice and significantly improves on weekends and vacations. We found that the pain intensity in non-HUD users is higher than in HUD users, but this correlation was not statistically significant. Sixty-one (84.7%) of HUD system users were satisfied with depth perception, and 27 (37.5%) reported improvement in peripheral acuity. Thirty-seven (51.4%) of the participants believed they perform surgeries better through HUD; this was why most participants (83.3%) recommended its use in surgical training.

          Conclusion

          Heads-up display use provides more comfortable sitting positions for surgeons, superior depth perception, and serves as a better educational tool. We believe that adopting this technology may help improve career longevity and productivity.

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          Most cited references28

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          Vergence-accommodation conflicts hinder visual performance and cause visual fatigue.

          Three-dimensional (3D) displays have become important for many applications including vision research, operation of remote devices, medical imaging, surgical training, scientific visualization, virtual prototyping, and more. In many of these applications, it is important for the graphic image to create a faithful impression of the 3D structure of the portrayed object or scene. Unfortunately, 3D displays often yield distortions in perceived 3D structure compared with the percepts of the real scenes the displays depict. A likely cause of such distortions is the fact that computer displays present images on one surface. Thus, focus cues-accommodation and blur in the retinal image-specify the depth of the display rather than the depths in the depicted scene. Additionally, the uncoupling of vergence and accommodation required by 3D displays frequently reduces one's ability to fuse the binocular stimulus and causes discomfort and fatigue for the viewer. We have developed a novel 3D display that presents focus cues that are correct or nearly correct for the depicted scene. We used this display to evaluate the influence of focus cues on perceptual distortions, fusion failures, and fatigue. We show that when focus cues are correct or nearly correct, (1) the time required to identify a stereoscopic stimulus is reduced, (2) stereoacuity in a time-limited task is increased, (3) distortions in perceived depth are reduced, and (4) viewer fatigue and discomfort are reduced. We discuss the implications of this work for vision research and the design and use of displays.
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            HEADS-UP SURGERY FOR VITREORETINAL PROCEDURES: An Experimental and Clinical Study.

            To investigate the feasibility of performing vitrectomies while viewing a three-dimensional image on a large display in a heads-up position.
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              Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists

              Physicians in procedural specialties are at high risk for work-related musculoskeletal disorders (MSDs). This has been called "an impending epidemic" in the context of the looming workforce shortage; however, prevalence estimates vary by study.
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                Author and article information

                Journal
                Clin Ophthalmol
                Clin Ophthalmol
                opth
                clinop
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove
                1177-5467
                1177-5483
                18 February 2021
                2021
                : 15
                : 679-686
                Affiliations
                [1 ]Research Department, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
                [2 ]Department of Physiology, College of Medicine, Al-Imam Mohammed Bin Saud Islamic University , Riyadh, Saudi Arabia
                [3 ]Vitreoretinal Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
                Author notes
                Correspondence: Adel AlAkeely Vitreoretinal Division, King Khaled Eye Specialist Hospital , Uruba Road, Riyadh, 11462, Saudi ArabiaTel +966114821234 Email Aakeely@kkesh.med.sa
                Author information
                http://orcid.org/0000-0003-2522-9234
                Article
                290396
                10.2147/OPTH.S290396
                7901555
                33633441
                81f39321-e568-424d-a40a-92962b8434fa
                © 2021 Bin Helayel et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 05 November 2020
                : 13 January 2021
                Page count
                Figures: 4, Tables: 7, References: 29, Pages: 8
                Funding
                Funded by: any funding: NA;
                Disclosure of any funding: NA.
                Categories
                Original Research

                Ophthalmology & Optometry
                ergonomics,heads-up display,three-dimensional visualization,ophthalmic surgery

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