Surgical Endoscopy

, Volume 30, Issue 11, pp 4889–4894 | Cite as

Age is highly associated with stereo blindness among surgeons: a cross-sectional study

  • Charlotte FergoEmail author
  • Jakob Burcharth
  • Hans-Christian Pommergaard
  • Jacob Rosenberg



The prevalence of stereo blindness in the general population varies greatly within a range of 1–30 %. Stereo vision adds an extra dimension to aid depth perception and gives a binocular advantage in task completion. Lack of depth perception may lower surgical performance, potentially affecting surgical outcome. 3D laparoscopy offers stereoscopic vision of the operative field to improve depth perception and is being introduced to several surgical specialties; however, a normal stereo vision is a prerequisite. The aim of this study was to establish the prevalence of stereo blindness among surgeons in the field of general surgery, gynecology, and urology as these are potential users of 3D laparoscopy.


The study was conducted according to the STROBE guidelines for cross-sectional studies. Medical doctors from the department of general surgery, gynecology, and urology were recruited and stereo tested by the use of the Random Dot E stereo test. Upon stereo testing, a demographic questionnaire was completed. Multivariate logistic regression analysis was employed to assess the association between stereo blindness and the variables resulting from the univariate analysis.


Three hundred medical doctors completed the study. Of these 9.7 % were stereo blind. There were 47 % women and 53 % men, aged 25–71 years. General surgery was represented with 64 % of the participants, gynecology with 26 %, and urology with 10 %. Age (OR 5.6; CI 1.7–18.9; P = 0.005) and not being aware of having any vision anomaly in need for correction (OR 4; CI 1.4–11.4; P = 0.010) were significantly associated with stereo blindness.


Approximately one in ten medical doctors in general surgery, gynecology, and urology were stereo blind with an increasing prevalence with age. This is relevant since stereo blind surgeons will not benefit from the implementation of 3D laparoscopy.


3D laparoscopy Stereopsis Stereo blindness Binocular Minimally invasive surgery 


Compliance with ethical standards


Charlotte Fergo, Dr. Jakob Burcharth, Dr. Hans-Christian Pommergaard and Dr. Jacob Rosenberg have no conflicts of interest or financial ties to disclose.


  1. 1.
    Taffinder N, Smith SGT, Huber J, Russell RCG, Darzi A (1999) The effect of a second-generation 3D endoscope on the laparoscopic precision of novices and experienced surgeons. Surg Endosc 13(11):1087–1092CrossRefPubMedGoogle Scholar
  2. 2.
    Smith R, Day A, Rockall T, Ballard K, Bailey M, Jourdan I (2012) Advanced stereoscopic projection technology significantly improves novice performance of minimally invasive surgical skills. Surg Endosc 26(6):1522–1527CrossRefPubMedGoogle Scholar
  3. 3.
    Sahu D, Mathew MJ, Reddy PK (2014) 3D Laparoscopy-help or hype; initial experience of a tertiary health centre. J Clin Diagn Res 8(7):NC01–NC03PubMedPubMedCentralGoogle Scholar
  4. 4.
    Bilgen K, Üstün M, Karakahya M, Isik S, Sengül S, Çetinkünar S, Küçükpinar TH (2013) Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 23(2):180–183CrossRefPubMedGoogle Scholar
  5. 5.
    Richards Whitman (1970) Stereopsis and stereoblindness. Exp Brain Res 10(4):380–388CrossRefPubMedGoogle Scholar
  6. 6.
    Blavier A, Nyssen AS (2014) The effect of 2D and 3D visual modes on surgical task performance: role of expertise and adaptation processes. Cogn Technol Work 16(4):509–518CrossRefGoogle Scholar
  7. 7.
    Read JC (2015) Stereo vision and strabismus. Eye 229(2):214–224CrossRefGoogle Scholar
  8. 8.
    Heron S, Lages M (2012) Screening and sampling in studies of binocular vision. Vis Res 62:228–234CrossRefPubMedGoogle Scholar
  9. 9.
    Bosten JM, Goodbourn PT, Lawrance-Owen AJ, Bargary G, Hogg RE, Mollon JD (2015) A population study of binocular function. Vis Res 110:34–50CrossRefPubMedGoogle Scholar
  10. 10.
    Bohr I, Read JCA (2013) Stereoacuity with frisby and revised FD2 stereo tests. PLoS One 8(12):e82999CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Schiller PH, Kendall GL, Kwak MC, Slocum WM (2012) Depth perception, binocular integration and hand-eye coordination in intact and stereo impaired human subjects. J Clin Exp Ophthalmol 3:210CrossRefGoogle Scholar
  12. 12.
    Coutant BE, Westheimer G (1993) Population distribution of stereoscopic ability. Ophthalmic Physiol Opt 13(1):3–7CrossRefPubMedGoogle Scholar
  13. 13.
    Storz P, Buess GF, Kunert W, Kirschniak A (2012) 3D HD versus 2D HD: surgical task efficiency in standardised phantom tasks. Surg Endosc 26(5):1454–1460CrossRefPubMedGoogle Scholar
  14. 14.
    Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, Initiative Strobe (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Prev Med 45(4):247–251CrossRefGoogle Scholar
  15. 15.
    Schmidt PP (1994) Vision screening with the RDE stereotest in pediatric populations. Optom Vis Sci 71(4):273–281CrossRefPubMedGoogle Scholar
  16. 16.
    Hammond RS, Schmidt PP (1986) A random dot E stereogram for the vision screening of children. Arch Ophthalmol 104(1):54–60CrossRefPubMedGoogle Scholar
  17. 17.
    Shallo-Hoffmann J, Coulter R, Oliver P, Hardigan P, Blavo C (2004) A study of pre-school vision screening tests’ testability, validity and duration: do group differences matter? Strabismus 12(2):65–73CrossRefPubMedGoogle Scholar
  18. 18.
    Fricke T, Siderov J (1997) Non-stereoscopic cues in the random-dot E stereotest: results for adult observers. Ophthalmic Physiol Opt 17(2):122–127PubMedGoogle Scholar
  19. 19.
    Heron G, Dholakia S, Collins DE, McLaughlan H (1985) Stereoscopic threshold in children and adults. Am J Optom Physiol Opt 62(8):505–515CrossRefPubMedGoogle Scholar
  20. 20.
    Vision in Preschoolers Study Group, Schmidt P, Maguire M, Kulp MT, Dobson V, Quinn G (2006) Random dot E stereotest: testability and reliability in 3-to 5-year-old children. JAAPOS 10(6):507–514Google Scholar
  21. 21.
    Ruttum MS, Nelson DB (1990) Stereopsis testing to reduce overreferral in preschool vision screening. J Pediatr Ophthalmol Strabismus 28(3):131–133Google Scholar
  22. 22.
    Fielder AR, Moseley MJ (1996) Does stereopsis matter in humans? Eye 10(2):233–238CrossRefPubMedGoogle Scholar
  23. 23.
    O’Connor AR, Birch EE, Anderson S, Draper H (2009) The functional significance of stereopsis. Invest Ophthalmol Vis Sci 51(4):2019–2023CrossRefPubMedGoogle Scholar
  24. 24.
    Levi DM, Knill DC, Bavelier D (2015) Stereopsis and amblyopia: a mini-review. Vis Res 114:17–30CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Melmoth DR, Finlay AL, Morgan MJ, Grant S (2009) Grasping deficits and adaptations in adults with stereo vision losses. Invest Ophthalmol Vis Sci 50(8):3711–3720CrossRefPubMedGoogle Scholar
  26. 26.
    Read JC, Begum SF, McDonald A, Trowbridge J (2013) The binocular advantage in visuomotor tasks involving tools. Iperception 4(2):101–110PubMedPubMedCentralGoogle Scholar
  27. 27.
    Bloch E, Uddin N, Gannon L, Rantell K, Jain S (2015) The effects of absence of stereopsis on performance of a simulated surgical task in two-dimensional and three-dimensional viewing conditions. Br J Ophthalmol 99(2):240–245CrossRefPubMedGoogle Scholar
  28. 28.
    Biddle M, Hamid S, Ali N (2014) An evaluation of stereoacuity in practising surgeons across a range of surgical specialities. Surgeon 12(1):7–10CrossRefPubMedGoogle Scholar
  29. 29.
    Nakagawara V, Wood KJ (1998) Clinical application of the new civil airman vision standards and certification procedures. J Am Optom Assoc 69(3):144–150PubMedGoogle Scholar
  30. 30.
    Zaroff CM, Knutelska M, Frumkes TE (2003) Variation in stereoacuity: normative description, fixation disparity, and the roles of aging and gender. Invest Ophthalmol Vis Sci 44(2):891–900CrossRefPubMedGoogle Scholar
  31. 31.
    Lee SY, Koo NK (2005) Change of stereoacuity with aging in normal eyes. Korean J Ophthalmol 19(2):136–139CrossRefPubMedGoogle Scholar
  32. 32.
    Ding J, Levi DM (2011) Recovery of stereopsis through perceptual learning in human adults with abnormal binocular vision. Proc Natl Acad Sci USA 108(37):E733–E741CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Bhatt NR, Morris M, O’Neil A, Gillis A, Ridgway PF (2016) When should surgeons retire? Br J Surg 103(1):35–42CrossRefPubMedGoogle Scholar
  34. 34.
    Westheimer G (2013) Clinical evaluation of stereopsis. Vis Res 90:38–42CrossRefPubMedGoogle Scholar
  35. 35.
    Kurt Simons (1981) A comparison of the frisby, random-dot E, TNO, and randot circles stereotests in screening and office use. Arch Ophthalmol 99(3):446–452CrossRefGoogle Scholar
  36. 36.
    Wong BPH, Woods RL, Peli E (2002) Stereoacuity at distance and near. Optom Vis Sci 79(12):771–778CrossRefPubMedGoogle Scholar
  37. 37.
    Ruttum MS (1988) Visual screening with random dot stereograms. Semin Ophthalmol 3(3):175–180CrossRefGoogle Scholar
  38. 38.
    Hoffmann H, Ruiz-Schirinzi R, Goldblum D, Dell-Kuster S, Oertli D, Hahnloser D, Rosenthal R (2014) Impact of examinees’ stereopsis and near visual acuity on laparoscopic virtual reality performance. Surg Today 45(10):1280–1290CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Center for Perioperative Optimization (CPO), Department of Surgery DUniversity of CopenhagenHerlevDenmark
  2. 2.Department of SurgeryKoege SygehusKoegeDenmark
  3. 3.Department of SurgeryHvidovre Hospital, University of CopenhagenHvidovreDenmark

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