Of 3D (and VR) Headaches

I have to confess: something scared me. It scared me a lot. The source of my fear could be found in a recent Display Daily entitled “The Relationship Between 3D Cinema and Headaches.” Certainly, Art Berman did an excellent job of objectively reporting the results of the study. But what scared me were the implications of this study. You see, the title could easily have been reworded in this way: “The relationship between 3D Virtual Reality and Headaches.” Given that much of the virtual reality world is also stereoscopic, I doubt the findings for a VR study would have been any different. And that’s not at all a helpful recommendation for a blossoming technology just now getting its legs in the industry.

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So, in an attempt to focus directly on this untimely furphy, I sought to bring a medical and scientific perspective to the table on this matter. I contacted some of the leading vision health experts in the world, asking them to respond to the Estonian research, hoping their advice would rescue us from this unwanted pseudodox. Below you will find their thoughts about this recent 3D headache research, lest it be bruited about further.

Dr. Jen Simonson OD FCOVD

Dr. Simonson

Dr. Jennifer Simonson (OD, FCOVD), clinical director of the Boulder Valley Vision Therapy center and Senior Research Optometrist for Gerull Labs is an expert in using 3D to diagnose and treat vision disorders (and headaches) explains the headache problem this way:

This study takes in to account eyesight, but not vision. The key difference between 3D and 2D is the amount of coordination required of the eye muscles to align and focus the eyes at multiple distances. It also takes more cognitive work in the brain to process the difference in information presented to each eye to combine two different images into 3D perception. Stereopsis – depth perception – causes common 3D Vision Syndrome symptoms such as headaches, blurred vision and tired eyes. When a person has difficulty seeing 3D in a movie theater, it is commonly due to a vision problem with the coordination of the eyes. A normal movie is viewed on the screen, but in a 3D movie, the images appear to float off of the screen. Even with normal eyesight, if there is a difficulty with tracking, eye teaming, or focusing a person will be symptomatic with 3D Vision Syndrome.

Dr. Simonson concludes: “It may not be the media itself, but the visual dysfunction which contributes to headaches.”


Dr. Sheedy
Dr. Jim Sheedy (OD, PhD.), Director of the Vision Performance Institute at Pacific University, is an internationally recognized researcher. Dr. Sheedy worries about sample size in the Estonian study, and he also points to vision disorders as the culprit, not the 3D stimulus itself:

The findings presented in the article by Braschinsky et al., concerning 3D Cinema and Headache, cannot be conclusive because of the poor response rate of 21.6% (1293 respondents of 6000 questionnaires distributed). Despite this shortcoming, the results are interesting. The subjects were asked only about the symptom of headache. We know that subjects with disorders of the visual system have symptoms such as eyestrain, double vision, blurred vision, and others related to the eyes. The subjects in the study by Braschinsky et. al. were not given opportunity to differentiate these symptoms from those of headache.

Dr. Sheedy concludes: “The results are those that would be expected on the basis of vision disorders and the symptoms they cause.”

Dr Dominick Maino

Dr. Maino

Dr. Dominic Maino (OD, MEd, FAAO, FCOVD and Professor, Pediatrics/Binocular Vision, Illinois College of Optometry/Illinois Eye Institute Distinguished Practitioner, National Academies of Practice, Leonardo da Vinci Award of Excellence in Medicine) offered his view in more detail, wondering about the five main points of the Estonian study:

1) Can 3D movies provoke headaches? Dr. Maino explains” “I found it interesting that the reviewer did not say 3D movies actually caused the headache, as was often stated in earlier articles on this topic. Current research indicates that a faulty binocular vision system (vergence (eye teaming), accommodation (focusing), and oculomotor (eye movement)) dysfunction appears to be etiology of the headache when viewing a 3D stimulus.”
2) Do individuals who view 3D movies report headache during or after the movie 1.61 times more often than 2D movie viewers? Dr. Maino concurs: “Those with binocular vision dysfunction are not usually adversely affected by 2D movies, so this finding should come as no surprise. “
3) Are the people at risk are mostly younger? Again, Dr. Maino agrees: “Younger populations typically have a higher rate of functional vision problems.”
4) Are 3D movie visitors with a previous history of headaches 4.17 times more prone to get a cinema-induced headache? Dr. Maino suggests: “Those with a history of headaches may also have undiagnosed vision problems as their non-3D movie related head pain.”
5) Is risk the highest for persons with a history of migraine headaches? Dr. Maino explains: “Migraine headaches can have many different triggers. These triggers can include stress, consumption of different foods and how light is perceived (e.g. flickering) by the individual. A dysfunctional visual system is known to cause stress as well. Also those who experience migraines may just be more in tune and sensitive to all head pain no matter the etiology.”

Dr. Maino, in concluding, recommended that readers “pursue more information on this topic by exploring the public health report issued by the American Optometric Association: 3D in the Classroom. He also recommended that folks having difficulty seeing 3D cinema (or VR) find doctors who can help by going to the College of Optometrists in Vision Development website ( or the American Optometric Association website (”


So, what are we to make of this Estonian study? I would suggest three takeaways:

  1. 3D cinema may be the stimulus, but it is not the etiology (cause).
  2. Anyone with difficulties viewing 3D cinema (such as headaches) has just received an informal vision test. It’s a lesson the industry still has not learned in its push for “the next big thing.”
  3. What may be true about watching 3D cinema will likely be true about content viewed with stereoscopic virtual reality headgear. (This helps explain why more than 20% of my undergrad students at the university experience headaches, dizziness, or nausea when viewing virtual reality content.)

CartoonImage credit: XKCD

On a positive note, in a future article I plan to identify some vision-friendly strategies for effectively posturing and marketing virtual reality-related products and services. It can be done. But for now, let’s cease the well-worn scare tactics. –Len Scrogan