Measurement of Visual Strain in Radiologists

Rationale and Objectives: The authors hypothesized that the current practice of radiology produces oculomotor fatigue that reduces diagnostic accuracy. Materials and Methods: Testing this hypothesis required an ability to measure eyestrain. This capability was developed by measuring the visual accommodation of radiologists before and after diagnostic viewing work using an autorefractor that was capable of making multiple measurements of accommodation per second. Three radiologists and three residents focused on a simple target placed at near to far distances while accommodation was measured. The target distances varied from 20 to 183 cm from the eye. The data were collected prior to and after a day of digital diagnostic viewing. Results: The results indicated that accommodation at near distances was significantly worse overall compared to far distances and was significantly worse after a day of digital reading at all distances. Conclusions: Because diagnostic image interpretation is performed at near viewing distances, this inability to maintain focus on an image could affect diagnostic accuracy. As expected, younger residents had better accommodative accuracy than older radiologists.