INTRODUCTIONTO BINOCULAR VISION

University of Gondar
By : Nebiyat Feleke (BSc, MSc in Clinical
Optometry)
 Outline of presentation

Definition of binocular vision

Factors determining Binocular vision
Binocular vision anomalies
pros and cons of BV
 Session objectives
By the end of this session, students will be able to :
• Define binocular vision
• Identify the factors that influence development of
BV
• Identify the main types of BVA
• Explain the advantages of Binocular vision
 Introduction to binocular vision

• What is binocular vision?

How the two eyes are used together?

 Definition….
Binocular Single Vision

• state of simultaneous vision

• the coordinated use of both eyes

• separate and slightly dissimilar images arising in

each eye are appreciated as a single image by the
process of fusion.
Thus binocular vision implies fusion, the blending of sight from the two eyes to form a single percept
 Factors determining BV
• Proper function of BSV without symptom
depends on :
1. Anatomy of visual apparatus
2. Motor system
3. Sensory system
 Factors….

1. Anatomy of visual system

• Embryological development of bony orbit
• Ocular muscle

• nervous system
 Motor System

• The eyes must be capable of aligning themselves so

that the retinal images of a fixated object can easily be
placed and maintained on the foveae of the two eyes
• Conditions that disrupt alignment of the two eyes can
cause binocular vision anomaly
• These may be due to disease or they may be
malfunctions of the physiology of the motor system.
• E.g.Convergence problem, strabismus
 3.Sensory system
 The retinal images of the two eyes must be in good
focus and of similar shape and size.
 Sensory integration of the images formed on the retinas
of the two eyes are combined into a single binocular
percept
 intact sensory pathways and the neural transmission
from the two eyes must reach the same area of the
brain
 Sensory…
• loss of clarity of the optical image in one or both
eyes, image larger in one eye than the other
(aniseikonia)
• anomalies of the visual pathway or cortex
• Difficulties in the coordinating of motor system can
also be accompanied by anomalies in the sensory
system, such as suppression, abnormal retinal
correspondence or amblyopia.
 Binocular Single Vision can be:

1. Normal – Binocular Single vision can be

classified as normal when it is bifoveal and

there is no manifest deviation.

 Types …

2. Anomalous - when the images of the fixated object

are projected from the fovea of one eye and an
extrafoveal area of the other eye .
 A small manifest strabismus is therefore always
present in anomalous Binocular vision
 Anomalous binocular vision
anisokonia, strabismus, decomponsated phoria
Diplopia
Confusion
suppression
Amblyopia
 NBSV requires:

1. Clear Visual Axis leading to a reasonably clear

vision in both eyes

2. The ability of the retino-cortical elements to

function in association with each other to
promote the fusion of two slightly dissimilar
images i.e. Sensory fusion.
 NBSV requires ….

3. The precise co-ordination of the two eyes for

all direction of gazes, so that corresponding
retino- cortical element are placed in a position
to deal with two images i.e. Motor fusion.
 Advantages of a Binocular vision

• What are the advantages of binocular vision?

• Are two eyes better than one?

 Major benefits:
The first and the foremost advantage of a binocular
vision is single vision.
Larger visual field
Compensation for blind spot and other differences
Stereopsis.

-depth perception is unique to binocular vision and the

most significant advantage gained by binocular vision.
Monocular Visual Field: 160 deg (w) X 135 deg (h)

Binocular Visual Field: 200 deg (w) X 135 deg (h)

 Other benefits:

 Spare eye.

- If one eye is lost to injury or disease, we will still be able to see well
with the other.
• Binocular summation.

- Greater sensitivity makes things which are smaller, dimmer,

quicker, etc. more detectible.
• Other enhancements to visual performance.

- Better space perception, hand-eye coordination, more efficient

and comfortable reading
 Disadvantages of BV

• Are two eyes always better than one?

• If so, would multiple eyes (such as spiders have) be
better than two?
• Not necessarily.

• In fact, there are some disadvantages to binocular

vision.
• The neurophysiology needed to support and fuse
the input from two eyes is more complex than if
we just had one eye.
• With greater complexity, there is more potential
for problems.
 Disadvantages …
• Binocular vision has its own unique set of problems that arise
when part of the binocular system is not working correctly.
• Binocular visual anomalies are frequently the cause of
symptoms such as eyestrain, headaches or difficulty reading.
• Many of these problems would not exist if we had only one
eye.
 Disadvantages …
For example, binocular stress can be caused by:
Incorrect refractive balance

Dissimilar images between the two eyes due to

Anisometropia or retinal disease
Over or under convergence
Conflicts between accommodation and
convergence
 Importance of Binocular Vision

Why is the study of binocular vision important to Clinical Optometry?

Clinical applications of this basic science include:

• Managing patients with complaints of asthenopia, difficulty reading,

etc.

• Pediatric optometry

• Vision therapy

• Monovision and contact lenses

 Summary

• Binocular vision is the coordination and integration of

what is received from the two eyes separately in to a
single binocular percept
• The anatomical ,motor and sensory system must be
normal for normal binocular vision to be present
• The greatest contribution of binocular vision is stereopsis
Thank you