Visual conditions such as anisometropia, monovision and monocular undercorrection affect the combination of visual input from both eyes. This study investigated the effects of monocular blur, in binocularly normal participants, on stereoacuity and binocular contrast sensitivity. Fifteen young adults (age range between 19 and 23 years old) with normal visual acuity and binocular vision participated in this study. Stereopsis was measured using the TNO test with a series of positive spherical lenses placed before the dominant eye. The procedure was repeated using the Titmus Stereotest on five participants as a control experiment. Monocular and binocular contrast sensitivities were also measured using the Pelli-Robson Contrast Sensitivity Chart. Blur was induced monocularly with a series of positive spherical lenses placed before the dominant eye and binocular contrast sensitivity was re-measured. Stereopsis scores decreased significantly when monocular blur was imposed. Across blur levels, absolute stereopsis scores measured with TNO test were worse than those measured with Titmus stereotest (all p < 0.05). However, the ratio of scores obtained without blur and under monocular blur appeared to be similar for both tests. Stereopsis without blur was between 6.82× to 8× better than that obtained with the highest level of imposed monocular blur. Binocular contrast sensitivity score decreased significantly with increasing level of monocular blur (p < 0.01). Binocular contrast sensitivity score without blur was 1.62× better than that obtained under binocular viewing with highest level of imposed blur. Stereopsis tests are more sensitive than measurements of binocular contrast sensitivity as an indicator of interocular acuity discrepancies which could occur in anisometropic or monovision patients. However, the choice of stereopsis test is crucial, as the TNO test appears to be more sensitive to monocular blur than the Titmus stereostest.
Depth Perception

The commonly used tests for stereopsis are Titmus-fly, Randot, and TNO tests. In this study, 50 normal subjects were tested with these tests in order to set a criterion for normal stereopsis. The value of mean, mode and 75% point of these three tests were derived and compared.These three tests were also performed in 23 intermittent exotropes and 32 accommodative esotropes who showed gross stereopsis in the range of 60 to 400 seconds of arc by Titmus-fly testing. The aim was to obtain standards for clinical applicability and accuracy of these tests.This study cincludes that the appropriate criteria for normal stereopsis are less than 60 seconds of arc for Titmus-fly or Randot test, and 120 seconds of arc fot TNO test. Accurate testing for stereopsis in patients with gross stereopsis requires both Titmus-fly and Randot tests together. TNO test was inferior to the other two tests in terms of the accuracy and clinical applicability.
Depth Perception ; Humans

PURPOSE: To study the effect of spherical lens induced aniseikonia on stereopsis and fusion. METHODS: One hundred subjects, with normal binocular function without any ophthalmic disease or surgery history, were examined. The aniseikonia was induced with spherical lenses in 1 diopter (D) stepwise manner from -2 D to +2 D. The amount of aniseikonia was measured by Awaya's New Aniseikonia Test. Stereopsis and fusion were determined with Titmus Stereo Test and fusion card of major amblyoscope respectively. RESULTS: As the amount of aniseikonia was increased, the stereopsis and fusion were decreased. The change was statistically significant (ANOVA, p<0.001). Aniseikonia was more correlated to fusion than stereopsis. A significant decline in the stereopsis was detected when the size of aniseikonia changed from 1% to 2%. A significant decline in fusion was noticed when aniseikonia changed from 2% to 3% (Independent t-test, p<0.01). CONCLUSIONS: Our study suggests that binocular function can be disturbed by experimentally induced aniseikonia in normal subjects and that stereoacuities and fusional amplitude can be decreased as the degree of aniseikonia becomes larger.
Aniseikonia* ; Depth Perception ; Telescopes*

It is known that early surgery between 6 and 24 months of age obtains better binocularity in infantile esotropia. We selected 59 patients who had infantile esotropia with onset before 6 months of age and underwent surgery at 10 years of age or less. Stereopsis was tested in 51 patients after surgery. Thirty four patients(66.7%) showed gross stereopsis. The patients who underwent surgery at 2 years of age or less, developed gross stereopsis in 80.8%. The patients who had their eyes aligned their eyes between 2 and 4 years of age, gross stereopsis was demonstrated in 64.3%, white the patients underwent surgery more than 4 years of age developed gross stereopsis in 36.3%. The younger the patients at the time of surgery, the greater the percentage of gross stereopsis was shown(p<0.05). Orthophoria(within +/-10 prism diopters) was seen in 81.3% of the patients underwent surgery at 2 years of age or less and in 59.3% of the patients underwent surgery more than 2 years of age(p>0.05). This study revealed that early surgery, before 2 years of age, yields better outcome for sensory fusion and good alignment.
Depth Perception ; Esotropia* ; Humans ; Telescopes

Authors reviewed 459 cases which had been followed up over 3 months after surgery to evaluate the incidence of consecutive esotropia and its associated factors. For every case, we investigated the age at the surgery, the methods of surgery, stereopsis, cycloplegic refractive power, the deviation difference between far and near fixation, the deviation before surgery and the results at the postoperative 1 day, 1 week, 1 month, 4 months, 6 months, 1 year and 3 years. The incidence of consecutive esotropia tended to decrease as time passed, and occurred in 21 cases[4.6%] at the last follow-up[averaging 13.1 months]. When the deviation difference between at the distance and the near fixation was above 10 delta and the results at the postoperative 1 day was overcorrection above 10 delta, with significantly higher[p<0.05] incidence of consecutive esotropia. Other factors were not statistically significant. In conclusion, the preoperative factor was the far and near deviation difference above 10 delta and the postoperative factor was the first day postoperative overcorrection above 10 delta. It is considered that the nonsurgical treatment can be desirable for the former cases, and overcorrection above 10 delta should be avoided for the latter.
Depth Perception ; Esotropia* ; Exotropia* ; Incidence

PURPOSE: To investigate the perception of 3-dimensional (3D) image after successful exotropia surgery and compare with Titmus stereo test. METHODS: A total of 23 children who underwent surgery for intermittent exotropia and 28 normal children were evaluated with a 3D laptop computer and Titmus stereo test. RESULTS: The mean minimal 3D scene depth level was 38.26 +/- 19.69 in the exotropia group and 33.21 +/- 16.11 in the normal group with no significant difference (p = 0.319). The mean stereoacuity was 60.97 +/- 34.23 arc sec in the exotropia group and 76.69 +/- 93.81 arc sec in the normal group with no significant difference (p = 0.444). The mean minimal 3D scene depth and mean stereoacuity showed statistically significant positive correlation in both the exotropia group (p = 0.024) and normal group (p = 0.026). CONCLUSIONS: After a successful exotropia surgery, patients can normally perceive 3D images. Better 3D image perception can be predicted if a previously established stereo test shows good results.
Child ; Depth Perception ; Exotropia ; Humans

PURPOSE: To investigate the effect of preoperative part-time occlusion therapy on long-term surgical success in early-onset exotropia. METHODS: The medical records of patients who underwent surgery for exotropia with onset before the first year of age and who were followed for ≥3 years were reviewed. Patients were divided into two groups according to the degree of compliance with part-time occlusion therapy: the good compliance group (>50% adherence rate) and the poor compliance group (≤50% adherence rate). Surgical success was defined as orthophoria to exodeviation less than 10 prism diopters both at distance and near. The level of postoperative stereopsis was compared between the two study groups among total enrolled patients and among those with constant exotropia. RESULTS: Of the 51 patients, 26 were assigned to the good compliance group and the remaining 25 patients to the poor compliance group. The surgical success rate was significantly higher in the good compliance group than in the poor compliance group (80.8% vs. 52.0%, p = 0.040). Among 24 constant exotropia patients (12 patients for each group), the success rate was insignificantly higher in the good compliance group than in the poor compliance group (75.0% vs. 58.3%, p = 0.448). The good compliance group had a better level of stereopsis than the poor compliance group (p = 0.045 for all 44 patients, p = 0.020 for 19 patients with constant exotropia). CONCLUSIONS: Preoperative part-time occlusion therapy was useful for improving the surgical outcome of early-onset exotropia and postoperative stereopsis.
Compliance ; Depth Perception ; Exotropia* ; Humans ; Medical Records

PURPOSE: To report the clinical outcome of patients with consecutive esotropia (ET) in the pre- and post-operative periods and at the last postoperative visit. METHODS: The present study included 12 patients who underwent surgery for the correction of consecutive ET. The angle of deviation, duration of consecutive ET, and surgical and non-surgical methods for correction of consecutive ET were investigated. The sensory status was evaluated before the surgery of exotropia (XT), during consecutive ET and after the surgery for consecutive ET. RESULTS: The average angle of deviation before the surgery of XT was 27.5 PD and 3 patients had lateral incomittancy. Alternate occlusion treatment was performed in all patients, and 10 patients wore Fresnel prisms. The average angle of deviation of consecutive ET was 24.3 PD. After an average of 30 months postoperative consecutive ET, 9 patients were orthotropic or had deviation within 8 PD, 2 patients had 15 PD ET, and 1 patient had 20 PD XT. There were 3 patients whose stereopsis was aggravated and 1 patient had poorer fusion during consecutive ET, and recovered after the surgery for consecutive ET. No patients had a decrease in visual acuity. CONCLUSIONS: As a result of alternate occlusion and Fresnel prisms during consecutive ET after surgery of XT, the incidence of aggravation in binocularity was low, and the cases with aggravated binocularity were recovered after surgical correction of consecutive ET. The surgical success rate was 75% in consecutive ET.
Depth Perception ; Esotropia ; Exotropia ; Humans ; Incidence ; Telescopes

PURPOSE: To investigate the long-term outcome of lateral rectus (LR) advancement for consecutive esotropia following bilateral LR recession for intermittent exotropia. METHODS: Medical records of 25 patients who underwent LR advancement for consecutive esotropia after bilateral LR recession and who were followed up for more than 24 months postoperatively were reviewed. Patients were divided into two groups: bilateral lateral rectus recession (BLR) group included 16 patients with consecutive esotropia greater than or the same magnitude as the initial exotropia and who underwent bilateral LR advancement; Unilateral lateral rectus recession (ULR) group included nine patients with consecutive esotropia less than the initial exotropia and who underwent unilateral LR advancement. Main outcome measurements were motor and sensory outcomes and the dose-effect relationship calculated from observed overall and group changes in the angle of deviation per millimeter. Motor success was defined as alignment from orthotropia to exodeviation less than 10 PD at distance. Sensory outcome was described by comparing the Titmus stereoacuity test before and after LR advancement. Sensory successvwas defined at 100 seconds of arc. RESULTS: Eighteen patients (72.0%) showed satisfactory long-term motor and sensory outcomes. Seventeen (77.3%) of 22 patients showed favorable stereopsis of 100 seconds of arc or more at final observation. The long-term motor success rate of the ULR group was better than that of the BLR group (p = 0.025). The average observed change in the angle of deviation was 3.6 PD/mm at the final visit in all patients. A greater dose-effect relationship was observed in the ULR group than in the BLR group at the final visit (p = 0.043). CONCLUSIONS: LR advancement showed favorable motor and sensory outcomes in the majority of patients. The surgical outcome was not favorable in patients in the BLR group with consecutive esotropia of the same magnitude as the initial exotropia. These results require further investigation for verification.
Depth Perception ; Esotropia* ; Exotropia* ; Humans ; Medical Records

PURPOSE: The Frisby Davis Distance (FD2) Stereotest has been introduced to measure distance stereoacuity. The purpose of this study is to establish the range of normal distance stereoacuity responses on the FD2 Stereotest in a normal population. METHODS: This study comprised 65 subjects. All had best corrected vision of 20/25 or better in each eye at distance, 1.0 diopters or less of anisometropia, 8 prism diopters or less of phoria on alternate cover test at both distance and near, binocular fusion on the Worth four dot test and stereopsis on Titmus test. Distance stereoacuity was measured using the FD2 stereotest. RESULTS: The mean age of the subjects was 18.6 years (range, 3 to 59). The mean stereoacuity for distance was 15.61+/-10.41 sec (seconds of arc), and the mean stereoaucity of the subject over 10 years old was 12.98+/-6.86 sec. Results of the test-retest variability as well as of different test distances revealed no statistically significant differences. Of 60 subject with one eye closed, 11 (18.3%) of them detected the disparity of 200 sec but none could detect smaller disparity except one. CONCLUSIONS: The FD2 Stereotest is reliable test without test distance variance. The results of this study can be used as a normative data of distance stereoacuity by FD2.
Anisometropia ; Child ; Depth Perception ; Humans ; Strabismus ; Telescopes