Stereopsis
KEY WORDS: PRINCIPLE, TESTS FOR STEREOPSIS
Stereopsis comes from the words:
o Stereo = Solid or three-dimensional
o Opsis = Appearance or sight
It refers to the ability to perceive depth by superimposing two slightly different images
taken from different angles.
Depth perception is the ability to determine the distance between objects in three-
dimensional space.
Principles of Stereopsis
Haploscopic
Anaglyph
Vectographic
Panographic
Tests for Stereopsis
Tests for Near Stereopsis
TNO Stereo Test
Lang Test
Frisby Test
Titmus Fly Test
Random Dot E Test
Bernell Stereo Reindeer Test
Lang Two Pencil Test
Test with Synoptophore
Tests for Distance Stereopsis
Frisby Davis Distance (FD2) Test
Distance Randot Test
TNO Stereo Test (The Netherlands Organization Test)
Measures retinal disparities ranging from 15 to 480 seconds of arc.
Consists of a booklet with 7 plates.
Uses random dot stereograms with complementary colors.
Two types of figures:
1. Figures seen only with stereopsis (when viewed binocularly with red-green glasses).
2. Figures visible even in monocular viewing (without stereopsis).
Procedure
1. Explain the test to the patient: “I am now going to test your 3D vision.”
2. Ask the patient to wear red/green goggles.
3. Hold the booklet at about 40 cm from the patient.
4. Ensure room lighting is on.
5. General Screening Plates (I-IV):
o Plate I: Two butterflies – one is seen monocularly, the other only with stereopsis.
o Plate II: Four discs – two can be seen without stereopsis.
o Plate III: Four hidden shapes (circle, square, triangle, diamond) around a visible
cross.
o Plate IV: Three discs – one seen by the right eye, one by the left, and one
binocularly.
6. Plates V-VII: Used to grade stereoacuities from 480 to 15 seconds of arc.
7. If the patient hesitates, give them time to answer.
8. Record the patient’s stereoacuity in seconds of arc.
Recording the Results
If the patient identifies stereo shapes in Plates I-III but not V-VII, record as "gross
stereopsis".
If Plate IV is incorrect, note the suppressing eye.
For Plates V-VII, record stereoacuity as the highest level correctly identified (e.g., TNO
stereoacuity ≤ 15 sec arc).
Lang Test
Designed by Lang (1983) for stereopsis screening in children.
Based on random dots & cylindrical gratings.
Uses a single card that can be held easily.
Includes three levels of stereopsis at low disparity levels.
Presented at 40 cm, the patient identifies:
o Arc of the moon (200 sec)
o Star (200 sec)
o Car (400 sec)
o Elephant (600 sec)
Frisby Test
Uses three plastic cards, each containing four squares with random small shapes.
One square contains a hidden circle, which is seen only with stereopsis.
Disparity is created by shifting random shapes based on the thickness of the plate.
Does not require special glasses.
Titmus Fly Test (Polaroid Vectograph Test)
Fly Test
The right side of the booklet contains a large housefly.
Tests gross stereopsis.
Particularly useful for young children.
The child is asked to "pick up the fly's wings".
Animal Test
Performed only if gross stereopsis is present.
Contains three rows of five animals.
The subject is asked which animal stands out.
Circles Test
Nine squares, each containing four circles.
One circle in each square is randomly displaced to create stereopsis.
Disparity ranges from 800 to 40 sec of arc.
The patient pushes down the circle that stands out, beginning from the first set.
Random Dot E Test
Vectograph-based test with demonstration and test plates.
Demonstration plate: Shows a raised "E" (visible to anyone with good acuity).
Test plates: Contain polarized random dot patterns.
Requires polarized glasses to see the hidden raised letter "E".
Patients without stereopsis will not see the "E" in the pattern.
Bernell Stereo Reindeer Test
Similar to the Titmus Stereo Test.
Uses polarized glasses for testing gross and fine stereopsis.
Contains three sections:
1. Near tests (gross and fine stereopsis)
2. Far tests (gross stereopsis)
3. Random dot tests (gross and fine stereopsis)
Lang Two Pencil Test
Popularized by Lang.
100% sensitivity with no negative responses.
Used as a screening test for gross stereopsis.
Easily performed without special equipment.
No need for stereoscopic test materials, polaroid glasses, or red-green goggles.
POSSIBLE QUESTIONS
1. What is stereopsis, and why is it important?
2. How does depth perception differ from stereopsis?
3. What are the principles of stereopsis?
4. What are the different types of stereopsis tests?
5. How does the TNO Stereo Test work?
6. What are the two types of figures in the TNO test?
7. What is the procedure for conducting the TNO test?
8. How is the TNO Stereo Test recorded?
9. What is the Lang Test, and why is it useful for children?
10. How does the Frisby Test differ from the Lang Test?
11. What is the Titmus Fly Test, and how is it performed?
12. What are the three parts of the Titmus Fly Test?
13. How does the Random Dot E Test detect stereopsis?
14. What is the Bernell Stereo Reindeer Test used for?
15. How does the Lang Two Pencil Test work?
16. Why is the Titmus Fly Test preferred for young children?
17. What are polarized glasses used for in stereopsis tests?
18. Which stereopsis tests require no special glasses?
19. What is the difference between near and distance stereopsis tests?
20. What does absence of stereopsis indicate in a patient?
Reference Books for Stereopsis
1. "Binocular Vision and Stereopsis" – by Ian P. Howard & Brian J. Rogers
2. "Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye
Movement Disorders" – by Mitchell Scheiman & Bruce Wick
