BINOCULAR VISION

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CONTENTS
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Introduction Advantages Development Theories of binocular vision Grades of binocular vision Normal retinal correspondance Binocular fusion Stereopsis Depth perception Tests for BSV Disturbances in development of BSV

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Introduction
Binocular vision: Highly co ordinated organization of series of sensory and motor processes that culminate in perception of singleness and Stereoscopic depth enabling the eye to attain single vision from 2 retinal images. Prerequisites: Central fixation with normal visual acquity Accurate occulomotor control  bifoveal fixation Normal inter retinal correspondance of visual directions Sensory mechanisms to provide haplopia Neural mechanisms to extract selective depth signals
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Advantages
Larger field of view (horizontal field of view is increased from 160o to 2000 .central 120o overlap)
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Masking of image distortion caused due to optical/pathological defects of 1 eye by another. Retention of vision on loss of 1 eye Binocular summation and steriopsis improved function Binocular field is larger than either of the fields alone.

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Evolution
Animals preyed upon: gain from 3600 field of view, with eyes pointing in opposite directions

Predators: gain from eyes facing in same direction  Stereopsis. hence predators including humans evolved by developing organisation such as - Frontally placed eyes (for overlap of visual field) - binocular coordination of eye movements  objects stimulate corresponding points. (muscles yoked together) - semidecussation of optic tract (interaction of inputs from different parts of retina) - eye hand coordination

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Development
EYE AT BIRTH AND NORMAL POSTNATAL DEVELOPMENT: orbits: change shape and size throughout childhood,till teenage. axis they form with one another decreases from 500to 450 in later life.
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Interpupillary distance: birth: 45mm (avg) adulthood:58 – 66 mm Convergence required to fixate an object at 33 cm: birth: 13 prism diopters later: 19 prism diopters

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Growth of globe:

birth: 17.5 cms

adulthood: 24mm

Ciliary muscle: birth: meridonial fibre fully developed circular portion during 1st one / two years of life.

Extraocular muscles: smaller but fully functioning at birth Postural reflxes: fully functional at birth,innate and unconditioned.

Visual acuity: 6 months: 6/30 (6/6 or 6/12) 2-3 years: adult levels
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Fixation: monocular at birth. -rudimentary in the beginning - 2-3 wks: begins to fixate - 4-5 wks: sustains monocular fixation - 6 wks: fixation alternates betweenn 2 eyes - 3months: fixation is bifoveal & conscious, rather than reflexive -3-5 months: smooth and gliding pursuit movements, compared to saccadic ones till then. Disjugate vergence movements: develop after conjugate movements. convergence is demonstrable at 3 months, stable at 6 months. Fusional movements: abt 3-6 mnths, 7/5/12 established by 1 year.

Maturation of binocular functions: at birth: both eyes act as independent sense organs • Bifoveal fixation: Fovea develop by 3 month providing stimulus to associate both eyes.child learns that image is most detailed when fixed on fovea. Relative space perception: -objects to right of fixation send images to retinal areas in 2 eyes with common visual direction - crossfiring of various sensory phenomenon: eg touch with vision • If eye is not allowed to associate  child never acquires binocular vision/ fusion vision remains monocular and alternating
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Stereopsis: normal eyes & neuromuscular mechanism  stereopsis develops all or none phenomenon cannot be trained

Theories of binocular vision

THEORY OF CORRESPONDANCE & DISPARITY: Simultaneous stimulation of corresponding points by 1 object  single visual impression with no depth quality Simultaneous stimulation with 2 objects that differ in character  Binocular rivalry Disparate elements stimulated by 1 object  diplopia Horizontal disparity within PANUM’S area  binocular single vision. Other theories: -motor theory - theory of isomorphism - alternation theory of binocular vision
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Grades of binocular vision
Simultaneous perception/ 1st grade: signals transmitted from 2 eyes to the visual cortex are percieved at the same time

Fusion / 2nd grade: ability to produce composite picture from 2 similar picture, each lacking some small details.
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Stereopsis / 3rd grade: impression of depth/appreciation of 3 dimensions by superimposition of 2 images of same object

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Visual directions

Occulocntric direction/local sign: specific visual direction of a retinal image location

Primary visual direction: occulocentric direction of an object fixated along the 1st line of vision, imaged at fovea

Secondary visual direction: (secondary line of sight) occulocentric direction of other retinal image locations relative to primary visual direction.

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Egocentric localization: point midway between two eyes  egocenter / cyclopean eye

Egocentric direction: direction of object in space relative to body occulocentric direction + informaion about eye orientation in head and head position relative to trunk

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Normal retinal correspondance

Corresponding points: specific pairs of retinal image locations in 2 eyes perceived to have identical visual direction. eg: Fovea

Normal retinal correspondance: when image is formed at corresponding retinal points,they produce perception of identical visual directions when viewing with 1 eye / both eyes simultaneously, permitting single visual impression.

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Veith-muller Horopter

For infinite fixation distance,a circle passing through -the fixation point , -object locations imaged on other corresponding points and -the entrance pupils of the two eyes. Every point on the horopter forms an angle with the entrance pupils, equal to that formed by the fixation point. At finite distance, the surface is reduced to 2 lines passing through the intersection of lines of sight when eyes fixate at symmetric convergence - LONGITUDINAL HOROPTER - VERTICAL HOROPTER Only points imaged on these two meridians can be formed on corresponding points without vertical 7/5/12 disparity.

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Physiologic diplopia

Diplopia of non fixated objects. all object that are nearer or farther away than the horopter (beyond normal fusional range) , are imaged on non-corresponding points. 2 egocentric directions Diplopia

We do not have constant diplopia during daily vision due to - exclusiveness of attention directed to fixating object. - low visual acuity of peripheral retina.

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Crossed diplopia
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For object closer than horopter Point is imaged on temporal retina each eye percieves the point on the opposite side.

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Uncrossed diplopia
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For Points located beyond horopter Point is imaged on nasal retina.

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Binocular fusion
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Sensory fusion: normally occurs: when images of an object fall on corresponding retinal points they are fused into a single mental impression. Also occurs when stimulus is similar, and not identical eg: size, shape, form,color, luminosity,contrast.

ANATOMIC BASIS: course of nerve fibres. by crossing at chiasma,nasal fibres of one eye are brought near temporal fibres of the other (counterparts) they terminate in the same cortical cell.

Motor fusion: ability to align eyes to maintain sensory fusion. stimulus: retinal disparity
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Panum’s fusional space
space in front and behind the horopter where objects located can be fused into a single image without producing diplopia. • Smallest at the fixation point. Retinal Panum’s area corresponds to depth of panum’s fusional space.

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Fixation disparity: primary line of sight of 1 eye misses fixation point slightly,being either underconverged or overconverged as disparity is less than size panum’s area no diplopia occurs

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Theories of binocular fusion
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Synergy hypothesis of Panum Local sign hypothesis Eye movement hypothesis of Helmholtz Supression hypothesis of du Tour and Verhoeff

PHYSIOLOGIC HYPOTHESIS: neurophysiologically 4 classes of neurons have been defined by Hubel and Wiesel 1. Binocular corresponding (BC) 2. Binocular disparate (BD) 3. Monocular right 4. Monocular left

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Physiologic hypothesis

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Stereopsis

Steriopsis is the visual appreciation of 3 dimensions during binocular vision, occuring through fusion of signals from disparate elements. Temporal disparities gives impression of nearness of an object. Nasal disparity gives impression of remoteness of an objecct. Vertical disparities do not produce stereoscopic effect. Requirements: - bifoveal fixation -good visual acuity - fusion

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FINE STEREOPSIS: highly specific pattern matching process operating over narrow range of spatial disparities( probably not more than 0.5 degrees) COARSE STEREOPSIS: less specific process that can operate on dissimilar visual images(form, luminance, contrast) separated by several degrees in spatial position(7 to 10 degrees)

Stereoscopic acuity: -minimal disparity beyond which no stereoscopic effect is produced. - stereoacuity is best at fovea, decreases towards periphery -normally :depth difference between two images with relative disparity of 10 arc sec can be discriminated -beyond 600 m, no true stereopsis, monocular clues take over.

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Depth perception

Distances of objects from each other or the observer Factors: Stereopsis Nonstereoscopic clues  retinal disparity Monocular clues ( nonstereoscopic clues to spatial orientation)
- parallactic movements -linear perspective -overlay of contours -size -distance from horizon -influence of highlights, shadows, light -aerial perspective

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4. Influence of accomodation and convergence.
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Overlay of contours

highlights and shadows

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Binocular vision tests
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Test for simultaneous macular perception Test for fusion Test for stereopsis - vectograph test - titmus stereo test - random dot stereogram test (RDT) - TNO random dot test - Lang test - frisby test - sterescopic contours induced optokinetic nystagmus test - television random dot stereotest

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4. Simple motor task tests 7/5/12 pencil test - two

Titmus stereo test

Random dot test(RDT)

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TNO Test

2 pencil test

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Disturbances in development of BSV
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Time of onset of defect in visual system is most important 18 months to 2 yrs: prognosis for eventual bifoveal single vision is poor At later age: normal function maybe regained with adequate treatment. Anomalies in development of BSV: - Diplopia & confusion - Supression - Amblyopia - Abnormal retinal correspondance.

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Diplopia & confusion

Objects in the plane of fixation are percieved as double. Misalignment of visual axis in deviated eye

retinal image of fixed target is seen in different egocentric directions (2 visual directions) DIPLOPIA and Visual confusion Intolerable visual environment ARC Supression Amblyopia Horror fusionis: intractable diplopia due to absence of central supression 7/5/12

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Supression:
Active cortical inhibition of vision in one eye. can be : - selective - facultative - constant (monocular strabismus)

Amblyopia: -partial loss of sight in one or both eyes in the absence of
ophthalmoscopic or any other marked signs. -maybe due to – anisometropic - strabismic - stimulus deprivation(amblyopia exanopsia) -amblyopia sets in early if strabismus begins in early years of life.
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Abnormal retinal correspondance
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Active cortical adjustment in the directional values of 2 eyes The fovea of one eye and a peripheral retinal element of another eye acquire common visual direction. Types : Harmonious ARC: Unharmonious ARC: Advantages: - gives patient a form of BSV - stabilizes angle of deviation - better visual adjustment, as there maybe depth perception Disadvantages: - difficult to establish normal retinal correspondance
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Summary

BSV: singlevision from 2 retinal images with depth perception. 3 grades of BSV: simultaneous perception, fusion, stereopsis Object locations on horopter give same visual directions Object locations within panum’s fusional area, can be fused to give single image Stereopsis occurs due to spatial disparity temporal disparity: nearness of object nasal disparity: remoteness of object Disturbances in BSV: diplopia & confusion supression amblyopia ARC 7/5/12

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References
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Adler’s physiology of eye Squint and orthoptics – A K Khurana

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Thank you
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