Course Objectives

• This course provides theoretical aspects of Binocular Vision and its clinical application. It deals with fundamentals of normal binocular vision and space perception, gross anatomy and physiology of extra ocular muscles, binocular movement coordination and binocular optical defects, amblyopia & nystagmus

Learning Outcomes

• At the end of the course students will be able to understand the following concepts,
  1. Grades of Binocular vision
  2. Fundamental theories of binocular vision
  3. Binocular muscle coordination
  4. Integration of motor and sensory system into binocular vision
  5. Depth perception
  6. Binocular optical defects
  7. Basic binocular evaluation
  8. Amblyopia
  9. Nystagmus
  

Course Syllabus

MODULE-I : (5 hours)

Spatial perception
Cyclopean eye
Evolution of binocular vision & Advantages of binocular vision
Grades of binocular vision-simultaneous perception, fusion, Stereopsis
Visual direction, Retino motor value, Egocentric localization
Corresponding point and normal retinal correspondence

Practice: Synoptophore for fusion and simultaneous perception (3 hours)

MODULE-II: (6 hours)

Horopter & Panum’s fusional area
Physiologic diplopia
Fixation disparity
Theories of binocular vision
Physiologic basis of fusion
Binocular rivalry
Suppression & Confusion
Blind spot syndrome<
Eccentric fixation

Practice: Worth four dot test, Red filter test, Bagolini test (3 hours)

MODULE-III: (4 hours)

Dichoptic stimulation and its types
Stereopsis- neurophysiology of stereopsis, local and global stereopsis and fusion
Depth perception- non stereoscopic clues to the perception of depth under binocular condition, monocular cues and its types
Influence of accommodation and convergence on depth perception

Practice: stereopsis evaluation tests, NPA, NPC (4 hours)

MODULE-IV: (4 hours)

Integration of the motor and sensory system into binocular vision
Anatomy of Extra Ocular Muscles - Rectii, Obliques and LPS, Innervation & Blood Supply
Physiology of Ocular movements - Center of rotation, Axes of Fick, Action, Laws of ocular motility - Donder’s and Listing’s law, Sherrington’s law, Hering’s law

Practice: Extra ocular motility test, Hirschberg test (2,5 hours)

MODULE-V: (3 hours)

Influence of binocular optical defects- visual acuity, anisometropia, anisokenia, geometric optical effects of spectacles

Practice: Bruckner test (1.5 hour)

MODULE-VI: (3 hours)

Binocular muscular co-ordination - orthophoria
Uniocular & Binocular movements – Fixation & its field, saccadic & pursuits, Version &Vergence

Practice: Saccades and pursuits test (2 hours)

MODULE-VII: (4 hours)

Amblyopia :Classsification ,Aeitiology, Investigation, Management
Nystagmus: Classsification ,Aeitiology, Investigation, Management

Practice: Neutral density filters (1 hour)

Session Plan

Session 1

Spatial perception, Cyclopean eye
Evolution of binocular vision & Advantages of binocular vision
Reference: Click to open video
Grades of binocular vision-simultaneous perception, fusion, Stereopsis
Theories of binocular vision

Session 2

Visual direction, Retino motor value
Egocentric localization
Corresponding point and normal retinal correspondence
Horopter & Panum’s fusional area
Physiological diplopia
Reference: Click to open video

Session 3

Fixation disparity
Theories of binocular vision
Physiologic basis of fusion
Binocular rivalry
Suppression & Confusion
Blind spot syndrome
Eccentric Fixation

Session 4

Dichoptic stimulation and its types
Stereopsis- neurophysiology of stereopsis, local and global stereopsis and fusion
Depth perception- non stereoscopic clues to the perception of depth under binocular condition, monocular cues and its types
Reference: Click to open video
Click to open video
Click to open video

Session 5

Influence of accommodation and convergence on depth perception
Integration of the motor and sensory system into binocular vision
Stereoacuity tests
Reference: Click to open video

Session 6

Anatomy of Extra Ocular Muscles - Rectii, Obliques and LPS, Innervation & Blood Supply
Reference: Click to open video
Physiology of Ocular movements - Center of rotation, Axes of Fick, Action, Laws of ocular motility - Donder’s and Listing’s law, Sherrington’s law, Hering’s law

Session 7

Influence of binocular optical defects- visual acuity, anisometropia, anisokenia, geometric optical effects of spectacles
Reference textbook: Gunter K. V.Nooden: Binocular vision & Ocular motility_ Theory and management of strabismus, Sixth edition, 2002, Mosby Company

Session 8

Binocular muscular co-ordination - orthophoria
Uniocular & Binocular movements – Fixation & its field, saccadic & pursuits, Version &Vergence
Reference: Click to open video

Session 9

Amblyopia :Classsification ,Aeitiology, Investigation, Management

Session 10

Nystagmus: Classsification ,Aeitiology, Investigation, Management

Text books

1.Scott B Steinman; Barbara A Steinman; Ralph P Garzia: Foundations of binocular vision _a clinical perspective, 2000, New York : McGraw-Hill publishers
2.Pradeep Sharma: Strabismus simplified, New Delhi, First edition, 1999, Modern publishers.
3.Fiona J. Rowe: Clinical Orthoptics, second edition, 2004, Blackwell Science Ltd
4.Gunter K. V.Nooden: Binocular vision & Ocular motility_ Theory and management of strabismus, Sixth edition, 2002, Mosby Company
5.Mitchell Scheiman; Bruce Wick: Clinical Management of Binocular Vision Heterophoric, Accommodative, and Eye Movement Disorders, 2008, Lippincot Williams & Wilkins publishers