BINOCULAR VISION

Binocular SINGLE vision allows fusion of

retinal images of the two eyes.
Advantage:
1-Streoscopic vision and depth perception is made
possible. This is the most important advantage.
2- Binocular visual field is large than monocular.
3-visual defect in one eye are musked.
4-optical defects in one eye are made less obvious
by normal image of the opposite eye.
Requirement for BSV:
1- normal healthy eye.
2-Transparant media.
3-optical system --clear image on normal
retina.
4-similar image on both retina as regard
shape , size, color, intensity.
5-normal physiological corresponding points.
6-normal visual pathway and efferent
pathway.
7-normal ocular movement to fixate the
object.
Basics for BSV:
1- Binocular field of vision.
2-Anatomical additions of images
(mechanism of fusion)
3- sensory fusion.
 .Binocular field of vision -1
It occupies the central part
of visual field. 60 nasal
and temporal to fixation
point, 70° above, 90°
below. On each side,
there is the monocular
crescent which
represents the
decussating of nerve
fibers (temporal field).
Binocular single field of
vision exists only in the
central part, where there
is overlap of the two
visual fields.
Mechanism of Fusion;
- theory of corresponding
points:
Each point in one retina
corresponds to a point in
the other retina. The
best example is the
(macula Corresponding
points in the two retina
have a common visual
direction in space .
Physiological diplopia:
When a subject fixes an
object in space, its
image falls on
corresponding points
on the two retina,
while objects in front
of or behind this
object will not fall on
corresponding points
and will be seen
double.
Physiological diplopia is usually not felt in
every day life. Squint in children does not
lead to diplopia because abnormal retinal
correspondence., i.e., retinal elements of
squinting eye assumes abnormal
relationship with the fovea of the straight
eye.
- Horopeter:
images' fall on
corresponding points"
in the two retinae will
form a geometric
figure called
horopeter .
It is a circle that passes by
the fixation point and the
optical centers of the two
eyes. It varies with each
position of the eyes. The
horopter is concave
towards the subject for
objects nearer than 2
meters, flat at 2 meters,
and convex at more than
2
D-Panamas area:
The concept of the horopter as
a line means that any point in
front or be­hind this line will
be seen double. In
reality this is not the case, since
there is an area in front and
behind where points can be
seen binocularly single.
Panama's area. This has been
explained by that a point in
one retina has many
corresponding points In the
other retina, simultaneous
stimulation of any two will
give single binocular vision.
Probably Panum's area
corresponds to cortical
units /rather than to retinal
points.
2- motor fusion:
Geometric superimposition of retinal images
is only possible by the optico-motor
fixation reflexes (or precise ocular
movements) to fix an object with
corresponding retinal areas, e.g., foveas.
3- sensory fusion:
For perception of a single binocular image, it is not
only necessary that the two images projected, to
an identical region of the brain to be fused; but
also the two images must be identical (silmilar in
size, shape, color, intensity). Thus when two
images fall on two corresponding areas of the
retina the folIowing possibilities may happen:
1- the images are identical :
they are fused, and slight difference can be
tolerated (second deeree fusion with the
svnaptophore) Fusion becomes more
difficult the more is the disparity or the
difference between the two images. Slight
difference is even necessary to get the
sensation of relief or depth
(3rd Degree depth perception with
synaptophore)
2- If the images are totally different :
fusion does not occur, the images are
projected one over the other in the same
visual direction. "Homotopic diplopia" (an
image of circle and of a triangle OR bird
and cage). (1st Degree simultaneous
macular perception in synaptophore)
Other processes may take place :
A- Suppression: If you put in front of one
eye a tube and in front of the other eye
your hand Tangent with the distal end of
the tube: the whole hand is seen
monocularly, but a part of it disappears in
binocular vision. This physiological
mechanism is exaggerated in disease
(Squint).
B- Retinal rivalry: If we project
on two corresponding areas
of the two
retina , images of similar
(sizd but very different (as
striated parallel
lines one horizontal and the
other vertical) they cannot
be seen simultanemjsly, but
the visual perception
alternates from one to
other.
C- Stereoscopic luster: When the two
images are for the same object, but one
white and the other black a particular
luster is perceived, not grey.
D- Fusion of colors: If two different colors
are presented to the two eyes, the
response varies either rivalry or
antagonism occurs and each color is seen
in succession. OR fusion into an
intermediate colon Fusion is easier when
the colors are neighbors in the spectrum
and their inten­sity is not high.)
E- The dominant eye;
The concept of retinal antagonism or
(rivalry), suppression, fusion of colors,
supposes that there is relative equality of
the two eyes. This is not exactly so,
because of dominance of one eye in 93%
of persons. This is usually the right eye. In
binocular vision, the dominant eye is
preferred, and its image dominates that of
the other eye in case of retinal rivalry.
F- Fixation disparity: -
When an object is fixed
(looked at), the visual
axis of the dominant eye
passes
in the center of the object,
while the visual axis of
the other eye does not
pass in the
center of the object, but still
binocular vision is
obtained. This is called
fixation disparity. It is due
to Panum's area and
marks the limit between
physiological and
pathological situations.
 Theories of fusion
1- Images received from corresponding points in
the two retina are fused ln a terminal effectors
cell in area17 of the occipital cortex [Worth and
Verhoeff].
2- Retinal rivalry; the object is seen as mosaic of
the two images [Verhoeff].
3-Two independent elementary sensations are
integrated into a single perception of
psychological nature. [Sherrington].
 Depth perception and -
:stereoscopic vision
Is a complex phenomenon depending
on many factors:

1-Monocular factor
 light and shade

light and shade. specially in

painting: light from above makes
the shadow above in a
depression and below in a bulge.
Horizontal lines appear to converge as they go away,
give the impression of distance, e.g., converging lines
of a road as it goes far.
Customary size of objects

The objects when smaller than its usual size

gives the impression that it is far and vice
.versa
 A- Geometric factors
i-Aerial perspective: iv- Perspective -Horizontal
Haziness and blue tint of lines appear to converge as
objects gives impression that they go away, give the
they are far. impression of distance, e.g.,
ii- light and shade. specially in converging lines of a road as it
painting: light from above goes far.
makes the shadow above in a
depression and below in a V- Customary size of
bulge.
objects -The objects when
iii-Interpostion of one object smaller than its usual size
in front of another hiding parts
of it gives the impression that it is far
and vice versa.
 :B-parallactic movements
When an object at a moderate distance is fixed
then the eyes are moved in one direction: farer
objects appear to move with, nearer objects
appear to move against the movement of the
eyes. The speed of this movement is
proportional to the distance.
 C- Muscular factor
The depth perception can be appreciated by
the effort spent in convergence and
accommodation to see a given object.
 Binocular factors: steroscopic -2
:factors
This is the most important factor
in appreciation of depth .The
two retinal
images of a tri-dimensional
object are not exactly the
same: one eye receives a right
slanted view of the object of
regard and the other a left
slanted view. This is due to
the separation of the two_eyes
by a distance. Stereoscopic
vision is depth perception
by viewing slightly different
images.
If the images are very dissimilar fusion is
impossible. If they are exactly similar, no
depth perception is appreciated The
tolerated disparity or difference between
the two images is more in horizontal than
in vertical planes; is more when the object
is near the edges of Panum's area. It is
even possible to perceive stereopsis from
images seen in physiologic diplopia area
outside Panum's area.
Thus three regions are distinguished
- The region of the horopter where objects are
seen single but no depth perception
- The region of Panum's area where objects are
seen single with depth.
-The region outside Panum's area where there is
physiologic diplopia and stereoscopic vision.
In general, nasal disparity gives the impression of
remoteness (farness) of an object, and temporal
disparity gives the impression of nearness of an
object Stereopsis has both a physiologic and a
psychologic basis.
Accuracy of stereopsis is determined by the
smallest discernible difference in binocular
parallax. A trained observer can make
correct judgments within 2 seconds of arc
This can be determined by means of
(Howard-Dolman apparatus) A stationary
upright rod is placed 6 meters from the
observer, the observer tries to move
another rod by a string, so that the two
rods are equidistant from him.
DEVELOPMENT OF BINOCULAR
VISION
-at birth, the eyes are not associated with each other but act
as two independent sense organs.
- By the third month of life, the foveas are formed, these
areas is developed . By trail and error.
1- The child learns to direct the foveal visual axes at the
object of regard to obtain the best image.

2- The eyes become accurately, associated with one

another and with tactile sensatations until gradually a
normal child develops perception of space.
In the human being the anatomic and
physiologic factors for depth perception
are either present at bjrth or developed
short after birth. If the eyes are normal and
the neuromuscular mechanism for moving
the eyes is normal depth perception will
follow automatically.
Stereopsis seems to be in a class by itself,
and seems to be an all - or-none
phenomenon, in that in a given subject it is
either present or absent, and is not ,
developed by training.
If the eyes are never allowed to become
associated, e.g., by failure of develop-
ment of one fovea or by paralytic squint so
that the two foveas cannot always be
focused together on the object of regard,
the child never acquire binocular single
vision. Vision is monocular and generally
alternating. The image of the eye which is
not fixating the object is suppressed.,
Suppression is active inhibiton of the vision of one
eye. This inhibition involves he whole retinal
function (total extinction), may involve selectively
a certain area central or peripheral (e.g.,
suppression scotorma in foveal area in some
convergent squint), or the inhibition may be
selective to a specific retinal function, e.g.,
inhibition of resolution of contour while color
sense is intact It may be monocular or
alternating.
Under normal circumstances, suppression
enables us to see binocularly without being
conscious of physiological diplopia.
 Types of Suppression
1-Facultative supression which occurs
when visual axes of both eyes are not in
alignment to be used simultaneously, e.g.,
alternating squint .
2-Obligatory suppression (or amblvopia):
occurs in the squinting eye in monocular
squint, and is constant and deep, and the
vision in this eye is defective.
 amblyopia
By definition. amblyopia; is defective vision without
obvious pathologic cause or even after treating the
cause. The age at which suppression starts
determines its depth and constancy. The amblyopia is
deeper and less easily broken up if suppression starts
in very young infancy than when it begins later in life.
Strabismic amblyopia is characterised by reduced
vision, which
is better if tested with a single character rather than a row
(crowding phenomina), and which is not reduced if a
neutral filter is put in front of the eye (in other types of
amblyopia vision is reduced). Other types of
amblyopia are due to: refractive (anisometropia and
ametropia) media opacities or ptosis (stimulus
deprivation).
Site of Interference( Lesion) in Strabismic Amblyopia :
1- In the cortex: inhibition of the higher cortical function of pattern
vision (form sense) without impairment of the lower cortical
functions of simple light perception and spatial localization. This
is supported by the findings of pathological EEG cortical
rhythms in amblyopic eyes.
2- subcortical Amblyopia is due to loss of the activation of the
reticular forma-tion, anterior to chiasma, in the retina itself.
This is evidenced by:
a- Relative central scotoma,
b- Decreased pupillary reflexes,
c- Decreased critical fusion frequency,
d- The visual acuity of amblyopic eye is better at lower
illumination,
e- The methods of pleoptics which stimulate the fovea and
depress the extra foveal region.
f- It was hypothetized that in strabismus the axes of the cones
are not perpendicular to the pigment epithelium but are titled,
so that the light rays as they enter the eye are not funneled
down to the cone outer seg­ment (Stiles-Crawford effect).