Course: Binocular Vision

Section

General

Domains: Clinical practice, Communication

No CPD Points

Binocular Vision provides a step-by-step practical guide to the various techniques required in practice to assess the binocular status of patients, both young and old.

Optometrists are guided through specific case studies to consider the appropriate management options for a broad range of anomalies. Presented by Professor Bruce Evans, this course uses specific clinical cases and clinical footage of assessment techniques on real life patients to illustrate best practices in binocular vision assessment. Summary slides, graphics and animations aid understanding, and supportive reference links can be found throughout the course page and in the 'More information' section.

Test techniques considered include:

Cover-uncover
Alternating cover
Convergence assessment
Accommodation
Ocular motility
Fixation disparity
Foveal suppression
Stereopsis
Fusional reserves.

First published: April 2015

Open allClose all

Instructions: Clicking on the section name will show / hide the section.

Learning outcomes

Communication

s.2 Communicate effectively with patients

Understand the best approach for taking history and symptoms to elicit information pertaining to any suspect binocular anomaly.

Clinical Practice

s.7 Conduct appropriate assessments, examinations, treatments and referrals

Understand the main techniques in the assessment of binocular status, including the cover/uncover test, motility, fixation disparity assessment, testing for compensation, NPC measurement and assessing fusional reserves.

s.5 Keep your knowledge and skills up to date

Understand, via the use of case studies, the management of a variety of binocular anomalies including comitant phoria and tropia and incomitancies.

Unit 1 - Introduction and clinical assessment (~7 mins)

For more information on viewing Docet videos, including how to watch them in full screen and how to screencast, please go to our FAQs.

Essential reading
FileDOCET BV Factsheet - Refractive development File Opens in a new window.

Unit 5 - Management and case studies (~17 mins)

More information

References
URLBarnhardt C, Cotter S, Mitchell G et al. (2012) Symptoms in Children with Convergence Insufficiency: Before and After Treatment. Optom Vis Sci. 89(10), pp 1512–1520 [Accessed Sep 2025] URL Opens in a new window.
Elliott D (2020) Clinical Procedures in Primary Eye Care. Elsevier. Chapter 6 – Assessment of Binocular Vision and Accommodation – Barrett BT.
Evans B (2017) Pickwell’s Binocular Vision Anomalies. 5th Edition Butterworth Heinemann.
Evans B (2005) Eye Essentials - Binocular Vision. Butterworth Heinemann.
Kushner B (2005) The treatment of convergence insufficiency. Arch Ophthalmol 123, pp 100–101
Leat J, Chan L, Maharaj P et al (2013) Binocular vision and eye movement disorders in older adults. Investigative Ophthalmology and Vision Science 54 (5), pp 3798-3805
Schieman M, Mitchell G, Cotter S et al. (2005) The convergence insufficiency treatment trial (CITT) study group. A randomised clinical trial of treatments for convergence insufficiency in children. Arch Ophthalmol 123, pp 14–24
Taub M (2004) Binocular vision anomalies: what every optometrist should know. Optometry Today, pp 42-45
College of Optometrists Guidance
URLCollege of Optometrists. Examining and managing patients with an anomaly of binocular vision. Guidance for Professional Practice. Knowledge, skills and performance. [Accessed Sep 2025] URL Opens in a new window.
Docet would like to thank the following for their contribution to this programme:

Professor Bruce JW Evans, BSc PhD FCOptom DipCLP DipOrth FAAO FBCLA

Dr Michael Johnson, PhD FCOptom DipGlauc DipOrth DipTP(IP)