Name: A Battery of Quantitative Binocular Vision Tests for Adults: Testing Protocols (Video) | JoVE Journal
Uploaded: 2026-06-16T12:30:00.000+00:00
Duration: 8 min 25 s
Description: Learn a comprehensive battery of eight quantitative binocular vision tests for assessing sensory fusion and stereopsis in adults. This protocol reveals hidden binocularity beyond standard clinical assessments.

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This work was supported by the Canadian Institutes of Health Research (CIHR) grant (PJT 183761) to EN, XG, DM, DIS, and BT. We thank the REWIRE-D Study Group (rewire-d.ca) for their contributions to the development of this work.

All authors declare no conflicts of interest.

This novel battery of tests was developed to assess multiple facets of binocular vision, ranging from simultaneous perception and fusion to distinct mechanisms underlying stereopsis. The entire protocol takes at least 85 minutes to complete, providing a comprehensive evaluation of depth perception. Tests may be administered individually or in combination, depending on research or clinical needs. The full test battery is best suited to research environments where longer testing durations are feasible. Nevertheless, subset...

Binocular vision enables accurate depth perception through three hierarchical processes. The first step is simultaneous perception, in which the observer perceives information from both eyes. Subsequently, motor and sensory fusion occur when the two eyes are aligned and receive spatially correlated images. Stereopsis is the highest level of sensory fusion and relies on the processing of binocular disparity1,2. A range of clinical tests is available to assess simultaneous perception and motor fusion, for example, synoptophores, fusional vergence using prisms, and Worth 4-Dot (W4D) tests3,4,5. However, quantitative assessment of sensory fusion and stereopsis outside of central vision remains limited. The purpose of this test battery is to evaluate aspects of binocular processing that are not currently assessed.
Sensory fusion is clinically assessed using tools such as the W4D test and Bagolini striated lenses3,4,5. These methods effectively determine whether a patient achieves binocular fusion or suppresses input from one eye. However, they are qualitative and unable to differentiate between patients with varying capabilities in sensory fusion. The battery of tests proposed here provides a quantitative measure of sensory fusion and interocular suppression6 based on the letter ocular dominance test and plaid motion integration7,8,9.
Stereopsis can be assessed using various clinical tests, including the TNO, Randot, and Frisby stereo tests3,4,5. While these instruments provide quantitative measures of stereoacuity, they remain limited in several aspects10,11. First, these printed tests offer only a fixed range of disparity levels, separated by discrete steps. Second, stereopsis is assessed only within central vision, where visual resolution is highest12,13,14. Third, printed formats measure only static stereopsis. It is well known that the processing of binocular disparity and motion information is linked at a neural level15; thus, it is important to develop tests that incorporate motion cues.
All tasks in the proposed battery aim to address these limitations by applying rigorous psychophysical methods, including adaptive procedures and the method of constant stimuli. The battery consists of eight tests (Table 1), targeting different components of depth perception. The tasks are designed to provide precise estimates of the individual thresholds for sensory fusion, stereopsis in peripheral vision16,17,18, and perception of motion-in-depth19,20,21,22.
This protocol requires minimal equipment, with most components easily replaced with standard commercial materials or purchased from a specialized vendor for the mirror stereoscope. The response box is optional and can be 3D-printed. The full test battery is best suited to research environments where longer testing durations are feasible (approximately 85 min, plus instructions, practice trials, and breaks). Nevertheless, subsets of these tests can yield quick and valuable insights into specific aspects of binocular vision (Table 1) for researchers and clinicians, especially peripheral stereopsis and motion-in-depth, domains that are not currently tested in clinical settings. With a basic understanding of psychophysical principles and minimal Python programming, these tasks can be modified to suit different research or clinical needs.
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Task</td>
			<td>Features</td>
			<td>Stimulus eccentricity</td>
			<td>Methodology</td>
			<td>Formal test duration (min)</td>
		</tr>
		<tr>
			<td>Letter ocular dominance</td>
			<td>Sensory fusion</td>
			<td>3.75&#176;</td>
			<td>Two 1-up-1-down staircases &#38; the method of constant stimuli</td>
			<td>7</td>
		</tr>
		<tr>
			<td>Plaid motion integration</td>
			<td>Sensory fusion</td>
			<td>0&#176;</td>
			<td>3 one-minute trials</td>
			<td>3</td>
		</tr>
		<tr>
			<td>Fine peripheral stereopsis</td>
			<td>Central &#38; peripheral stereopsis</td>
			<td>0&#176; &#38; 10&#176;</td>
			<td>2-interval forced choice; 1-up-2-down staircases</td>
			<td>20 (4 min per location)</td>
		</tr>
		<tr>
			<td>Coarse peripheral stereopsis</td>
			<td>Peripheral stereopsis</td>
			<td>5&#176;</td>
			<td>15 trials per condition</td>
			<td>5</td>
		</tr>
		<tr>
			<td>Dynamic local stereopsis</td>
			<td>Motion-in-depth; central &#38; peripheral stereopsis</td>
			<td>6&#176;</td>
			<td>2-interval forced choice; 1-up-2-down staircases</td>
			<td>25 (5 min per location)</td>
		</tr>
		<tr>
			<td>The Pulfrich task</td>
			<td>Stereopsis from temporal disparity</td>
			<td>Full screen</td>
			<td>The method of constant stimuli</td>
			<td>12</td>
		</tr>
		<tr>
			<td>Motion parallax</td>
			<td>Occlusion; motion-in-depth</td>
			<td>4&#176;</td>
			<td>1-up-2-down staircases</td>
			<td>10</td>
		</tr>
		<tr>
			<td>Da Vinci stereospsis</td>
			<td>Occlusion; binocular integration</td>
			<td>1.5&#176;</td>
			<td>10 trials per condition</td>
			<td>3</td>
		</tr>
		<tr>
			<td>Total test duration</td>
			<td></td>
			<td></td>
			<td></td>
			<td>85</td>
		</tr>
	</tbody>
</table>
Table 1: Overview of tasks in the battery. Description of the eight tasks included in the battery. Note that test durations do not include practice and breaks.

<table><tbody><tr><td>Codes</td><td>N/A</td><td>https://git.uwaterloo.ca/hvnl/binocularbatterycodes_manuscript/-/tree/9f7ff9eb1705d50060ca46a8ac2d2d1848349368/</td><td>The codes used to generate the stimuli and run the protocol are available at the repository provided in the &quot;Catalog Number&quot; column.&amp;nbsp;</td></tr><tr><td>Computer</td><td>Alienware, Dell Inc., Texas, USA</td><td>XPS 8930</td><td>Intel Core i7-9700 CPU, 64 GB RAM</td></tr><tr><td>Forehead and chin rest</td><td>N/A</td><td>N/A</td><td>Custom-built, used to maintain head position and viewing distance</td></tr><tr><td>Mirror stereoscope</td><td>N/A</td><td>N/A</td><td>Custom-built</td></tr><tr><td>Monitor</td><td>LG Electronics, Seoul, Korea</td><td>LG 27UP600-W</td><td>Resolution: 3840 &amp;times; 2160 pixels, screen width: 59.5 cm, refresh rate: 60 Hz, response time: 5 ms; gray background luminance was set to 340 cd/m2</td></tr><tr><td>Mouse and keyboard</td><td>N/A</td><td>N/A</td><td>For experimenter use</td></tr><tr><td>Numeric pad</td><td>N/A</td><td>N/A</td><td>For participant use</td></tr><tr><td>Programming Environment</td><td>N/A</td><td>https://www.psychopy.org/</td><td>PsychoPy 2022.2.4 (on Python 3.6.6), running on Windows 10 (Microsoft Corporation, Redmond, WA, USA)</td></tr><tr><td>Response box</td><td>N/A</td><td>N/A</td><td>Custom-built, please see Schematics in Supplementary Documents for parts required</td></tr></tbody></table>

a battery of quantitative binocular vision tests for adults: testing protocols

A Battery of Quantitative Binocular Vision Tests for Adults: Testing Protocols

Sensory fusion and stereopsis are two crucial components of binocular depth perception. Current clinical tests do not provide a quantitative measure of sensory fusion and assess limited aspects of stereopsis. More importantly, patients who show no binocular fusion in standard clinical tests can demonstrate binocular integration and perceive depth from binocular disparity and motion cues, suggesting that current tests are insufficient to examine all aspects of binocularity. A battery of eight tests is presented here to provide a comprehensive assessment of binocular vision. These tests are designed to refine and extend existing assessments by targeting different components of binocular processing. Specifically, letter ocular dominance and plaid motion integration provide quantitative measures of sensory fusion. Binocular integration in peripheral vision is evaluated using fine- and coarse-peripheral stereopsis tests, dynamic local stereopsis, and motion parallax. Motion-in-depth is assessed by dynamic local stereopsis, the Pulfrich task, and motion parallax. An additional da Vinci stereopsis test provides qualitative insight into binocular integration by measuring the occlusion difference between the two eyes. Exemplary results are shown from a participant with normal vision. Modifications to the current protocol can be made to accommodate specific needs and to support applications in broader populations.

Representative data were collected from a 20-year-old participant with normal vision (visual acuity 0.0 logMAR for each eye; stereoacuity 40 arcsec).
Letter ocular dominance 
Results from two staircases and&#160;the method of constant stimuli (Figure 2C,D) indicate slightly stronger right-eye dominance for this participant.
Expected results: Each staircase should progressively approach its threshol...

Here we present a comprehensive battery of tasks to assess binocular vision. Tasks include peripheral stereoacuity and motion-in-depth, which are not assessed by current clinical tests. Incorporating these tasks will provide an in-depth assessment of an individual&#8217;s binocularity.

Sensory fusion and stereopsis are two crucial components of binocular depth perception. Current clinical tests do not provide a quantitative measure of ...

This protocol presents a battery of eight tests that aims to provide a comprehensive assessment of binocular vision. These tests are designed to reveal hidden binocularity in patients who show no stereo vision in current clinical tests. To begin, set up and calibrate the mirror stereoscope and the monitor and open the binocular battery Pi script in PsychoPy coder.Modify the monitor information in PsychoPy Monitor Center, and in the script including the monitor's name, viewing distance, screen size, refresh rate, resolution, and gamma calibration according to the monitor in use. Click the Run Experiment button at the top. Next, instruct a participant to look through the mirror stereoscope.Ask the participant if a cross is visible in the middle comprised of a vertical line and a horizontal line. If not, ask whether the vertical line should move to the left or right. Use the left and right arrow keys to move the vertical line in the indicated direction until it aligns at the center of the horizontal line.Assign and input a participant identification. At the main menu screen, use the numeric pad to select among the eight available tasks. Select the fine peripheral stereopsis task from the main menu.Start by running a practice test and choose the stationary task to familiarize the participant and provide the required instructions. Instruct the participant to fixate on the cross wherever it is presented on the screen. Ask the participant whether the black square appears behind or in front of the white frame or on the same plane and press one if the depth is perceived, or two if no depth is perceived.Complete the practice test and evaluate the results. If the practice results are below 80%correct, press Enter and restart the practice test. If the results for the stationary practice are above 80%correct, proceed to run the regular practice.Inform the participant that the stimulus will flash twice and the depth will appear in one of the two flashes. Instruct the participant to report in which of the two flashes the depth is observed. When practice results are above 80%correct, run a formal test.Once the task is completed, press Enter to return to the main menu. Select the dynamic local stereopsis task from the main menu. Start by running a practice test.Among the four practice types that allow step-by-step familiarization, run the practice task one for a single location and a single interval. Instruct the participant to look at the center while paying attention to the specified target location. Ask the participant whether the square moved closer or farther away.Press one if motion in depth is observed, or two if not. Proceed to the next practice task if the participant reports motion in depth. Run the practice task two for a single location with a two interval force choice task.Inform the participant that the stimulus will flash twice. Ask the participant which of the two flashes contains motion in depth at the specified target location. Press one or two based on the participant's choice.If the participant cannot reliably perceive motion in depth, reinstruct the participant and allow direct viewing of the target location. If the participant correctly identifies motion in depth, run the practice task three for two locations with a two interval force choice task. Provide the same instructions as in the previous task.Accept that the target may appear at either of two locations. Next, run the practice task four. In this case, the target may appear at any of the four peripheral locations.Review the test results carefully. If the practice results are below 80%correct, ask the participant to restart the practice. When ready, run the dynamic periphery and dynamic center for the formal test.Once the task is completed, press Enter to return to the main menu. Select the Pulfrich Task from the main menu. Start by running a practice test.Ask the participant whether the depth is visible and whether the moving moons appear in front of or behind the stars. Ask the participant to use the slash or asterisk key to move the stationary moon at the bottom of the screen forward or backward until it appears at the same depth as the moving moons. Optionally, ask the participant to indicate the perceived depth using the response box.Present the response box facing the participant with the center positioned approximately 40 centimeters from the participant's eyes. Ask the participant to move the sliders on both sides of the box until the moons inside the box appear at the same depth as the moving moons on the screen. Type the reading from the slider onto the computer screen.Press the plus button then enter to continue and complete the rest of the trials. For a participant with normal vision, the practice results should show a linear response pattern. Proceed to a formal test if the practice results appear normal or consistent for the last two practice tests.Results showed fine stereopsis thresholds at the central and at four peripheral locations at 10 degrees eccentricity with lower thresholds at the center compared to the periphery. In the dynamic local stereopsis test, thresholds for crossed and uncross disparities at the central and at four peripheral locations were identified. Cross disparities correspond to stimuli perceived in front of the fixation plane, whereas uncrossed disparities correspond to stimuli perceived behind it with slightly lower thresholds observed at the center compared to the periphery.The Pulfrich task results showed a linear relationship between filter strength and perceived depth in both the disparity matching and the physical depth matching tasks with intercepts close to zero, indicating no spontaneous Pulfrich effect. The eight tests in our battery provide insights into sensory fusion, peripheral stereopsis, and motion in depth perception. The most important consideration is to provide clear instruction to ensure the participants understand each task correctly.We aim to better understand how binocular vision develops to guide rehabilitation for amblyopia.

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Learn a comprehensive battery of eight quantitative binocular vision tests for assessing sensory fusion and stereopsis in adults. This protocol reveals hidden binocularity beyond standard clinical assessments.

A Battery of Quantitative Binocular Vision Tests for Adults: Testing Protocols

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