The functional significance of stereopsis

Purpose. Development or restoration of binocular vision is one of the key goals of strabismus management; however, the functional impact of stereoacuity has largely been neglected. Methods. Subjects aged 10 to 30 years with normal, reduced, or nil stereoacuity performed three tasks: Purdue pegboard (measured how many pegs placed in 30 seconds), bead threading (with two sizes of bead, to increase the difficulty; measured time taken to thread a number of beads), and water pouring (measured both accuracy and time). All tests were undertaken both with and without occlusion of one eye. Results. One hundred forty-three subjects were recruited, 32.9% (n = 47) with a manifest deviation. Performances on the pegboard and bead tasks were significantly worse in the nil stereoacuity group when compared with that of the normal stereoacuity group. On the large and small bead tasks, those with reduced stereoacuity were better than those with nil stereoacuity (when the Preschool Randot Stereoacuity Test [Stereo Optical Co, Inc., Chicago, IL] results were used to determine stereoacuity levels). Comparison of the short-term monocular conditions (those with normal stereoacuity but occluded) with nil stereoacuity showed that, on all measures, the performance was best in the nil stereoacuity group and was statistically significant for the large and small beads task, irrespective of which test result was used to define the stereoacuity levels. Conclusions. Performance on motor skills tasks was related to stereoacuity, with subjects with normal stereoacuity performing best on all tests. This quantifiable degradation in performance on some motor skill tasks supports the need to implement management strategies to maximize development of high-grade stereoacuity.