The clinical assessment of binocular vision before and after a working day

This paper looks at the clinical investigative and measurement procedures used in assessing binocular vision at the beginning of a normal working day and compared with the same procedures carried out in the afternoon which included several hours of close work. In 84 young adults, it was found that dissociated heterophoria, associated heterophoria and fixation disparity increased. This was accompanied by visual symptoms. It is likely that any decompensation of heterophoria is worse at the end of a working day. The results of this investigation raise the question of the value of some clinical tests for binocular assessment carried out at the beginning of the day.