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Related Experiment Video

Updated: May 6, 2026

Assessing Binocular Central Visual Field and Binocular Eye Movements in a Dichoptic Viewing Condition

Assessing Binocular Central Visual Field and Binocular Eye Movements in a Dichoptic Viewing Condition

Published on: July 21, 2020

Does order matter? Evaluating the impact of binocular vision test sequence.

Pauline Kang¹, Lisa Asper¹, Alice Chan¹

¹School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.

Optometry and Vision Science : Official Publication of the American Academy of Optometry

|March 18, 2026

Summary

The order of clinical tests for vision function does not impact results. Consistent testing sequences ensure reliable measurements of accommodation and vergence, but multiple tests are needed for accurate monitoring.

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Area of Science:

Ophthalmology
Optometry
Vision Science

Background:

Accurate assessment of accommodative and vergence function is crucial for diagnosing and managing binocular vision disorders.
The repeatability of clinical tests and the influence of testing sequence on outcomes are not well-established.

Purpose of the Study:

To evaluate the repeatability of common clinical tests for accommodative and vergence function.
To determine if the sequence of associated versus dissociated testing affects measurement outcomes.

Main Methods:

Participants underwent repeated assessments of accommodative and vergence function over three visits.
Testing order (associated first vs. dissociated first) was varied across visits to assess sequence effects and intersession repeatability.
Tests included amplitude of accommodation, relative accommodation, accommodative facility, stereoacuity, fixation disparity, and phorias.

Main Results:

No significant differences in binocular vision measures were found regardless of whether associated or dissociated tests were performed first.
Consistent testing sequences between visits yielded no significant differences in accommodative and vergence measures.
Tests such as push-in/out accommodation, lens flippers, and certain phoria measurements demonstrated good intersession repeatability (ICC >0.75).
Other tests exhibited poor repeatability (ICC <0.75).

Conclusions:

The sequence of associated and dissociated testing does not influence the outcomes of accommodative and vergence function tests.
Consistent testing protocols enhance the reliability of measurements.
High variability in some tests suggests that a comprehensive battery of tests is necessary for reliably detecting changes in binocular vision function.