Foundations of Binocular Vision: A Clinical Perspective.

Foundations of Binocular Vision: A Clinical Perspective. Scott B. Steinman, Barbara A. Steinman, Ralph Philip Garza. New York: McGraw-Hill Companies, 2000. Pages: 345. Price: $59.95. ISBN 0-8385-2670-5. The study of the processes involved in binocular vision certainly ranks with the most complex challenges in science. Topics such as the horopter, fusion and correspondence, and the generation of stereopsis requires a very substantial investment of time and effort for all but the most dedicated and immersed students of the science of vision. Although normal binocular vision is a course required at virtually all schools and colleges of optometry, many clinicians have been able to cram for tests, pass the course, and leave the course and their school or college with only a foggy notion about the nature of binocular vision. Even more so, many clinicians lack any idea of the connection between important topics in a typical normal binocular vision course and anomalies seen in their patients. FIGUREFigureSteinman, Steinman, and Garzia’s new book, Foundations of Binocular Vision: A Clinical Perspective, is an absolutely wonderful textbook. More so than any text with which I am familiar, this books makes extremely difficult material simple, clear, and understandable. Best of all, this book continues, page by page, to answer the first, second, and last question of an optometry student: “Why do I have to study this stuff?” On virtually every page, the clinical relevance is integrated into the basic information being presented about binocular vision. Key Points are highlighted in special boxes that emphasize the material. In addition, Clinical Application sections carefully explain how the effect in question relates to patient care. Furthermore, Clinical Procedure sections describe in detail how many common procedures are derived from the material on binocular vision. Two other features of the book assist learning: a Summary and Key Points section at the end of each chapter reinforces the essence of the material. Finally, a Questions section provides an opportunity for better students to confirm their understanding of the material in an alternative manner by answering a series of well-considered questions designed to reinforce the important points. This book consists of nine chapters. Chapter 1 provides a thoughtful and readable discussion of why we have two eyes. The authors spend time on this basic question in this section and again later in the book. The explanation that stereopsis is the prize of binocular vision is presented in an appropriate context that explains the benefits of camouflage breaking in addition to relative depth information. Many other texts simply “explain” the benefit by stating that stereopsis provides accurate depth information. This text (as in other places in the book) provides an intellectually satisfying examination of the topic. Clearly, the authors have wrestled with these topics for many years. The following chapters examine Visual Direction; Fusion and Correspondence; The Horopter; Alternatives to Fusion; Binocular Summation; Stereopsis; Neuroanatomy and Neurophysiology of Binocular Vision; and Development of Binocular Vision. In the 345 pages, there are many well-designed figures and graphs. Many are constructed to illustrate what a patient would see, making understanding relevant and easy. The text presents a thoughtful and well-considered variety of topics in binocular vision. I did not find a single significant omission. I have very few criticisms of this book. In some places the definitions and concepts are presented very simply. For example the description of the visual axis on page 11 describes the line as “the visual line that passes specifically from the fovea to an object of regard.” Although a complete definition that includes the nodal points may be more accurate, I believe that this and several other concepts are presented intentionally in this manner to enhance student learning. The discussion of Knapp’s law on page 108 seems to not fully recognize the relevance of contact lenses for all types of aniseikonia but this is a small point. Other areas of the book may err a bit on the side of clarity and simplicity, but, again, I believe that this is an “error” to which the authors would happily confess. I strongly and unconditionally recommend this book. It clearly and simply makes a sometimes-esoteric area vibrant and relevant. Although it is designed for optometry students, the clarity, brevity, and insight would serve nearly anyone in clinical vision science. Kent M. Daum School of Optometry University of Alabama at Birmingham Birmingham, Alabama