Do Standard Optometric Measures Predict Binocular Coordination During Reading?

In reading, binocular eye movements are required for optimal visual processing and thus, in case of asthenopia or reading problems, standard orthoptic and optometric routines check individual binocular vision by a variety of tests. The present study therefore examines the predictive value of such standard measures of heterophoria, accommodative and vergence facility, AC/A-ratio, NPC and symptoms for binocular coordination parameters during reading. Binocular eye movements were recorded (EyeLink II) for 65 volunteers during a typical reading task and linear regression analyses related all parameters of binocular coordination to all above-mentioned optometric measures: while saccade disconjugacy was weakly predicted by vergence facility (15% explained variance), vergence facility, AC/A and symptoms scores predicted vergence drift (31%). Heterophoria, vergence facility and NPC explained 31% of fixation disparity and first fixation duration showed minor relations to symptoms (18%). In sum, we found only weak to moderate relationships, with expected, selective associations: dynamic parameter related to optometric tests addressing vergence dynamics, whereas the static parameter (fixation disparity) related mainly to heterophoria. Most surprisingly, symptoms were only loosely related to vergence drift and fixation duration, reflecting associations to a dynamic aspect of binocular eye movements in reading and potentially non-specific, overall but slight reading deficiency. Thus, the efficiency of optometric tests to predict binocular coordination during reading was low - questioning a simple, straightforward extrapolation of such test results to an overlearned, complex task.