Here Is How To Diagnose and Treat Binocular Vision Conditions In 5 Minutes


Your patient complains of eye strain at night. Headaches on the computer. Blurry vision in their contacts. Poor performance in school. Refraction shows no change. 20/20.

A lot of docs get uncomfortable managing a patient with binocular vision problems. Their head swims with forgotten equations and thresholds and AC/A ratios.

They don’t have time to dig up and re-learn how to handle it – there’s another patient in 15 minutes.

So they ignore it.

The patient silently suffers year after year until they come to you. With no special equipment, you diagnose and treat their condition in less than 5 minutes.

The patient’s life changes, they are loyal to you for life, and send all their friends and family as referrals.

This is how you can diagnose and treat binocular conditions in less than 5 minutes:

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About Bruce Colton

Bruce Colton
Bruce Colton, O.D. earned his degrees from BYU and UHCO, where he taught Microbiology and did stem cell research with the NIH to help cure macular degeneration. He loves fitting sclerals, prescribing prism, and performing minor surgeries. He has done years of humanitarian work in Argentina, China, and Guatemala. In his free time, Dr. Colton plays with his 3-year-old daughter and newborn son, and takes his wife on romantic dates.


  1. Jeffrey Palmer

    The quickest and most accurate binocular screening question I ask is, “Have you been to a 3D movie?” The answer will be either, “Yes, I liked it” or “NO!! I HATE THEM!!” There is no middle ground. The second answer confirms a binocular problem every time. An alternative is to use a polarized binocular balance at the end of your refraction. The suppression will be a giveaway. Now you have to accurately diagnose and solve their vision problem. You will change the patient’s life, so do a good job.

  2. Antonio Chirumbolo

    Too often I find myself not investing more effort into Binocular Vision Conditions because I have this idea it “takes too long,” and would rather send it to someone else.

    Thank you for this!

    • Carol Scott

      The best way to know that someone has a binocular vision problem is to use the COVD symptom checklist. There is a short one and a longer one. If their points are more than 25 they need help.
      It really doesn’t take long to do NPC, cover test, vergences and pra, nra. If you have a VT OD in the area vision therapy is always the way to fix the problem unless it is minor. The only valid treatment for CI is VT.

      You can find the symptom checklist on the covd website.

  3. Francesca Cirillo

    Best wishes to all my colleagues in the US.
    I was along same thoughts as Antonio Chirumbolo: too often I think binocular vision assessment takes too long but this article makes me want to add an extra 2-5 min on every patient from 5 y.o. to 105 y.o.
    Thank you from AUSTRALIA:)

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