Artifacts in fusion and stereopsis testing based on red/green dichoptic image separation

A red/green anaglyph stereotest (TNO) was administered to a group of patients who had anisometropic amblyopia, and the Worth 4-Dot test for fusion to two groups of strabismus patients. Both tests were administered twice, with the red/green lens position of the glasses reversed between eyes for the second administration. Twelve of 15 patients with anisometropic amblyopia exhibited a stereo acuity difference of 2:1 or more, and 18 of 89 strabismic patients changed Worth 4-Dot fusion or suppression status, between the two positions of the glasses. A group of seven strabismic patients who showed the reversal effect on the Worth 4-Dot test had the results of one glass' position discrepant with those of a geometrically identical achromatic test. It appears that the red/green format can introduce artifacts in binocular vision testing. Testing twice, with the red/green glasses reversed between trials, will prevent misinterpretation of binocular status and may provide diagnostically useful information.