Binocular vision in the twenty-first century

This special issue of the Journal of Optometry has a focus on ‘‘binocular vision’’. Over the past decade, the area of binocular vision, and related oculomotor-based reading performance and visual comfort, as well as other visual aspects, has taken on a special prominence. This is primarily due to two factors.1 First, there are the United States conflicts that have persisted in the mideast over the past decade or so. Mild traumatic brain injury (mTBI) has been the ‘signature’ and frequently the ‘invisible’ war injury, with its pervasive, adverse effects on binocularity, in particular the vergence and accommodative systems, with carryover to the complex act of reading and visual performance in general. In fact, reading problems, typically of an oculomotor nature, are the most frequent visual symptoms in this population. Second, the same holds true for the area of sport concussions. These two phenomena have converged and brought to the forefront the range of visual sequelae in both the war and sports arenas, and mTBI in general. And, in turn, they have specifically highlighted these common binocular vision problems, as well as the importance and efficacy of vision therapy (VT)/neuro-optometric vision rehabilitation), in the millions of afflicted patients worldwide.1,2 This leads to the important notion of brain plasticity, and more specifically of visual system plasticity. Just over 10 years ago, visual system plasticity, in particular in adults, was ‘‘rediscovered’’ by the Oliver Sacks/Sue Barry (‘‘Stereo Sue’’) collaboration.3 Of course, such plasticity at all ages was always ‘there’, but perhaps not brought to the public eye in such a dramatic and widespread manner. Those in optometry performing high-level vision therapy in both children and adults, including in strabismics, knew this all along. This was not new, but rather it gave important confirmation and affirmation to the wide range of successful optometric interventions in such patients. Yes, vision therapy ‘‘works’’, even in adults!! How could it not ‘‘work’’, as its underlying s c v