Amblyopia is a neuro-developmental disorder of the visual cortex that arises from abnormal visual experience early in life. Amblyopia is clinically important because it is a major cause of vision loss in infants and young children. Amblyopia is also of basic interest because it reflects the neural impairment that occurs when normal visual development is disrupted. Amblyopia provides an ideal model for understanding when and how brain plasticity may be harnessed for recovery of function. Over the past two decades there has been a rekindling of interest in developing more effective methods for treating amblyopia, and for extending the treatment beyond the critical period, as exemplified by new clinical trials and new basic research studies. The focus of this review is on stereopsis and its potential for recovery. Impaired stereoscopic depth perception is the most common deficit associated with amblyopia under ordinary (binocular) viewing conditions (Webber & Wood, 2005). Our review of the extant literature suggests that this impairment may have a substantial impact on visuomotor tasks, difficulties in playing sports in children and locomoting safely in older adults. Furthermore, impaired stereopsis may also limit career options for amblyopes. Finally, stereopsis is more impacted in strabismic than in anisometropic amblyopia. Our review of the various approaches to treating amblyopia (patching, perceptual learning, videogames) suggests that there are several promising new approaches to recovering stereopsis in both anisometropic and strabismic amblyopes. However, recovery of stereoacuity may require more active treatment in strabismic than in anisometropic amblyopia. Individuals with strabismic amblyopia have a very low probability of improvement with monocular training; however they fare better with dichoptic training than with monocular training, and even better with direct stereo training.

There has been a long-standing debate about the mechanisms underlying the perception of stereoscopic depth and the computation of the relative disparities that it relies on. Relative disparities between visual objects could be computed in two ways: (a) using the difference in the object's absolute disparities (Hypothesis 1) or (b) using relative disparities based on the differences in the monocular separations between objects (Hypothesis 2). To differentiate between these hypotheses, we measured stereoscopic discrimination thresholds for lines with different absolute and relative disparities. Participants were asked to judge the depth of two lines presented at the same distance from the fixation plane (absolute disparity) or the depth between two lines presented at different distances (relative disparity). We used a single stimulus method involving a unique memory component for both conditions, and no extraneous references were available. We also measured vergence noise using Nonius lines. Stereo thresholds were substantially worse for absolute disparities than for relative disparities, and the difference could not be explained by vergence noise. We attribute this difference to an absence of conscious readout of absolute disparities, termed the absolute disparity anomaly. We further show that the pattern of correlations between vergence noise and absolute and relative disparity acuities can be explained jointly by the existence of the absolute disparity anomaly and by the assumption that relative disparity information is computed from absolute disparities (Hypothesis 1).

Stereopsis is the rich impression of three-dimensionality, based on binocular disparity-the differences between the two retinal images of the same world. However, a substantial proportion of the population is stereo-deficient, and relies mostly on monocular cues to judge the relative depth or distance of objects in the environment. Here we trained adults who were stereo blind or stereo-deficient owing to strabismus and/or amblyopia in a natural visuomotor task-a 'bug squashing' game-in a virtual reality environment. The subjects' task was to squash a virtual dichoptic bug on a slanted surface, by hitting it with a physical cylinder they held in their hand. The perceived surface slant was determined by monocular texture and stereoscopic cues, with these cues being either consistent or in conflict, allowing us to track the relative weighting of monocular versus stereoscopic cues as training in the task progressed. Following training most participants showed greater reliance on stereoscopic cues, reduced suppression and improved stereoacuity. Importantly, the training-induced changes in relative stereo weights were significant predictors of the improvements in stereoacuity. We conclude that some adults deprived of normal binocular vision and insensitive to the disparity information can, with appropriate experience, recover access to more reliable stereoscopic information.This article is part of the themed issue 'Vision in our three-dimensional world'.