A method to determine a binocular alignment includes measuring a disassociated phoria of a patient at a first simulated distance by presenting fusible images including targets with a first parallax corresponding to the first simulated distance, using a headset stereo display at a screen distance; presenting non-fusible images by presenting the target for a first eye with the first parallax and presenting a disassociated targetless image for a second eye, and measuring the disassociated phoria in response to the presenting of non-fusible images, using an eye tracker of the headset; and determining a vergence of the patient at the first simulated distance by presenting fusible images for the first and second eyes with the first parallax, corrected with the measured disassociated phoria; measuring an associated phoria in response to the presenting of fusible images; and determining the vergence as a combination of the disassociated phoria and the associated phoria.