I'm on dual Win OS (XP-32 SP3 | 7-64), running on AMD FX-8320 with Nvidia GTX 760.
I'm using XP for older games and regular browsing and yet I experience awful vsync issues with Balls of Steel in scrolling mode (both fullscreen and windowed, so it's not a resolution thing).

Win XP SP3:
via launcher.exe: vsync issues (constant tearing from the go), minimal garbling on the sides
via bos.exe: smooth scrolling, no garbling but tearing persists (it only starts about 20-30 seconds after table launch, NOT right away, which is the weirdest thing)

Win 7:
via launcher.exe: no tearing, no garbling, playable but movement not so smooth :/
via bos.exe: garbled graphics, lots of tearing, unplayable.

So my only option is via launcher in Win 7 but gameplay is not smooth. Or via bos.exe in XP until my eyes bleed from the tearing.

* Changing compatibility modes in properties won't change a thing.
* Turning vsync on, off or adaptive (or any other graphics option) in nvidia panel won't affect the game AT ALL.
* I got an older physical copy of the game, I had applied the latest patch and I get the same exact issues (as with bos.exe). The same issues also arise in the Devil's Island table. In the hopes of better compatibility I bought the GOG version, which currently seems a real waste.

At first I thought this must be Nvidia drivers problem for my XP, but then I realize that for reasons unknown Nvidia options cannot override the game's locked graphical settings (?).

Any ideas?

So... I was gonna test an HDMI<->DVI cable to replace my D-SUB which led to further testing and calibrations.

Long story short, the tearing issues were (mostly) a result of the monitor's refresh rate (75hz, regardless of resolution). At 60hz it plays much much better and smoother. Tearing is not completely eliminated, but it's playable.