Stability of human binocular alignment in the dark and under conditions of nonfixation

Jung, Jaeho; Klaehn, Lindsay D.; Brodsky, Michael C.

doi:10.1016/j.jaapos.2016.05.011

Journal of American Association for Pediatric Ophthalmology and

2016

DOI: 10.1016/j.jaapos.2016.05.011

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Stability of human binocular alignment in the dark and under conditions of nonfixation

Jaeho Jung

Lindsay D. Klaehn

Michael C. Brodsky

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Cited by 2 publications

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“…But, if the eyes are tracked with a device of sufficient sensitivity, misalignment will always be detected. 3 In patients with intermittent exotropia, extraocular muscle tonus exerts a divergent force, referred to as an exophoria. [4][5][6][7] The exophoria is held in check by an innate drive to fuse the image from each eye.…”

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confidence: 99%

Bilateral Occlusion Reduces the Ocular Deviation in Intermittent Exotropia

Economides

Adams

Horton

2021

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.The most common form of strabismus, intermittent exotropia, is thought to become manifest when the drive to fuse is overcome by excessive divergent muscle tone. This principle is tested by examining the alignment of the eyes in the absence of vision. We compare the ocular deviation in patients with intermittent exotropia under conditions of monocular versus binocular occlusion.METHODS. This prospective study of a patient cohort referred to our laboratory enrolled 18 patients with typical findings of well-controlled intermittent exotropia. Eye positions were recorded with video eye trackers while patients looked at a fixation spot at a distance of 57 cm. One eye was occluded, and the resulting ocular deviation was measured. Both eyes were then occluded, and the ocular deviation was re-measured. RESULTS.The majority of patients (11/18) had a smaller deviation when both eyes were covered. Occlusion of one eye resulted in a mean exotropia of 13.5°± 4.7°. Occlusion of both eyes reduced the mean exotropia to 6.0°± 6.5°(paired t-test, P < 0.001), corresponding to a 56% reduction in the ocular deviation. This reduction persisted during prolonged bilateral occlusion but reversed as soon as vision was restored. CONCLUSIONS.Bilateral occlusion reveals a fixation-free state of alignment that is different from orthotropia and usually less than the exotropia that occurs spontaneously during binocular viewing. This finding demonstrates that the deviation angle in patients with intermittent exotropia is actively mediated by visual feedback, which the fixating eye is capable of providing alone.

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mentioning

confidence: 99%

Bilateral Occlusion Reduces the Ocular Deviation in Intermittent Exotropia

Economides

Adams

Horton

2021

Invest. Ophthalmol. Vis. Sci.

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Phoria Adaptation: The Ghost in the Machine

Brodsky

2020

Journal of Binocular Vision and Ocular Motility

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Stability of human binocular alignment in the dark and under conditions of nonfixation

Cited by 2 publications

References 22 publications

Bilateral Occlusion Reduces the Ocular Deviation in Intermittent Exotropia

Bilateral Occlusion Reduces the Ocular Deviation in Intermittent Exotropia

Phoria Adaptation: The Ghost in the Machine

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