Pursuit eye movements in late-onset esotropia

Horizontal, smooth pursuit eye movements were recorded from adults and children with infantile and late-onset esotropia using a remote, video-based, eye-movement recording system. Each subject monocularly tracked a 0.5-degree target moving back and forth on a video monitor at a constant velocity of 10 degrees, over a range of 12 degrees. Each subject's nasal and temporal gain (eye velocity/target velocity) was measured. Confirming the results of previous studies, we found that infantile esotropes had asymmetrical pursuit eye movements (nasal gain greater than temporal gain) while late-onset esotropes had symmetrical gains. However, unlike previous investigators, we found that half of the late-onset esotropes had impaired pursuit gain. The magnitude of the pursuit abnormality and the amount of refractive error were correlated--patients with the highest refractive error had the lowest pursuit gain.