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Assessing Binocular Central Visual Field and Binocular Eye Movements in a Dichoptic Viewing Condition
Published on: July 21, 2020
Disorders of vergence eye movements
Alessandro Serra1, Athena L Chen, R John Leigh
1Neurology Department, Veterans Affairs Medical Center and University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.
Current Opinion in Neurology
|December 15, 2010
Summary
Disorders of vergence are re-interpreted by viewing disjunctive eye movements as part of three-dimensional gaze control. Understanding this complex interplay aids in diagnosing and managing vergence disorders.
Area of Science:
- Neuroscience
- Ophthalmology
- Physiology
Background:
- Natural eye movements integrate vergence with saccades, pursuit, and vestibular functions.
- Frontal and parietal cortex are implicated in governing vergence as a component of three-dimensional gaze control.
- Traditional interpretation of disjunctive movements relies on Hering's law, but new evidence suggests independent eye movement programming.
Purpose of the Study:
- To re-interpret vergence disorders within the framework of three-dimensional gaze control.
- To integrate recent findings on the neural basis of eye movements into clinical understanding.
- To provide a revised perspective on the functional role of vergence in complex gaze shifts.
Main Methods:
- Review of recent electrophysiological studies in humans and animal models.
- Analysis of clinical evidence from patients with conditions like internuclear ophthalmoplegia (INO).
- Examination of the effects of convergence on nystagmus and vestibular mechanisms.
Main Results:
- Electrophysiological data suggest disjunctive saccades are programmed independently.
- Internuclear ophthalmoplegia (INO) patients may retain vergence for compensatory purposes.
- Convergence can influence nystagmus, potentially through vestibular mechanisms or differential muscle fiber activation, not solely co-contraction.
Conclusions:
- A comprehensive understanding of vergence disorders requires considering their role in three-dimensional gaze control.
- Clinical interpretation benefits from a scheme that incorporates the integration of vergence with other eye movement systems.
- Future research should focus on the neural basis and clinical implications of vergence within integrated gaze control.
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