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Using Eye-tracking to Assess the Relative Importance of Visual and Vestibular Input to Subcortical Motion Processing in the Roll Plane

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Optokinetic asynunetry in esotropia.

J L Demer, G K von Noorden

Journal of Pediatric Ophthalmology and Strabismus

|June 1, 2014

Summary

Optokinetic asymmetry in responses is a strong indicator of early-onset esotropia (eye misalignment). While not always present, its detection aids in diagnosing infantile strabismus and understanding visual development.

Area of Science:

Neuroscience
Ophthalmology
Developmental Biology

Background:

Early-onset strabismus can disrupt normal visual pathway development.
Optokinetic responses may reveal asymmetries linked to binocular vision deficits.

Purpose of the Study:

To determine the clinical prevalence of asymmetric optokinetic responses in strabismic patients.
To assess the utility of optokinetic asymmetry in identifying early-onset esotropia.

Main Methods:

Studied 134 strabismic and 16 orthotopic patients.
Assessed monocular optokinetic responses (nasal vs. temporal) for symmetry.
Correlated asymmetry with strabismus onset age and other clinical signs.

Main Results:

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Asymmetric optokinetic responses were found in 58% of esotropia cases with onset before 6 months.
Asymmetry prevalence decreased with later onset of esotropia.
Optokinetic asymmetry strongly suggests early-onset esotropia (85% probability if present).

Conclusions:

Clinically evident optokinetic asymmetry is a significant sign of early-onset esotropia.
Absence of asymmetry does not exclude early-onset strabismus.
Other infantile esotropia signs like latent nystagmus are not consistently linked to optokinetic asymmetry.