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Updated: May 28, 2026

Assessing Binocular Central Visual Field and Binocular Eye Movements in a Dichoptic Viewing Condition
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Differential Fixation and Eye Alignment Patterns in Strabismus with and Without Amblyopia Across Viewing Conditions.

Archayeeta Rakshit1, Ibrahim M Quagraine2, Gokce Busra Cakir1

  • 1Ocular Motility & Vision Neurosciences Laboratory, Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

Journal of Eye Movement Research
|May 27, 2026
PubMed
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This summary is machine-generated.

Fixation instability (FI) and vergence instability (VI) in strabismic individuals vary with viewing conditions. Visual acuity deficits impact viewing eye FI, while strabismus affects non-viewing eye FI and eye movement speed.

Area of Science:

  • Ophthalmology
  • Neuroscience
  • Vision Science

Background:

  • Fixation instability (FI) and vergence instability (VI) are linked to abnormal fixation eye movements (FEMs) in amblyopia and strabismus.
  • Understanding how viewing conditions influence these instabilities is crucial for diagnosing and managing these conditions.

Purpose of the Study:

  • To investigate the impact of different viewing conditions on FEM patterns in strabismic subjects with and without amblyopia.
  • To differentiate FEM characteristics between strabismic amblyopic, strabismic non-amblyopic, and control groups.

Main Methods:

  • Video-oculography was used to record FEMs in both eyes of participants under various viewing conditions: both-eye viewing (BEV), fellow/dominant-eye viewing (FEV/DEV), and amblyopic/non-dominant-eye viewing (AEV/NDEV).
  • Participants included strabismic subjects with amblyopia (SA, n=56), strabismic subjects without amblyopia (S, n=19), and controls (C, n=25).
Keywords:
amblyopiaeye alignmentfast and slow FEMfixation instabilitystrabismus

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  • Analysis focused on FI, VI, fast FEM amplitudes, slow FEM velocities, and eye deviation control.

    • Main Results:

    • The SA group exhibited significantly greater FI in the amblyopic eye during AEV compared to the fellow eye during FEV.
    • Both SA and S groups showed increased FI in the non-viewing eye and higher VI under monocular viewing compared to controls.
    • Regression analysis revealed visual acuity deficits primarily affect viewing-eye FI and FEM dynamics, whereas strabismus impacts non-viewing-eye FI and slow FEMs.

    Conclusions:

    • Distinct FEM patterns emerge under different viewing conditions, reflecting unique visuomotor control mechanisms in strabismic individuals.
    • These condition-dependent FEM patterns may serve as valuable biomarkers for artificial intelligence (AI)-based classification of visual disorders.
    • The SA group displayed a unique pattern of incomitance, with least eye deviation but highest VI during AEV.