Peripheral vision and optokinetic nystagmus in children with unilateral congenital cataract

The vision of cats which were monocularly deprived during early infancy, of kittens, and of young human infants shares two limitations: detection in the nasal visual field is far poorer than detection in the temporal visual field, and optokinetic nystagmus (OKN) is difficult to elicit when a pattern moves nasally to temporally. Here we report similar limitations on the vision of children who had a dense central cataract in one eye during early infancy. Extensive static perimetry with one of these children whose visual acuity was good in both eyes revealed that her threshold for detection all along the horizontal meridian was higher in her aphakic than in her normal eye, with this difference much more pronounced in the nasal visual field than in the temporal visual field. Three children who developed cataracts after 6 months of age showed no such discrepancy between thresholds in the temporal and nasal fields. We tested the symmetry of OKN in 12 children treated for unilateral congenital cataract. In every test of an aphakic (n = 4) or normal eye (n = 12), OKN occurred significantly more often when stripes moved temporally to nasally than when they moved nasally to temporally. In contrast, no asymmetry was observed in any of 13 children treated for traumatic cataracts incurred after 3 years of age. We conclude that children treated for unilateral congenital cataract, like young human infants and monocularly deprived cats, show asymmetric OKN and relatively poor detection in the nasal visual field.