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Binocularity in comitant strabismus: binocular visual fields studies

E C Campos

    Documenta Ophthalmologica. Advances in Ophthalmology
    |November 1, 1982
    PubMed
    Summary
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    Binocular perimetry in strabismus reveals that small-angle deviations exhibit anomalous binocular vision, not suppression, when using fusable stimuli. This pseudo-Panum's area is wider than normal and method-dependent.

    Area of Science:

    • Ophthalmology
    • Neuroscience
    • Visual Science

    Background:

    • Binocular perimetry in strabismus has yielded varied results due to differing methodologies.
    • Sensory testing under casual viewing conditions is crucial for understanding strabismic patients' visual perception.
    • Existing literature often misinterprets areas of single vision in small-angle strabismus as suppression.

    Purpose of the Study:

    • To investigate binocular vision in patients with small-angle comitant strabismus using non-artificial testing conditions.
    • To differentiate between suppression and anomalous retinal correspondence (ARC) in strabismic visual fields.
    • To evaluate the impact of testing methodologies on binocular perimetry results in strabismus.

    Main Methods:

    • A series of experiments testing patients with small-angle esotropia and exotropia.

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  • Utilizing fusable stimuli and appropriate control marks for binocularity assessment.
  • Comparing the author's binocular perimetry technique with the classical Harms method.

    • Main Results:

    • Small-angle esotropia shows areas of binocular vision sustained by anomalous retinal correspondence (ARC), not suppression, with fusable stimuli.
    • No suppression scotomas were found in the entire visual field of small-angle strabismus patients.
    • The pseudo-Panum's area in strabismus is wider than normal Panum's area and more easily disrupted.
    • Large-angle exotropia exhibits wide suppression scotomas, particularly when dissociating techniques are used.

    Conclusions:

    • Small-angle strabismus features an anomalous form of binocular single vision, detectable via specific binocular visual field techniques.
    • This anomalous binocularity is evident only under non-artificial, casual viewing conditions.
    • The findings challenge traditional interpretations of suppression in strabismus and highlight the importance of testing methodology.