Dynamic vergence eye movements in strabismus and amblyopia: symmetric vergence

Dynamic vergence eye movements in response to step target displacements along the midline were measured by an infrared reflection technique in 11 patients having either intermittent strabismus, constants-strabismus amblyopia, or amblyopia without strabismus. We found the absence of normal disparity (fusional) vergence in all patients having strabismus and in some patients having amblyopia without strabismus. A characteristic response consisting of a binocular accommodative vergence component and an early binocular saccadic component was used to foveate the target of interest with the dominant eye. Vergence responses in our control subjects and patients with the nondominant eye occluded were similar to those recorded in our patients during binocular viewing. These results suggest that disparity information is not utilized by patients, probably as a result of long-term, ongoing suppression in the deviated or amblyopic eye. Accommodative vergence with the aid of an early foveating saccade was the primary mechanism for tracking targets in three-dimensional space.