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Richard W. Hertle, Eileen E. Birch, Jingyun Wang, Joost Felius, David Stager, Vidhya Subramanian, Reed M. Jost; Ocular Motor Analysis of Monocular Visual Preference in Patients with Infantile Cataracts. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3018.
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© ARVO (1962-2015); The Authors (2016-present)
We evaluated concordance of asymmetry in ocular motor function and acuity development in children treated for cataracts.
Data from 31 children treated for dense cataracts were analyzed. Patients with complications were excluded. Clinical evaluation of eye health, alignment and visual acuity were assessed regularly. Eye movement recordings at ≥5 years of age were evaluated qualitatively and quantitatively and correlated with subjective, monocular assessment of visual acuity.
24 patients (77%) developed nystagmus (9 infantile nystagmus, 14 fusion maldevelopment nystagmus, 1 both). Of these 24 children, 16 showed qualitative and quantitative asymmetry present on ocular motor recordings. 14 of the 16 patients with ocular motor asymmetry (88%) showed concordance between ‘eye with worse/better nystagmus’ and ‘eye with poorer/better visual acuity’. There was no difference in interocular EMR asymmetry between those who had early deprivation (12 months (75%). Patients with asymmetric nystagmus had larger interocular acuity difference (IOD) (0.53+/-0.33 logMAR) than patients with symmetric nystagmus (0.13 +/- 0.09 logMAR) (T=4.5, P<0.001).
Studies have shown mixed results examining the concordance of behavioral "motor preference" and "visual acuity symmetry." This study demonstrated detailed eye movement recordings may be a valid "motor" approach to assessing "sensory" preference in preverbal children after cataract surgery. The central pathways for motor dominance may have a different time course for sensitivity to developmental insults than afferent visual pathways.Figure Legend - Patient with asymmetric FMNS, worse OS, the eye with poorer vision. OD fixing JRFMNS with long periods of fixation and foveation, OS fixing, large amplitude high frequency jerk JLFMNS with long foveation.
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