PurposeWe performed video-oculography to evaluate vergence eye movement abnormalities in students diagnosed clinically with vergence disorders. We tested the efficiency of a novel rehabilitation method and evaluated its benefits with video-oculography cross-correlated with clinical tests and symptomatology.MethodsA total of 19 students (20–27 years old) underwent ophthalmologic, orthoptic examination, and a vergence test coupled with video-oculography. Eight patients were diagnosed with vergence disorders with a high symptomatology score (CISS) and performed a 5-week session of vergence rehabilitation. Vergence and rehabilitation tasks were performed with a trapezoid surface of light emitting diodes (LEDs) and adjacent buzzers (US 8851669). We used a novel Vergence double-step (Vd-s) protocol: the target stepped to a second position before the vergence movement completion. Afterward the vergence test was repeated 1 week and 1 month later.ResultsAbnormally increased intertrial variability was observed for many vergence parameters (gain, duration, and speed) for the subjects with vergence disorders. High CISS scores were correlated with variability and increased latency. After the Vd-s, variability of all parameters dropped to normal or better levels. Moreover, the convergence and divergence latency diminished significantly to levels better than normal; benefits were maintained 1 month after completion of Vd-s. CISS scores dropped to normal level, which was maintained up to 1 year.Conclusions and Translational Relevance:Intertrial variability is the major marker of vergence disorders. The Vd-s research-based method leads to normalization of vergence properties and lasting removal of symptoms. The efficiency of the method is due to the spatiotemporal parameters of repetitive trials that stimulate neural plasticity.
Interaction mechanisms between cognition and binocular motor control in reading saccades remain unclear. In this study we examine objectively saccades and fixations parameters during the Stroop test, involving three different levels of cognitive demand (reading, color denomination and interference). In addition, we experimentally induce accommodation and vergence conflicts during the different tasks. Twenty-one visually normal subjects (age 20.9 ± 1.45) performed the Stroop test in three different randomized conditions: a control normal viewing condition, a 16Δ base-out prism condition, and a −2.50D spherical lenses condition. Prisms and spherical lenses induced Vergence-Accommodation conflict. Eye movements were recorded with the Eyeseecam video-oculography device. The results show (1) longer fixation duration in the interference task than in the denomination task, and shorter fixation duration in the reading task; (2) a higher interference effect in the conflict induced conditions compared to the control condition; (3) a lower tolerance to prism induced conflict, with a higher destabilization of the binocular motor control of saccades and fixations. This suggests an interplay between vergence accommodation conflict and cognitive load: tolerance to the conflict seems to be lower in the more cognitively demanding interference Stroop task. The results consolidate the link between cognition and high quality of single binocular vision.
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