Fixation instability during binocular viewing in anisometropic and strabismic children

Kelly, Krista R.; Cheng-Patel, Christina S.; Jost, Reed M.; Wang, Yizhong; Birch, Eileen E.

doi:10.1016/j.exer.2018.07.013

Cited by 49 publications

(52 citation statements)

References 41 publications

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“…4,6,13,18,19 However, smaller angles of deviation and preserved binocular function may lessen instability. 13 Unpublished monocular viewing data from the cohort described by Kelly et al 20 also show amblyopic and nonamblyopic children with strabismus and/or anisometropia have larger fellow eye instability than controls (Figure 1).…”

Section: Fixation Instabilitymentioning

confidence: 89%

“…8 Vergence instability has been reported while viewing with two eyes in adults with large angle exotropia, suggesting an association of suppression with disconjugate eye movements. 6 Recently, Kelly et al 20 reported increased fixation instability and vergence instability, regardless of current amblyopia, in strabismic and anisometropic children compared with controls ( Figure 2). Fellow eye instability was not associated with amblyopic eye visual acuity or stereoacuity.…”

Section: Fixation Instabilitymentioning

confidence: 95%

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Fellow Eye Deficits in Amblyopia

Birch

Kelly

Giaschi

2019

Journal of Binocular Vision and Ocular Motility

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Amblyopia is a neurodevelopmental disorder of the visual system, as a result of discordant visual experience during infancy or early childhood. Because amblyopia is typically defined as monocularly reduced visual acuity accompanied by one or more known amblyogenic factors, it is often assumed that the fellow eye is normal and sufficient for tasks like reading and eye-hand coordination. Recent scientific evidence of ocular motor, visual, and visuomotor deficits that are present with fellow eye monocular viewing and with binocular viewing calls this assumption into question. This clinical update reviews the research that has revealed fellow ocular motor and visual deficits and the effect that these deficits have on an amblyopic child's visuomotor and visuocognitive skills. We need to understand how to prevent and rehabilitate the effects of amblyopia not only on the nonpreferred eye but also on the fellow eye.

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Section: Fixation Instabilitymentioning

confidence: 89%

Section: Fixation Instabilitymentioning

confidence: 95%

Fellow Eye Deficits in Amblyopia

Birch

Kelly

Giaschi

2019

Journal of Binocular Vision and Ocular Motility

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“…7 Methods of retinal videographic analysis of fixation instability were not available for this study. 8,9…”

Section: Methodsmentioning

confidence: 99%

<p>Comparative AAPOS Validation of the Birefringent Amblyopia Screener with Isolated Small-Angle Strabismus</p>

Arnold¹

2020

OPTH

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Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/tM4UmGCiUtU Background: The Rebion blinq binocular birefringent ocular alignment screener was recently commercially released, but it did not yet have validation by American Association for Pediatric Ophthalmology and Strabismus (AAPOS) uniform guidelines. Methods: Children and adults from a high-risk eye practice had screening by blinq with validation by AAPOS 2003 guidelines. Then, the blinq was compared to the Adaptica 2WIN with CR corneal reflex strabismus estimation by AAPOS 2003 guidelines plus additional efforts to identify patients with diminished binocularity. Results: Blinq in 100 patients compared to 2003 AAPOS amblyopia risk factors (ARF) had sensitivity 67%, specificity 75% and PPV of 82%. Both blinq and 2WIN were completed by 87 patients median age 6.5 years. Sensitivity, specificity and positive predictive value (PPV) for blinq were 75%, 68% and 81% whereas 2WIN had 91%, 68% and 84%. The blinq referred two young patients with isolated, small-angle strabismic amblyopia that 2WIN refractive function passed. Conclusion: Despite its non-refractive design to identify binocular foveation, blinq performed well with refractive and strabismic uniform risk factors and a PPV greater than 80%. Clinical Trials Registry: NCT04195711.

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“…22,26 Furthermore, anisometropic amblyopia is associated with greater fixation stability. 27 In strabismic amblyopia on the other hand, there is often no measurable stereoacuity, even if visual acuity has improved after treatment. 22,28 However, contrast sensitivity is more likely to be preserved, 26 which might suggest that individuals with strabismic amblyopia retain better monocular spatial resolution at the expense of reduced binocularity.…”

Section: Behavioral Consequencesmentioning

confidence: 99%