PMID- 28698242
DCOM- 20180214
LR  - 20180214
IS  - 1468-2079 (Electronic)
IS  - 0007-1161 (Linking)
VI  - 102
IP  - 2
DP  - 2018 Feb
TI  - Abnormal fixational eye movements in strabismus.
PG  - 253-259
LID - 10.1136/bjophthalmol-2017-310346 [doi]
AB  - INTRODUCTION: Fixational saccades are miniature eye movements that constantly
      change the gaze during attempted visual fixation. Visually guided saccades and
      fixational saccades represent an oculomotor continuum and are produced by common 
      neural machinery. Patients with strabismus have disconjugate binocular horizontal
      saccades. We examined the stability and variability of eye position during
      fixation in patients with strabismus and correlated the severity of fixational
      instability with strabismus angle and binocular vision. METHODS: Eye movements
      were measured in 13 patients with strabismus and 16 controls during fixation and 
      visually guided saccades under monocular viewing conditions. Fixational saccades 
      and intersaccadic drifts were analysed in the viewing and non-viewing eye of
      patients with strabismus and controls. RESULTS: We found an increase in
      fixational instability in patients with strabismus compared with controls. We
      also found an increase in the disconjugacy of fixational saccades and
      intrasaccadic ocular drift in patients with strabismus compared with controls.
      The disconjugacy was worse in patients with large-angle strabismus and absent
      stereopsis. There was an increase in eye position variance during drifts in
      patients with strabismus. Our findings suggest that both fixational saccades and 
      intersaccadic drifts are abnormal and likely contribute to the fixational
      instability in patients with strabismus. DISCUSSION: Fixational instability could
      be a useful tool for mass screenings of children to diagnose strabismus in the
      absence of amblyopia and latent nystagmus. The increased disconjugacy of
      fixational eye movements and visually guided saccades in patients with strabismus
      reflects the disruption of the fine-tuning of the motor and visual systems
      responsible for achieving binocular fusion in these patients.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text
      of the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Ghasia, Fatema F
AU  - Ghasia FF
AD  - Daroff-Del'Osso Ocular Motility Laboratory, Cleveland VA Medical Center,
      Cleveland, Ohio, USA.
FAU - Otero-Millan, Jorge
AU  - Otero-Millan J
AD  - Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland,
FAU - Shaikh, Aasef G
AU  - Shaikh AG
AD  - Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA.
AD  - Neurology Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio,
AD  - Neurology, Daroff-Del'Osso Ocular Motility Laboratory, Cleveland VA Medical
      Center, Cleveland, Ohio, USA.
LA  - eng
PT  - Journal Article
DEP - 20170711
PL  - England
TA  - Br J Ophthalmol
JT  - The British journal of ophthalmology
JID - 0421041
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Eye Movements/*physiology
MH  - Female
MH  - Fixation, Ocular/*physiology
MH  - Humans
MH  - Male
MH  - Mass Screening/*methods
MH  - Middle Aged
MH  - Strabismus/diagnosis/*physiopathology
MH  - Vision, Binocular/*physiology
MH  - Visual Acuity
MH  - Young Adult
OT  - *children
OT  - *fixational saccades
OT  - *gaze holding
OT  - *ocular drift
OT  - *strabismus
COIS- Competing interests: None declared.
EDAT- 2017/07/13 06:00
MHDA- 2018/02/15 06:00
CRDT- 2017/07/13 06:00
PHST- 2017/02/16 00:00 [received]
PHST- 2017/04/11 00:00 [revised]
PHST- 2017/05/06 00:00 [accepted]
PHST- 2017/07/13 06:00 [pubmed]
PHST- 2018/02/15 06:00 [medline]
PHST- 2017/07/13 06:00 [entrez]
AID - bjophthalmol-2017-310346 [pii]
AID - 10.1136/bjophthalmol-2017-310346 [doi]
PST - ppublish
SO  - Br J Ophthalmol. 2018 Feb;102(2):253-259. doi: 10.1136/bjophthalmol-2017-310346. 
      Epub 2017 Jul 11.