Jack Alexander

Negative feedback control model of proximal convergence and accommodation

A comprehensive model has been developed to illustrate the interactions between the observer and the surrounding environment in the control of oculomotor responses to distance or 3‐D space. Accommodation and vergence respond to both spatiotopic (body referenced) proximal percepts and retinotopic (eye referenced) physical stimuli of blur and disparity. Both spatiotopic and retinotopic stimuli are derived respectively from perceptual and physical correlates of negative feedback for eye position. The spatiotopic and retinotopic stimulus errors are combined in the feed forward path and drive a common occulomotor controller which has a phasic‐tonic organization. Spatiotopic and retinotopic stimuli are shown to be effective over complementary operating ranges. Perceptual spatiotopic errors of gaze provide optimal stimuli for near responses to large depth intervals whereas physical‐retinotopic cues of blur and disparity provide quantitative information about small binocular fixation errors. Small dynamic variations of target distance are sensed both spatiotopically and retinotopically. Coarse and fine spatiotopic errors of gaze are processed differently. Large spatiotopic errors are sampled intermittently al the beginning of the near response, whereas small retinotopic position errors and spatiotopic velocity errors are sampled continuously throughout the near response. Former reports of empirically observed higher velocity of vergence responses to very large depth intervals is explained in terms of stimulus sampling modes rather than in terms of separate oculomotor control mechanisms. The model demonstrates a complementary function of top‐down spatiotopic cues, which are used to initiate the near response, and bottom‐up retinotopic cues, which are used to refine and complete the near response. Cross‐couplings by vergence‐accommodation and accommodative‐vergence serve to coordinate the components of the near response when feedback from the sensed response of one motor system (i.e. vergence) is more accurate than that of the other motor system (i.e. accommodation). The model presented here is concerned primarily with the near response mediated by accommodation and disjunctive eye movements and not by the independent vergence mediated by non‐conjugate or yoked saccades of unequal amplitude.

Interocular interactions during acuity measurement in children and adults, and in adults with amblyopia

The binocular interactions that occur during dichoptic and binocular viewing were investigated using a letter acuity task in normally sighted children (age range 6-14 years) and adults, and in adults with anisometropic amblyopia. Our aims were to investigate the nature of binocular interactions that occur in each group, and the extent to which the characteristics of binocular interactions differ across the groups. The non-tested eye was occluded during monocular (baseline) viewing, and was allowed to view a uniform stimulus with fusion lock in dichoptic viewing. In adults and children with normal vision, acuity under dichoptic viewing was unchanged relative to monocular baseline in the dominant eyes, while acuity of the non-dominant eye improved under dichoptic viewing relative to baseline. The magnitude of dichoptic change in the non-dominant eyes was similar in the two normally sighted groups, but the dichoptic advantage was found to decrease with increasing age within the children tested. Binocular acuity was better than monocular acuity in normal subjects, and a decrease in binocular summation with age was noted within the age range of the children tested. In contrast, the amblyopic observers showed no change in acuity with viewing conditions. The results demonstrate development of interocular interactions during childhood, and wide inter-individual variation in pattern of interocular interactions among anisometropic amblyopic adults.

Sensory ocular dominance based on resolution acuity, contrast sensitivity and alignment sensitivity

Background:  Ocular dominance is the superiority or preference of one eye over the other in terms of sighting, sensory function (for example, visual acuity) or persistence in binocular rivalry. There is poor agreement between sighting and sensory dominance and findings are equivocal on the possible neural basis of ocular dominance and its significance. Thus, there are questions on the meaning and importance of ocular dominance. Despite the lack of clarity in this area, ocular dominance is used clinically, for example, as the basis for decisions on monovision in contact lens wear and on treatment of anomalies of binocular vision.

A psychophysical study of human binocular interactions in normal and amblyopic visual systems.

During infancy and childhood, spatial contrast sensitivity and alignment sensitivity undergo maturation, and during this period the visual system has considerable plasticity. The purpose of this study was to compare the nature of interocular interactions of these spatial functions in normally sighted children and adults, and to study the extent to which interocular interactions are impaired in anisometropic amblyopia. Spatial functions were measured under three viewing conditions: monocular (fellow eye occluded), dichoptic (uniform stimulus presented to the fellow eye but with a peripheral fusion lock), and binocular. Measurements were made in each eye during monocular and dichoptic viewing. In the contrast sensitivity task, Gabor stimuli were presented in one of two temporal intervals. For the alignment task, a three-element Gabor stimulus was used. The task of the subject was to indicate the direction of displacement of the middle patch with respect to the outer patches. The findings indicate that in children, binocular contrast sensitivity was better than monocular (binocular summation) but so too was dichoptic sensitivity (dichoptic summation). The magnitude of binocular/dichoptic summation was significantly greater in children than in normally sighted adults for contrast sensitivity, but not for alignment sensitivity. In anisometropic amblyopes, however, we find that for the group as a whole the amblyopic eye does not benefit when the fellow eye views a dichoptic stimulus, compared to dark occlusion of that eye. In addition, we found considerable inter-individual variation within the amblyopic group. Implications of these findings for techniques used in vision therapy are discussed.

Visual Functions and Interocular Interactions in Anisometropic Children with and without Amblyopia

PURPOSE In uncorrected anisometropia, protracted dichoptic stimulation may result in interocular inhibition, which may be a contributing factor in amblyopia development. This study investigates the relationship between interocular interactions and anisometropic amblyopia. METHODS Three visual functions (low-contrast acuity, contrast sensitivity, and alignment sensitivity) were measured in the nondominant eye of 44 children aged 5 to 11 years: 10 with normal vision, 17 with anisometropia without amblyopia, and 17 with anisometropic amblyopia. The dominant eye was either fully or partially occluded. The difference in nondominant eye visual function between the full-and partial-occlusion conditions was termed the interaction index. The index of each visual function was compared between subject groups. A higher index indicates stronger inhibition of nondominant eye function with partial occlusion of the dominant eye. Amblyopic children had 6 months of therapy (refractive correction and occlusion), and the reduction in interocular difference in high-contrast acuity was regarded as the treatment outcome. The relationships of the interaction index with the degree of anisometropia, the severity of amblyopia, and the treatment outcomes were examined. RESULTS The acuity interaction index was significantly higher in anisometropic children with amblyopia than in those without (P = 0.003). It was positively correlated with the degree of anisometropia (r(s) = 0.35, P = 0.042) and the amblyopic treatment outcomes (r(s) = 0.54, P = 0.038). No such difference or association was found between the contrast sensitivity or alignment sensitivity interaction index and anisometropic amblyopia. CONCLUSIONS Interocular interactions are associated with amblyopia, the degree of anisometropia, and amblyopia treatment outcomes, but these associations are visual function dependent.

The development of crowding and interocular interactions in a resolution acuity task.

PURPOSE To investigate the impact of interocular similarities of a surround stimulus on foveal resolution acuity in the normally developing visual system. METHODS Liquid crystal shutter goggles synchronized with the monitor frame rate were used to present a Landolt C and surround bars to one or both eyes, in monocular, dichoptic, half-binocular, and binocular viewing conditions. Resolution acuity was measured under each condition in 56 normally sighted children (7 to 14 years of age) and 22 adults (21 to 38 years of age). The effect of the surround bars (crowding) was tested in a subgroup of nine children, and 10 adults. RESULTS Across all age groups resolution acuity was significantly better in the binocular condition than in the other three viewing conditions (binocular summation), and was significantly better in the half-binocular (with target presented to the test eye and bars presented to both eyes) than in the dichoptic condition (target presented to test eye and bars presented to the nontested eye only). In children, but not in adults, resolution acuity was significantly better without than with bars. CONCLUSIONS The interocular similarities may explain the better visual resolution in the half-binocular condition than in the dichoptic condition for all age groups tested. The results suggest that interocular interactions underpinning resolution acuity under these viewing conditions are developed in early childhood. The foveal crowding effect was found to be apparent at the beginning of school age, and diminished with maturation.

Enhancement of Resolution Acuity in a Half-Binocular Viewing Condition

PURPOSE To investigate the effect of interocular stimulus similarity on foveal resolution acuity. METHODS Liquid crystal shutter goggles synchronized with the monitor refresh rate were used to present a Landolt C and surround bars to one or both eyes, in four viewing conditions (monocular, dichoptic, half-binocular, and binocular). Resolution acuity was measured in each condition in 22 normally sighted adults. RESULTS Resolution acuity was significantly better in the binocular condition than in the other three viewing conditions (binocular summation) and was significantly better in the half-binocular condition (with target presented to the test eye and bars presented to both eyes) than in the dichoptic condition (target presented to the test eye and bars presented to the nontested eye only). CONCLUSIONS Monocular resolution acuity depends in part on interocular similarities of the stimulus surrounding the central target. This finding may have implications in the design of stimuli for vision-training therapies.

Design and validation of a method for evaluation of interocular interaction.

Purpose. To design a simple viewing system allowing dichoptic masking, and to validate this system in adults and children with normal vision. Methods. A Trial Frame Apparatus (TFA) was designed to evaluate interocular interaction. This device consists of a trial frame, a 1 mm pinhole in front of the tested eye and a full or partial occluder in front of the non-tested eye. The difference in visual function in one eye between the full- and partial-occlusion conditions was termed the Interaction Index. In experiment 1, low-contrast acuity was measured in six adults using five types of partial occluder. Interaction Index was compared between these five, and the occluder showing the highest Index was used in experiment 2. In experiment 2, low-contrast acuity, contrast sensitivity, and alignment sensitivity were measured in the non-dominant eye of 45 subjects (15 older adults, 15 young adults, and 15 children), using the TFA and an existing well-validated device (shutter goggles) with full and partial occlusion of the dominant eye. These measurements were repeated on 11 subjects of each group using TFA in the partial-occlusion condition only. Repeatability of visual function measurements using TFA was assessed using the Bland-Altman method and agreement between TFA and goggles in terms of visual functions and interactions was assessed using the Bland-Altman method and t-test. Results. In all three subject groups, the TFA showed a high level of repeatability in all visual function measurements. Contrast sensitivity was significantly poorer when measured using TFA than using goggles (p < 0.05). However, Interaction Index of all three visual functions showed acceptable agreement between TFA and goggles (p > 0.05). Conclusions. The TFA may provide an acceptable method for the study of some forms of dichoptic masking in populations where more complex devices (e.g., shutter goggles) cannot be used.

A novel apparatus for interocular interaction evaluation in children with and without anisometropic amblyopia.

Background:  Dichoptic visual stimulation may be achieved using shutter goggles and mirror systems. These methods vary in their feasibility for use in children. This study aims to investigate the feasibility of use of a simple trial frame‐based system to evaluate interactions in children.