Convergence Eye Movements Research Articles

1 Sex Differences in Middle Cerebral Artery Velocity in Patients with Persistent Post-Concussion Convergence Insufficiency (PPCS-CI)

OBJECTIVES/GOALS: The objective of this study is to investigate the neurophysiological mechanism of vision therapy in male and female adolescents with persistent post-concussion convergence insufficiency (PPCS-CI). This study may improve diagnostics and inform more effective personalized point of care treatment strategies to remediate symptoms. METHODS/STUDY POPULATION: Participants (ages 11-25) were diagnosed with PPCS by a physician, CI was diagnosed by an optometrist and OBVAT was performed by certified therapists. Patients with PPCS-CI were randomly assigned to a therapy type (immediate therapy or natural recovery). Hemodynamic measures were examined in patients with PPCS-CI at baseline (1-3 months post-concussion), and post OBVAT to evaluate recovery outcomes. Non-invasive techniques were used to measure middle cerebral artery velocity (MCAv), blood pressure, heart rate, and end-tidal CO2 at rest and during objective symmetrical convergence step eye movements. Functional magnetic resonance imaging (fMRI) was acquired during convergence step eye movement experiments contrasted to sustained fixation and resting state data collection. RESULTS/ANTICIPATED RESULTS: To investigate the neural mechanism of OBVAT, eye movements, fMRI and physiological measures were collected in 8 patients with PPCS-CI (4 men and 4 women). Results show an 10% decrease in the MCA during 4-degree symmetrical convergent eye movement responses in males post-OBVAT and a 19% increase in MCA during convergent eye movement responses in females. Furthermore, there was a group level activation of the frontal eye fields, which improves post-OBVAT. The beta weights in the left frontal eye fields show a trending decrease in male patients post-OBVAT and trending increase in females. Males had a decrease in MCAv post OBVAT (baseline 83.6 ± 7.5 cm/sec & 75.7 ± 12.5 cm/sec post-OBVAT), while females show a significant increase post-OBVAT (baseline 53.77 ± 5.2 cm/sec & post-OBVAT 65.13 cm/sec ± 12.5). DISCUSSION/SIGNIFICANCE: This initial pilot demonstrates there may be different underlying pathophysiological outcomes associated with a concussion dependent on sex. This work may have direct implications on treatment strategies for male and female adolescent patients with PPCS-CI.

Frequency dependence of coordinated pupil and eye movements for binocular disparity tracking.

Coordinated alignment of the eyes during gaze fixation and eye movements are an important component of normal visual function. We have previously described the coordinated behavior of convergence eye movements and pupillary responses using a 0.1 Hz binocular disparity-driven sine profile and a step profile. The goal of this publication is to further characterize ocular vergence-pupil size coordination over a wider range of frequencies of ocular disparity stimulation in normal subjects. Binocular disparity stimulation is generated by presentation of independent targets to each eye on a virtual reality display, while eye movements and pupil size are measured by an embedded video-oculography system. This design allows us to study two complimentary analyses of this motion relationship. First, a macroscale analysis describes the vergence angle of the eyes in response to binocular disparity target movement and pupil area as a function of the observed vergence response. Second, a microscale analysis performs a piecewise linear decomposition of the vergence angle and pupil relationship to permit more nuanced findings. These analyses identified three main features of controlled coupling of pupil and convergence eye movements. First, a near response relationship operates with increasing prevalence during convergence (relative to the "baseline" angle); the coupling is higher with increased convergence in this range. Second, the prevalence of "near response"-type coupling decreases monotonically in the diverging direction; the decrease persists after the targets move (converge back) from maximum divergence toward the baseline positions, with a minimum prevalence of near response segments near the baseline target position. Third, an opposite polarity pupil response is infrequent, but tends to be more prevalent when the vergence angles are at maximum convergence or divergence for a sinusoidal binocular disparity task. We suggest that the latter response is an exploratory "range-validation" when binocular disparity is relatively constant. In a broader sense, these findings describe operating characteristics of the near response in normal subjects and form a basis for quantitative assessments of function in conditions such as convergence insufficiency and mild traumatic brain injury.

The effect of real-world and retinal motion on speed perception for motion in depth.

For motion in depth, even if the target moves at a constant speed in the real-world (physically), it would appear to be moving with acceleration on the retina. Therefore, the purpose of this study was to determine whether real-world and retinal motion affect speed perception in depth and to verify the influence of eye movements on both motion signals in judging speed in depth. We used a two-alternative forced-choice paradigm with two types of tasks. One stimulus moved at a constant speed in the real-world (world constant task) with three conditions: 80-60 cm (far), 60-40 cm (middle), and 40-20 cm (near) from the participant. The other stimulus moved at a constant speed on the retina (retinal constant task) with three conditions: 4-8 deg (far), 8-12 deg (middle), and 12-16 deg (near) as the vergence angle. The results showed that stimulus speed was perceived faster in the near condition than in the middle and far conditions for the world constant task, regardless of whether it was during fixation or convergence eye movements. In contrast, stimulus speed was perceived faster in the order of the far, middle, and near conditions for the retinal constant task. Our results indicate that speed perception of a visual target approaching the observer depends on real-world motion when the target position is relatively far from the observer. In contrast, retinal motion may influence speed perception when the target position is close to the observer. Our results also indicate that the effects of real-world and retinal motion on speed perception for motion in depth are similar with or without convergence eye movements. Therefore, it is suggested that when the visual target moves from far to near, the effects of real-world and retinal motion on speed perception are different depending on the initial target position.

Horizontal Gaze Palsy with Progressive Scoliosis Syndrome: A Concise Synopsis from the Ophthalmologist’s Perspective

The aim of this article is to provide a concise synopsis of Horizontal Gaze Palsy and Progressive Scoliosis syndrome and give the ophthalmologist’s perspective. Horizontal Gaze Palsy and Progressive Scoliosis is a rare autosomal recessive genetic condition. It has been described in both consanguineous and non-consanguineous families. It is caused by mutations in the round-about guidance receptor 3 (ROBO3) gene. Based on our literature review, to date, roughly 100 patients with this rare syndrome and 55 round-about guidance receptor 3 gene mutations have been reported. The age of onset of symptoms varies from 2 months up to 60 years, but usually start in early childhood. Musculoskeletal symptoms include scoliosis and difficulties with posturing. Mental retardation and global developmental delay may also ensue. Ophthalmological manifestations include convergent squint, pendular nystagmus and horizontal gaze palsy. Vertical and convergence eye movements are preserved. Lid position, pupillary reflexes and fundus examination are usually normal as well. Brain neuroimaging reveals striking radiological findings, including brainstem hypoplasia with an anterior and dorsal pontine cleft and a butterfly shaped medulla and absence of the normal promontories of the facial colliculi. To date, there is no definitive treatment of this condition. Convergent squint can be corrected with prisms or surgery. Spectacles are used to correct any significant refractive error. Patching or atropine drops can be used for the treatment of amblyopia. This rare syndrome is a systemic condition that requires a multidisciplinary team to treat the patients with a holistic approach, address their needs and alleviate the emotional burden. It should always be included in the differential diagnosis in patients who present with skeletal anomalies and ocular motility disorders.

Role of locomotor efference copy in vertebrate gaze stabilization.

Vertebrate locomotion presents a major challenge for maintaining visual acuity due to head movements resulting from the intimate biomechanical coupling with the propulsive musculoskeletal system. Retinal image stabilization has been traditionally ascribed to the transformation of motion-related sensory feedback into counteracting ocular motor commands. However, extensive exploration of spontaneously active semi-intact and isolated brain/spinal cord preparations of the amphibian Xenopus laevis, have revealed that efference copies (ECs) of the spinal motor program that generates axial- or limb-based propulsion directly drive compensatory eye movements. During fictive locomotion in larvae, ascending ECs from rostral spinal central pattern generating (CPG) circuitry are relayed through a defined ascending pathway to the mid- and hindbrain ocular motor nuclei to produce conjugate eye rotations during tail-based undulatory swimming in the intact animal. In post-metamorphic adult frogs, this spinal rhythmic command switches to a bilaterally-synchronous burst pattern that is appropriate for generating convergent eye movements required for maintaining image stability during limb kick-based rectilinear forward propulsion. The transition between these two fundamentally different coupling patterns is underpinned by the emergence of altered trajectories in spino-ocular motor coupling pathways that occur gradually during metamorphosis, providing a goal-specific, morpho-functional plasticity that ensures retinal image stability irrespective of locomotor mode. Although the functional impact of predictive ECs produced by the locomotory CPG matches the spatio-temporal specificity of reactive sensory-motor responses, rather than contributing additively to image stabilization, horizontal vestibulo-ocular reflexes (VORs) are selectively suppressed during intense locomotor CPG activity. This is achieved at least in part by an EC-mediated attenuation of mechano-electrical encoding at the vestibular sensory periphery. Thus, locomotor ECs and their potential suppressive impact on vestibular sensory-motor processing, both of which have now been reported in other vertebrates including humans, appear to play an important role in the maintenance of stable vision during active body displacements.

Ernst Wilhelm Brücke on stereoscopic vision

ABSTRACT In the early 19th century the doctrine of identical retinal points, linked with the Vieth-Müller circle, was a pillar of German physiological optics. It was challenged by Wheatstone’s observations of stereoscopic depth perception announced in 1838; he also advanced a cognitive theory of binocular vision that attacked physiological interpretations. In 1841 Brücke mounted a defense of the doctrine by questioning Wheatstone’s observations and offering an alternative interpretation in terms of the integration over time of a rapid sequence of convergence eye movements. The theory could not be sustained because of evidence that stereoscopic depth occurred without eye movements. Brücke also questioned Wheatstone’s observations that with some stereoscopic displays stimulation of identical retinal points could result in double vision. The binocular combination of circles differing in size was accounted for by differentially dissociating accommodation in opposite directions for each eye from convergence. Despite the negative reaction to Brücke’s proposals, his speculations about the nature of rapid eye movements and of their neural basis were ahead of his time.

Accommodation

Accommodation is the natural increase or decrease of the refraction of the eye lens as a function of the fixation distance. It relies on the proper elasticity of the natural eye lens. The evaluation of accommodation and the coupled convergent eye movements enables us to make the diagnosis of certain eye-related conditions and allows the differential diagnostic from some of the "neuroophthalmic diseases". This may avoid some unnecessary diagnostic procedures and reduce patient anxiety in terms of having a health threatening disease.

Properties of fast vergence eye movements and horizontal saccades in athletes

Visual information based on eye movements influences sports performance in 3-D space. The purpose of this study was to clarify the properties of fast vergence eye movements and horizontal saccades in athletes. Thirty-four college students were classified into three groups: twelve baseball players (BAS), ten track and field athletes (TRA) and twelve non-athletes (NON). The oculomotor tasks consisted of vergence eye movements (vergence task) including convergence and divergence, and horizontal saccades (saccade task). The participants made a rapid gaze shift toward a visual target. For the vergence task, the target was irradiated at 5 different vergence angles (3, 5, 10, 15, 20°) randomly. For the saccade task, the target was irradiated at 5 different saccade amplitudes (0, ±5, ±10°) randomly. The results showed that the peak eye velocity was higher in order of saccade, convergence, and divergence eye movements. The gain of convergence and saccades was higher than that of divergence. Furthermore, the latency of saccades was shorter than that of convergence and divergence. These results suggest that saccades and convergence are superior compared with divergence, and the dynamic property of convergence is partially analogous to horizontal saccades. The results of the comparison between the three groups showed that the latency of convergence was shorter for BAS than for NON. Therefore, different visual experience and baseball training could influence the gaze-shift dynamics during convergence eye movements.

The Analysis of Accommodation Response and Convergence Eye Movement When Viewing 8K Images

The Analysis of Accommodation Response and Convergence Eye Movement When Viewing 8K Images

Distinctive Convergence Eye Movements in an Acquired Neurosensory Dysfunction.

In late 2016, diplomats in Havana, Cuba, began presenting with a unique symptom complex after perceiving a strange noise and/or feeling a pressure field in their domicile. This report is a retrospective, quantitative analysis of video-oculography data of pupillary light reflex performance and binocular disparity-driven eye and pupil movements during the acute time period after the reported exposure. The patterns of response in these 19 individuals are markedly different than those seen in a group of individuals with the usual acute mild traumatic brain injury (17 subjects) and from 62 control subjects (21–60 years old) with no injury. Non-linear least squares regression was used to estimate the model parameters from the eye movement and the pupil measurements (1). Linear discriminant analysis was then used to identify a classifier for an objective discrimination of the groups with >91% accuracy and no confusion between the acute neurosensory findings among the members of the Havana diplomatic community and the subjects with acute mild traumatic brain injury. This pattern difference in eye and pupil behavior may be a useful screen to help objectively distinguish blunt trauma from Havana-type effects in the future and to guide the affected individuals to appropriate care.

Changes in the disparity vergence main sequence after treatment of symptomatic convergence insufficiency in children

This study investigates the underlying physiological mechanisms that may lead to improved outcomes for symptomatic convergence insufficiency (CI) patients after 12 weeks of office-based vergence/accommodation therapy (OBVAT) by evaluating the change in the main sequence of vergence and saccadic eye movements. In this prospective trial, 12 participants with symptomatic CI were recruited and treated with 12 weeks of OBVAT. Outcome measures included the objective assessment of the following: peak velocity, time to peak velocity, latency, response amplitude, and clinical changes in the near point of convergence (NPC), positive fusional vergence (PFV) and symptoms via the Convergence Insufficiency Symptom Survey (CISS). Ten of the twelve participants (83%) were categorized as “successful” and two were “improved” based on pre-determined published criteria (CISS, NPC, PFV). There were statistically significant changes in peak velocity, time to peak velocity, and response amplitude for both 4° and 6° symmetrical convergence and divergence eye movements. There was a significant change in the main sequence ratio for convergence post-OBVAT compared to baseline measurements (P=0.007) but not for divergence or saccadic responses. Phasic/step vergence movements adjust the underlying neural control of convergence and are critical within a vision therapy program for CI patients.

Convergence and divergence to radial optic flow in infancy.

Research finds a relationship between the development of depth perception and ocular motion functions including smooth pursuit and ocular following response. Infants' reactions to looming stimuli also suggest sensitivity to optic flow information that specifies relative distance. With radial optic flow, an expanding flow field elicits involuntary convergent eye movements while a contracting one elicits involuntary divergent eye movements. This response suggests the visual system is interpreting the radial flow as a change in relative depth. We measured the oculomotor response to radial optic flow in infants aged two to five months. The stimulus comprised a radial optic flow pattern that expanded or contracted across eight 400 ms trials while eye position was monitored with a Tobii X120 eye tracker. A subset of infants also viewed trials of a static version of the stimulus. On average, most infants in each age group demonstrated convergence to the expanding pattern and divergence to the contracting one. Moreover, the difference in gain between the convergence and divergence eye movements was significant. The presence of correct-direction vergence eye movements in response to expansion and contraction provides further evidence that infants are sensitive to information that specifies relative motion in depth.

A differential role for the posterior cerebellum in the adaptive control of convergence eye movements

IntroductionThe vergence oculomotor system possesses two robust adaptive mechanisms; a fast “dynamic” and a slow “tonic” system that are both vital for single, clear and comfortable binocular vision. The neural substrates underlying these vergence adaptive mechanisms in humans is unclear. MethodsWe investigated the role of the posterior cerebellum in convergence adaptation using inhibitory continuous theta-burst repetitive transcranial magnetic stimulation (cTBS) within a double-blind, sham controlled design while eye movements were recorded at 250hz via infrared oculography. ResultsIn a preliminary experiment we validated our stimulation protocols by reproducing results from previous work on saccadic adaptation during the classic double-step adaptive shortening paradigm. Following this, across a series of three separate experiments we observed a clear dissociation in the effect of cTBS on convergence adaptation. Dynamic adaptation was substantially reduced while tonic adaptation was unaffected. Baseline dynamic fusional vergence response were also unaffected by stimulation. ConclusionsThese results indicate a differential role for the posterior cerebellum in the adaptive control of convergence eye movements and provide initial evidence that repetitive transcranial magnetic stimulation is a viable tool to investigate the neurophysiology of vergence control. The results are discussed in the context of the current models of implicit motor adaptation of vergence and their application to clinical populations and technology design in virtual and augmented head mounted display architectures. Significance statementThe cerebellum plays a critical role in the adaptive control of motor systems. Vergence eye movements shift our gaze in depth allowing us to see in 3D and exhibit two distinct adaptive mechanisms that are engaged under a range of conditions including reading, wearing head-mounted displays and using a new spectacle prescription. It is unclear what role the cerebellum plays in these adaptive mechanisms. To answer this, we temporarily disrupted the function of the posterior cerebellum using non-invasive brain stimulation and report impairment of only one adaptive mechanism, providing evidence for neural compartmentalization. The results have implications for vergence control models and applications to comfort and experience studies in head-mounted displays and the rehabilitation of clinical populations exhibiting vergence dysfunctions.

Convergence eye movement deficits in bipolar disorder

Convergence eye movement deficits in bipolar disorder

Measurement of Accommodation and Convergence Eye Movement when a Display and 3D Movie Move in the Depth Direction Simultaneously

Measurement of Accommodation and Convergence Eye Movement when a Display and 3D Movie Move in the Depth Direction Simultaneously

Near-Infrared Spectroscopy as a Useful Research Tool to Measure Prefrontal Cortex Activity During Visually Demanding Near Work

OCCUPATIONAL APPLICATIONS Effort, which overrides the need for rest and recuperation to avoid deterioration in visual performance, is commonplace in many contemporary workplaces. The prefrontal cortex is capable of allocating more mental/physical resources to carry out a given work task in the presence of fatigue. However, adverse musculoskeletal and mental health consequences are an anticipated outcome of this since fatigue is a physiological sign of the need for recuperative rest. This article outlines the current evidence suggesting that probing into prefrontal brain activity with near-infrared spectroscopy could advance progress in visual ergonomic research, and pilot data are provided that exemplify the proposed approach. Improved understanding of the age-related health consequences of straining the brain and/or the eyes “to see well” will likely help ergonomic stakeholders find better methods to meet the needs of safer and more productive work environments.TECHNICAL ABSTRACT Background: Unlike the usual skeletal muscles, ciliary muscles responsible for focusing the crystalline eye lens and extraocular muscles responsible for convergence eye movements appear resistant to fatigue. Purpose: The dual goals of this article are to briefly outline the current evidence that suggests that probing into blood flow and hemodynamic prefrontal brain activity with near-infrared spectroscopy could advance progress in visual ergonomic research and to provide pilot data exemplifying the proposed approach. Methods: The vision task consisted of sustained focusing on a contrast-varying black-and-white Gabor grating. Four participants with a median age of 46 (interquartile range 44–50) fixated the grating from a distance of 65 cm. Three counterbalanced 10-minute tasks required central fixation and accommodation/convergence on the grating target through (i) 0.0 diopter lenses, (ii) −1.5 diopter lenses, and (iii) −3.5 diopter lenses while maintaining maximal focus. Non-invasive measurements of local oxyhemoglobin (HbO2) were quantified with a one-channel near-infrared spectrometer. The near-infrared spectroscopy probe was placed on the prefrontal cortex in the vicinity of the right dorsolateral prefrontal cortex or Brodmann area 46. Accommodation response and contrast threshold were measured in parallel. Results: General estimating equation analyses showed that baseline-subtracted dorsolateral prefrontal cortex blood flow (ΔHbO2) increased significantly over time in all three lens conditions. The effect of time may be caused by a continuous increase in mental effort to compensate for progressively more mental fatigue induced by increased visual attention. The increase of dorsolateral prefrontal cortex ΔHbO2 was also larger in magnitude in participants with larger amplitudes accommodation response (i.e., in participants who minimized deterioration in visual performance). Conclusion: The results from this study indicate that oxyhemoglobin changes recorded over the dorsolateral prefrontal cortex with near-infrared spectroscopy can be used to assay the degree to which the visual system is strained during demanding near work.

Saccade-vergence properties remain more stable over short-time repetition under overlap than under gap task: a preliminary study.

Under natural circumstances, saccade-vergence eye movements are among the most frequently occurring. This study examines the properties of such movements focusing on short-term repetition effects. Are such movements robust over time or are they subject to tiredness? 12 healthy adults performed convergent and divergent combined eye movements either in a gap task (i.e., 200 ms between the end of the fixation stimulus and the beginning of the target stimulus) or in an overlap task (i.e., the peripheral target begins 200 ms before the end of the fixation stimulus). Latencies were shorter in the gap task than in the overlap task for both saccade and vergence components. Repetition had no effect on latency, which is a novel result. In both tasks, saccades were initiated later and executed faster (mean and peak velocities) than the vergence component. The mean and peak velocities of both components decreased over trials in the gap task but remained constant in the overlap task. This result is also novel and has some clinical implications. Another novel result concerns the accuracy of the saccade component that was better in the gap than in the overlap task. The accuracy also decreased over trials in the gap task but remained constant in the overlap task. The major result of this study is that under a controlled mode of initiation (overlap task) properties of combined eye movements are more stable than under automatic triggering (gap task). These results are discussed in terms of saccade-vergence interactions, convergence-divergence specificities and repetition versus adaptation protocols.

Psychophysical point: A disc tends to become a point when Weber’s law fails

In three experiments, we showed that the visual system treats a dot somewhat like a geometrical point, which has a location but no area. We represented a "point" or "dot" with a small disc (diameter of 0.08º of visual angle), and a "disc" with a larger disc (diameter of 1.5º). The Weber fraction of the dot was larger than that of the disc. In Experiment 1, the relative retinal image size cues for depth for the dot and the disc were placed in conflict with the motion parallax cue. We found that the dot indicated the positions defined by the motion parallax cue better than the disc did. In Experiment 2, we placed a constant retinal image size in conflict with convergence eye movements. We found that a binocularly fused dot appeared to move in depth with convergence eye movement, whereas a fused disc appeared to move less. In Experiment 3, we examined the apparent sizes of the afterimages of a dot and a disc and found that Emmert's law failed for the dot afterimage; the apparent size of the dot afterimage changed very little for different distances-as though it had no area-whereas the apparent size of the disc afterimage changed by an extent predicted by Emmert's law. The differences in the dot and disc conditions could not be explained by the differences in the Weber fractions alone.

Spatial frequency selectivity of visual suppression during convergence eye movements

Visual suppression of low-spatial frequency information during eye movements is believed to contribute to a stable perception of our visual environment. While visual perception has been studied extensively during saccades, vergence has been somewhat neglected. Here, we show that convergence eye movements reduce contrast sensitivity to low spatial frequency information around the onset of the eye movements, but do not affect sensitivity to higher spatial frequencies. This suggests that visual suppression elicited by convergence eye movements may have the same temporal and spatial characteristics as saccadic suppression.

Vergence and Standing Balance in Subjects with Idiopathic Bilateral Loss of Vestibular Function

There is a natural symbiosis between vergence and vestibular responses. Deficits in vergence can lead to vertigo, disequilibrium, and postural instability. This study examines both vergence eye movements in patients with idiopathic bilateral vestibular loss, and their standing balance in relation to vergence. Eleven patients participated in the study and 16 controls. Bilateral loss of vestibular function was objectified with many tests; only patients without significant response to caloric tests, to video head impulse tests and without vestibular evoked myogenic potentials were included in the study.Vergence testing (from 8 patients and 15 controls)A LED display with targets at 20, 40, and 100 cm along the median plane was used to elicit vergence eye movements, recorded with the IRIS device.Standing balance (11 patients and 16 controls)Four conditions were run, each lasting 1 min: fixation of a LED at 40 cm (convergence of 9°), at 150 cm (convergence of 2.3°); this last condition was repeated with eyes closed. Comparison of the eyes closed-eyes open conditions at 150 cm allowed evaluation of the Romberg Quotient. In the forth condition, two LEDS, at 20 and at 100 cm, were light on, one after the other for 1 sec, causing the eyes to converge then diverge. Standing balance was recorded with an accelerometer placed at the back near the center of mass (McRoberts, Dynaport).ResultsVergenceRelative to controls, convergence eye movements in patients showed significantly lower accuracy, lower mean velocity, and saccade intrusions of significantly higher amplitude.BalanceThe normalized 90% area of body sway was significantly higher for patients than for controls for all conditions. Yet, similarly to controls, postural stability was better while fixating at near (sustained convergence) than at far, or while making active vergence movements. We argue that vestibular loss deteriorates convergence, but even deficient, convergence can be helpful for postural control.