Vergence System Research Articles

Statistical normal values of visual parameters that characterize binocular function in children

A wide range of visual parameters used to evaluate binocular function were evaluated in a paediatric population (1056 subjects aged 6-12 years). Mean values are provided for these ages in optometric tests that directly assess the vergence system, horizontal phorias for near and far vision (measured by a modified version of the Thorington method), negative and positive vergence amplitude for near and far vision (step vergence testing), vergence facility (flippers 8 Delta BI/8 Delta BO), and near-point of convergence (penlight push-up technique and red-lens push-up technique), as well as stimulus accommodative convergence/accommodation ratio and stereoacuity (Randot test) which provide an overall evaluation of the vergence, accommodative and oculomotor systems. A statistical comparison (anova and Bonferroni post hoc test) of these values between ages was performed. The differences, although statistically significant, were not clinically meaningful, and therefore we identified two trends in the behaviour of these parameters. For all parameters, except for vergence facility, we established a single mean reference value for the age range studied. The difference between the means for vergence facility indicated the need to divide the population into two age ranges (6-8 and 8-12 years). This study establishes statistical normal values for these parameters in a paediatric population and their means are a valuable instrument for separating children with binocular anomalies from those with normal binocular vision.

Vertical disparities can recalibrate the vergence system

Vertical disparities can recalibrate the vergence system

Latency of adaptive vergence eye movements induced by vergence-vestibular interaction training in monkeys.

Clear vision of objects that move in depth toward or away from an observer requires vergence eye movements. The vergence system must interact with the vestibular system to maintain the object images on the foveae of both eyes during head movement. Previous studies have shown that training with sinusoidal vergence-vestibular interaction improves the frequency response of vergence eye movements during pitch rotation: vergence eye velocity gains increase and phase-lags decrease. To further understand the changes in eye movement responses in this adaptation, we examined latencies of vergence eye movements before and after vergence-vestibular training. Two head-stabilized Japanese monkeys were rewarded for tracking a target spot moving in depth that required vergence eye movements of 10 degrees/s. This target motion was synchronized with pitch rotation at 20 degrees/s. Both target and chair moved in a trapezoidal waveform interspersed with random inter-trial intervals. Before training, pitch rotation in complete darkness without a target did not induce vergence eye movements. Mean latencies of convergence and divergence eye movements induced by vergence target motion alone were 182 and 169 ms, respectively. After training, mean latencies of convergence and divergence eye movements to a target synchronized with pitch rotation shortened to 65 and 53 ms, and vergence eye velocity gains (relative to vergence target velocity) at the normal latencies were 0.68 and 1.53, respectively. Pitch rotation alone without a target induced vergence eye movements with similar latencies after training. These results indicate that vestibular information can be used effectively to initiate vergence eye movements following vergence-vestibular training.

An examination of the variables that affect express saccade generation.

The frequency with which express saccades are generated under a variety of conditions in rhesus monkeys was examined. Increasing the gap time between fixation spot termination and target onset increased express saccade frequency but was progressively less effective in doing so as the number of target positions in the sample was increased. Express saccades were rarely produced when two targets were presented simultaneously and the choice of either of which was rewarded; a temporal asynchrony of only 17 ms between the targets reinstated express saccade generation. Express saccades continued to be generated when the vergence or pursuit systems was coactivated with the saccadic system.

The stimulus integration area for horizontal vergence.

Over what region of space are horizontal disparities integrated to form the stimulus for vergence? The vergence system might be expected to respond to disparities within a small area of interest to bring them into the range of precise stereoscopic processing. However, the literature suggests that disparities are integrated over a fairly large parafoveal area. We report the results of six experiments designed to explore the spatial characteristics of the stimulus for vergence. Binocular eye movements were recorded using magnetic search coils. Each dichoptic display consisted of a central target stimulus that the subject attempted to fuse, and a competing stimulus with conflicting disparity. In some conditions the target was stationary, providing a fixation stimulus. In other conditions, the disparity of the target changed to provide a vergence-tracking stimulus. The target and competing stimulus were combined in a variety of conditions including those in which (1) a transparent textured-disc target was superimposed on a competing textured background, (2) a textured-disc target filled the centre of a competing annular background, and (3) a small target was presented within the centre of a competing annular background of various inner diameters. In some conditions the target and competing stimulus were separated in stereoscopic depth. The results are consistent with a disparity integration area with a diameter of about 5 degrees. Stimuli beyond this integration area can drive vergence in their own right, but they do not appear to be summed or averaged with a central stimulus to form a combined disparity signal. A competing stimulus had less effect on vergence when separated from the target by a disparity pedestal. As a result, we propose that it may be more useful to think in terms of an integration volume for vergence rather than a two-dimensional retinal integration area.

Diagnosis and Management of Central Motor Deficits Following Trauma

Following facial or head trauma, a few unfortunate individuals lose the ability to fuse. With time or treatment, some regain this ability; others have permanent loss of fusion. The fusional mechanism comprises both sensory and motor components with motor fusion being synonymous with the vergence system. If the vergence mechanism is damaged, motor fusion is affected. Although it may be possible to superimpose images, they are not maintained together over a range. If sensory fusion is disrupted centrally, superimposition of images is unlikely. Central fusion loss is rare, and almost always follows a head injury. A careful history about the injury may contribute to the differential diagnosis. Convergence paralysis is the most common vergence disorder following head injury.

The development of convergence and accommodation

Aim: To review current literature on the development of convergence and accommodation. The accommodation and vergence systems provide the foundation upon which bifoveal binocular single vision develops. Deviations from their normal development not only are implicated in the aetiology of convergence anomalies, accommodative anomalies and strabismus, but may also be implicated in failure of the emmetropisation process. Method: This review considers the problems of researching the development of accommodation and vergence in infants and how infant research has had to differ from adult methods. It then reviews and discusses the implications of current research into the development of both systems and their linkages. Results: Vergence and accommodation develop rapidly in the first months of life, with accommodation changing from relatively fixed myopic focus in the neonatal period to adult-like responses by 4 months of age. Vergence develops gradually and becomes more accurate after 4 months of age, but has been demonstrated in infants well before the age that binocular disparity detection mechanisms are thought to develop. Hypotheses for this early vergence mechanism are discussed. The relationship between accommodation and vergence shows much more variability in infants than adult literature has found, but this apparent adult/infant difference may be partly attributed to methodological differences rather than maturational change alone. Conclusions: Variability and flexibility characterise infant responses. This variability may enable infants to develop a flexible and robust binocular system for later life. Studies of infant visual cue use may give clues to the aetiology of strabismus and refractive error.

A longitudinal study of vergence adaptation in incipient presbyopia.

To investigate vergence adaptation during the incipient phase of presbyopia, when the amplitude of accommodation approaches the level where the first reading addition is required. The study aimed to assess the ability of the vergence system to counteract changes in the component contributions to the overall vergence response with the decline in the amplitude of accommodation in presbyopia, although previous reports on the nature of changes in accommodative, tonic and proximal vergence are equivocal. Using a 'flashed' Maddox rod technique, an assessment of vergence adaptation to 6delta base-out and 6delta base-in prism was made for 28 subjects (aged 35-45 years at the commencement of the study). The measurements were taken four times over a 2-year period. Using a repeated measures analysis of variance, the results show that with the decline in amplitude of accommodation, there is a statistically significant reduction in the magnitude of vergence adaptation to both base-out (p < 0.05) and base-in prism (p < 0.01). This study shows that with ageing, there is a decrease in the ability of the slow vergence mechanism to overcome a change in fusional vergence demand and would suggest that either the fast component of fusional vergence must cope with any change in fusional vergence demand or that the sum of the accommodative, tonic and proximal vergence responses are virtually stable with age.

Coding of smooth eye movements in three-dimensional space by frontal cortex.

Through the development of a high-acuity fovea, primates with frontal eyes have acquired the ability to use binocular eye movements to track small objects moving in space. The smooth-pursuit system moves both eyes in the same direction to track movement in the frontal plane (frontal pursuit), whereas the vergence system moves left and right eyes in opposite directions to track targets moving towards or away from the observer (vergence tracking). In the cerebral cortex and brainstem, signals related to vergence eye movements--and the retinal disparity and blur signals that elicit them--are coded independently of signals related to frontal pursuit. Here we show that these types of signal are represented in a completely different way in the smooth-pursuit region of the frontal eye fields. Neurons of the frontal eye field modulate strongly during both frontal pursuit and vergence tracking, which results in three-dimensional cartesian representations of eye movements. We propose that the brain creates this distinctly different intermediate representation to allow these neurons to function as part of a system that enables primates to track and manipulate objects moving in three-dimensional space.

Fixation disparity: binocular vergence accuracy for a visual display at different positions relative to the eyes.

Some observers do not fixate accurately at the point of regard: Their vergence angle (between the visual axes of the two eyes) may correspond to points slightly nearer or farther away. This vergence error, or fixation disparity, was measured with nonius (vernier) lines at six positions of a visual display relative to the eyes. At viewing distances of 40, 60, and 100 cm, the display was located either at eye level or at a downward inclination of gaze direction of -25 degrees relative to horizontal. Viewing conditions resembled typical office work. Lowering the screen induced a near shift in mean vergence response of 0.6 min arc, irrespective of viewing distance; the closer the screen, the more distant was the vergence response relative to the target (by 2.5 min arc on average). The slope of this proximity-fixation-disparity curve is an individual parameter of the vergence system. Actual or potential applications of this research include recommendations for the comfortable viewing distance of visual displays.

The proximity-fixation-disparity curve and the preferred viewing distance at a visual display as an indicator of near vision fatigue.

This laboratory study investigates the relation between measures of fixation disparity (FD) (and other optometric measures) and near vision fatigue at a computer workstation. Young adult subjects with normal binocular vision performed three blocks of a visual task of 30 min each. In Block A, the viewing distance was 100 cm, as a reference without near vision. In Block B, the viewing distance of 50 cm induced a defined near vision load. In Block C, subjects were free to choose a comfortable viewing distance. This preferred viewing distance was used as an indicator of near vision fatigue because subjects adopting longer viewing distances in Block C had more near vision fatigue at 50 cm in Block B. Subjects with preferred viewing distances longer than average (63 cm) had steeper slopes of FD as a function of viewing distance (100-30 cm), as shown by discriminant analyses. Thus, this steep proximity-FD curve indicates a weak disparity vergence system that may cause near vision fatigue. This may explain why some young adults prefer longer viewing distances at the computer workstation.

Age changes in the interactions between the accommodation and vergence systems.

Experiments are described in which static and dynamic accommodation (Ar), accommodative convergence (AC), vergence (C) and convergence accommodation (CA) responses to small stimuli were measured dynamically in 13 subjects with ages in the range 16 to 48 years. Analysis showed that the amplitudes of both blur and disparity-driven accommodation declined significantly with age, whereas the two types of vergence response did not. As a result, the AC/Ar ratio rose significantly with age, whereas the CA/C ratio fell. No significant change with age was found in response latencies and durations.

Vergence dynamics predict fixation disparity.

The neural origin of the steady-state vergence eye movement error, called binocular fixation disparity, is not well understood. Further, there has been no study that quantitatively relates the dynamics of the vergence system to its steady-state behavior, a critical test for the understanding of any oculomotor system. We investigate whether fixation disparity can be related to the dynamics of opponent convergence and divergence neural pathways. Using binocular eye movement recordings, we first show that opponent vergence pathways exhibit asymmetric angle-dependent gains. We then present a neural model that combines physiological properties of disparity-tuned cells and vergence premotor cells with the asymmetric gain properties of the opponent pathways. Quantitative comparison of the model predictions with our experimental data suggests that fixation disparity can arise when asymmetric opponent vergence pathways are driven by a distributed disparity code.

Modelling adaptation effects in vergence and accommodation after exposure to a simulated Virtual Reality stimulus

SummaryNatural viewing conditions place equal demands on the vergence and accommodation systems. The two responses are co‐ordinated via the interactive components which couple the two systems: accommodative vergence and vergence accommodation. The crosslink components are usually quantified by the AC/A and CA/C ratios. Whether these ratios are stable entities, genetically determined, or modifiable by experience has been the subject of some debate. A ‘Virtual Reality’ stimulus was used to place unequal demands on the vergence and accommodation systems. Pre‐task and post‐task measures of AC/A and CA/C were objectively determined. The changes in the post‐task measures are discussed with reference to a dual interactive model of vergence and accommodation. Model simulations suggest that adaptation of the vergence and accommodative controllers (tonic adaptation) may also play a part by altering the open loop bias. The results therefore support the idea that vergence accommodation and accommodative vergence are capable of adaptation.

Modelling adaptation effects in vergence and accommodation after exposure to a simulated Virtual Reality stimulus

Natural viewing conditions place equal demands on the vergence and accommodation systems. The two responses are co-ordinated via the interactive components which couple the two systems: accommodative vergence and vergence accommodation. The crosslink components are usually quantified by the AC/A and CA/C ratios. Whether these ratios are stable entities, genetically determined, or modifiable by experience has been the subject of some debate. A ‘Virtual Reality’ stimulus was used to place unequal demands on the vergence and accommodation systems. Pre-task and post-task measures of AC/A and CA/C were objectively determined. The changes in the post-task measures are discussed with reference to a dual interactive model of vergence and accommodation. Model simulations suggest that adaptation of the vergence and accommodative controllers (tonic adaptation) may also play a part by altering the open loop bias. The results therefore support the idea that vergence accommodation and accommodative vergence are capable of adaptation.

Naso-occipital vestibulo-ocular reflex responses in normal subjects.

The naso-occipital translational vestibulo-ocular reflex provides a particularly difficult problem for the brain's control system, as the movements of the two eyes are disjunctive and are often even in different directions. Consequently, when the target is located on the midline and the required eye movements are similar to vergence movements, the reflex might be driven using vergence pathways. Alternatively, the ascending tract of Deiters might be used to generate these required disjunctive movements. Since the vergence system is known to have rather sluggish dynamics, it might be possible to distinguish between these two hypotheses based on the dynamics of the movements. This article presents experiments that were undertaken in order to shed more light on these questions.

Neurophysiological aspects of eye and eyelid movements during blinking in humans.

The neural relationships between eyelid movements and eye movements during spontaneous, voluntary, and reflex blinking in a group of healthy subjects were examined. Electromyographic (EMG) recording of the orbicularis oculi (OO) muscles was performed using surface electrodes. Concurrently, horizontal and vertical eye positions were recorded by means of the double magnetic induction (DMI) ring method. In addition, movement of the upper eyelid was measured by a specially designed search coil, placed on the upper eyelid. The reflex blink was elicited electrically by supraorbital nerve stimulation either on the right or the left side. It is found that disconjugate oblique eye movements accompany spontaneous, voluntary as well as reflex blinking. Depending on the gaze position before blinking, the amplitude of horizontal and vertical components of the eye movement during blinking varies in a systematic way. With adduction and downward gaze the amplitude is minimal. With abduction the horizontal amplitude increases, whereas with upward gaze the vertical amplitude increases. Unilateral electrical supraorbital nerve stimulation at low currents elicits eye movements with a bilateral late component. At stimulus intensities approximately two to three times above the threshold, the early ipsilateral blink reflex response (R(1)) in the OO muscle can be observed together with an early ipsilateral eye movement component at a latency of approximately 15 ms. In addition, during the electrical blink reflex, early ipsilateral and late bilateral components can also be identified in the upper eyelid movement. In contrast to the late bilateral component of upper eyelid movement, the early ipsilateral component of upper eyelid movement appears to open the eye to a greater degree. This early ipsilateral component of upper eyelid movement occurs more or less simultaneously with the early eye movement component. It is suggested that both early ipsilateral movements following electrical stimulation do not have a central neural origin. Late components of the eye movements slightly precede the late components of the eyelid movement. Synchrony between late components of eyelid movements and eye movements as well as similarity of oblique eye movement components in different types of blinking suggest the existence of a premotor neural structure acting as a generator that coordinates impulses to different subnuclei of the oculomotor nucleus as well as the facial nerve nucleus during blinking independent from the ocular saccadic and/or vergence system. The profile and direction of the eye movement rotation during blinking gives support to the idea that it may be secondary to eyeball retraction; an extra cocontraction of the inferior and superior rectus muscle would be sufficient to explain both eye retraction and rotation in the horizontal vertical and torsional planes.

Vertical gaze direction and postural adjustment: An extension of the Heuer model.

The authors provide a consideration of the vergence system and suggest an extension of the original model proposed by H. Heuer, M. Bruwer, T. Romer, H. Kroger, and H. Knapp (1991) to explain why preferred vertical gaze angle is downward when fixating proximal targets. The practical implication of the revised model is that heterophoria (open-loop vergence bias) provides an indication of potential vergence effort. The extended model has several advantages: It allows for modification of workstations, is consistent with models of the accommodation and vergence system, is compatible with clinical data, and provides a more complete explanation of extant research data. The extended model was able to predict oculomotor responses, explain postural adjustments, and provide ergonomically useful data.

Developing visual systems and exposure to virtual reality and stereo displays: some concerns and speculations about the demands on accommodation and vergence

Little is known about the developmental plasticity of the vergence and accommodative systems, an important issue since abnormalities can lead to visual problems, e.g. strabismus. One way of artificially altering the links between accommodation and vergence is to vary the stimulus to vergence while fixing the accommodative stimulus, as is found in virtual reality displays. While it would be of interest to study developmental plasticity in this situation, since many children are exposed to games machines which use this arrangement, no studies to date have tackled this issue. There is, however, some indication that long-term VR viewing in adults can lead to visual problems. It seems important to determine the safety of these systems for the developing human visual system before they come into common use. In this paper, adaptation of the accommodation and vergence systems and the effect of VR viewing in adults is discussed. The sparse literature on adaptation in children is then reviewed, and suggestions made for approaches that would enhance our knowledge of plasticity of accommodation and vergence in children.

Vertical gaze direction and postural adjustment: An extension of the Heuer model.

The authors provide a consideration of the vergence system and suggest an extension of the original model proposed by H. Heuer, M. Bruwer, T. Romer, H. Kroger, and H. Knapp (1991) to explain why preferred vertical gaze angle is downward when fixating proximal targets. The practical implication of the revised model is that heterophoria (open-loop vergence bias) provides an indication of potential vergence effort. The extended model has several advantages: It allows for modification of workstations, is consistent with models of the accommodation and vergence system, is compatible with clinical data, and provides a more complete explanation of extant research data. The extended model was able to predict oculomotor responses, explain postural adjustments, and provide ergonomically useful data.