Vergence System Research Articles

Nystagmus and oscillopsia

The ocular motor system consists of several subsystems, including the vestibular ocular nystagmus saccade system, the pursuit system, the fixation and gaze-holding system and the vergence system. All these subsystems aid the stabilization of the images on the retina during eye and head movements and any kind of disturbance of one of the systems can cause instability of the eyes (e.g. nystagmus) or an inadequate eye movement causing a mismatch between head and eye movement (e.g. bilateral vestibular failure). In both situations, the subjects experience a movement of the world (oscillopsia) which is quite disturbing. New insights into the patho-physiology of some of the ocular motor disorders have helped to establish new treatment options, in particular in downbeat nystagmus, upbeat nystagmus, periodic alternating nystagmus, acquired pendular nystagmus and paroxysmal vestibular episodes/attacks. The discussed patho-physiology of these disorders and the current literature on treatment options are discussed and practical treatment recommendations are given in the paper.

Short-term adaptations of the dynamic disparity vergence and phoria systems

The ability to adapt is critical to survival and varies between individuals. Adaptation of one motor system may be related to the ability to adapt another. This study sought to determine whether phoria adaptation was correlated with the ability to modify the dynamics of disparity vergence. Eye movements from ten subjects were recorded during dynamic disparity vergence modification and phoria adaptation experiments. Two different convergent stimuli were presented during the dynamic vergence modification experiment: a test stimulus (4° step) and a conditioning stimulus (4° double step). Dynamic disparity vergence responses were quantified by measuring the peak velocity (°/s). Phoria adaptation experiments measured the changes in phoria over a 5-min period of sustained fixation. The maximum velocity of phoria adaptation was determined from an exponential fit of the phoria data points. Phoria and dynamic disparity vergence peak velocity were both significantly modified (P<0.001). The maximum velocity of phoria adaptation was significantly correlated with the changes in convergence peak velocity (r>0.89; P<0.001). There was a strong correlation between the ability to adaptively adjust two different oculomotor parameters: a tonic and dynamic component. Future studies should investigate additional interactions between these parameters, and the ability to adaptively change other oculomotor systems such as the saccadic or smooth pursuit system. Understanding the ability to modify phoria, dynamic disparity vergence, and other oculomotor parameters can yield insights into the plasticity of short-term adaptation mechanisms.

Vergence dysfunction in mild traumatic brain injury (mTBI): a review

Vergence eye movements are used to track objects that move in depth in one's binocular visual field to attain and maintain a fused and single percept. The mechanism and control of vergence eye movements involves complex neurological processes that may be compromised in individuals with traumatic brain injury, thus frequently resulting in a wide range of vergence dysfunctions and related near-work symptoms, such as oculomotor-based reading problems. This paper presents a review of the vergence system and its anomalies in mild traumatic brain injury, as well as their diagnostic and therapeutic clinical ramifications. Implications related to brain imaging and human neuroplasticity are also considered.

Short exposure to telestereoscope affects the oculomotor system

Under natural viewing conditions, the accommodation and vergence systems adjust the focus and the binocular alignment of the eyes in response to changes in viewing distance. The two responses are linked via cross-coupling and proceed almost simultaneously. Some optical devices, such as virtual reality or helmet mounted displays, create an oculomotor conflict by modifying demands on both vergence and accommodation. Previous studies extensively investigated the effect of such a conflict on the cross-coupling between vergence and accommodation, but little is known about the plasticity of the whole oculomotor system. In the present study, an oculomotor conflict was induced by a telestereoscope which magnified the standard inter-pupillary separation threefold and thus increased the convergence demand while accommodation remained almost unchanged. The effect of a 10 min exposure was assessed via a series of optometric parameters selected on the basis of existing oculomotor models. Associated with subject's visual complaints, most of the oculomotor parameters tested were modified: there was (1) deterioration of stereoscopic threshold; (2) increase in AC/A ratio; (3) increase in near and far phorias; and (4) shift of the zone of clear and single binocular vision towards convergence. These results showed a change in gain of accommodative vergence and a shift of vergence reserves towards convergence in response to telestereoscopic viewing. The subject's binocular behaviour tended towards esophoria with convergence excess as confirmed by Sheard's and Percival's criteria. Such changes in oculomotor parameters support adaptive behaviour linked with telestereoscopic viewing.

A spatial variant approach for vergence control in complex scenes

The flexibility in primate vision that utilizes active binocular vision is unparalleled even with modern fixed-stereo-based vision systems. However to follow the path of active binocular vision, the difficulty of attaining fixative capabilities is of primary concern. This paper presents a binocular vergence model that utilizes the retino-cortical log polar mapping in the primate vision system. Individual images of the binocular pair were converted to multi-resolution pyramids bearing a coarse-to-fine architecture (low resolution to high resolution) and disparity estimation on these pyramidal resolutions was performed using normalized cross correlation on the log polar images. The model was deployed on an actual binocular vergence system with independent pan-tilt controls for each camera and the system was able to robustly verge on objects even in cluttered environment with real time performance. This paper even presents the experimental results of the system functioning in unbalanced contrast exposures between the two cameras. The results proved favorable for real world robotic vision applications where noise is prevalent. The proposed vergence control model was also compared with a standard window based Cartesian stereo matching method and showed superior performance.

The effect of changing size on vergence is mediated by changing disparity

In this study, we investigated the effect of changing size on vergence. Erkelens and Regan (1986) proposed that this cue to motion in depth affects vergence in a similar way as it affects perception. The measured effect on vergence was small and we wondered why the vergence system would use changing size as an additional cue to changing disparity. To elucidate the effect of changing size on vergence, we used an annulus carrying both changing size and changing disparity signals to motion in depth. The cues were either congruent or signaled a different depth. The results showed that vergence was affected by changing size, however in an opposite way than that perception was affected. These results were incongruent with those reported by Erkelens and Regan (1986). We therefore additionally measured the effects on vergence of the individual parameters associated with changing size, i.e., stimulus area, retinal eccentricity, and luminance. Stimulus (retinal) eccentricity was inversely related to vergence gain. Luminance, on the other hand, had a smaller but positive relation to vergence gain. Thus, changing size affected the disparity signal two-fold: it changed the retinal location of the disparity signal and it changed the strength of the disparity signal (luminance change). These effects of changing size on disparity can explain both our results (change in retinal location of the disparity signal) and those of Erkelens and Regan (1986; change in luminance). We thus conclude that changing size did not in itself contribute to vergence, rather its effect on vergence was mediated by disparity.

Ocular motor development in normal and premature children

AbstractThe ocular motor system is immature at birth and the different types of eye movements develop at different stages of child development. This presentation aims to discuss the normal ocular motor development and the often delayed development of the ocular motor functions seen in premature children. For example, the visual fixation is often more instable in the premature child. Also the saccadic as well as the smooth pursuit and vergence systems exhibit delays in development in the premature child. The delayed development has implications for the clinical investigation and must be taken into consideration when examining the visual functions of the premature child.

Effect of Vergence Adaptation on Convergence–Accommodation: Model Simulations

Several theoretical control models depict the adaptation effects observed in the accommodation and vergence mechanisms of the human visual system. Two current quantitative models differ in their approach of defining adaptation and in identifying the effect of controller adaptation on their respective cross-links between the vergence and accommodative systems. Here, we compare the simulation results of these adaptation models with empirical data obtained from emmetropic adults when they performed sustained near task through + 2D lens addition. The results of our experimental study showed an initial increase in exophoria (a divergent open-loop vergence position) and convergence-accommodation (CA) when viewing through +2D lenses. Prolonged fixation through the near addition lenses initiated vergence adaptation, which reduced the lens-induced exophoria and resulted in a concurrent reduction of CA. Both models showed good agreement with empirical measures of vergence adaptation. However, only one model predicted the experimental time course of reduction in CA. The pattern of our empirical results seem to be best described by the adaptation model that indicates the total vergence response to be a sum of two controllers, phasic and tonic, with the output of phasic controller providing input to the cross-link interactions.

Why Do Patients with Impaired Vergence Not Show “Saccadic” Vergence?

Low gain of the smooth-pursuit system causes correcting saccades that are clinically observed as "saccadic pursuit." In contrast, low gain of the vergence system during tracking does not appear to cause "saccadic tracking." To further evaluate whether this clinical observation is caused by a missing interaction of vergence to step and ramp targets, vergence eye movements to step-ramp, step, and ramp targets in 3-dimensional space were tested. Results show that vergence to a step and a ramp stimulus is additive in the step-ramp paradigm, indicating no interaction of both components.

An examination of binocular reading fixations based on sentence corpus data

Binocular eye movements of normal adult readers were examined as they read single sentences. Analyses of horizontal and vertical fixation disparities indicated that the most prevalent type of disparate fixation is crossed (i.e., the left eye is located further to the right than the right eye) while the left eye frequently fixates somewhat above the right eye. The Gaussian distribution of the binocular fixation point peaked 2.6 cm in front of the plane of text, reflecting the prevalence of horizontally crossed fixations. Fixation disparity accumulates during the course of successive saccades and fixations within a line of text, but only to an extent that does not compromise single binocular vision. In reading, the version and vergence system interact in a way that is qualitatively similar to what has been observed in simple nonreading tasks. Finally, results presented here render it unlikely that vergence movements in reading aim at realigning the eyes at a given saccade target word.

The Influence of the Vergence System on Strabismus Diagnosis and Management

The vergence system is an important element in human eye movement control. It comprises horizontal, vertical, and torsional components, the largest of which is convergence. Vergence performance is largely involuntary, although voluntary effort can influence convergence. Vergence function can be damaged by trauma or organic disease and, because convergence can be exerted voluntarily, it is susceptible to purposeful subjective disturbances. Vergence function is important in the maintenance of binocular control, being synonymous with motor fusion. The most common vergence dysfunction affects convergence and may be exhibited as an excess or weakness such as convergence spasm or paralysis. Divergence dysfunction generally presents with diminished function such as divergence weakness; vertical and cyclovergence disturbances are rare. An update is given on the neuroanatomical areas that subserve the vergence system. Clinical examples of the most common vergence disorders are presented. The influence of the vergence system on the diagnosis and management in common and less well-known clinical entities is described and discussed.

Vergence in reverspective: Percept-driven versus data-driven eye movement control

‘Reverspectives’ (by artist Patrick Hughes) consist of truncated pyramids with their small faces closer to the viewer, allowing realistic scenes to be painted on them. Because their pictorial perspective reverses the physical depth arrangement, reverspectives provide a bistable paradigm of two radically different, competing depth percepts, even when viewed binocularly: points that are physically further are perceived to be closer and vice versa. The key question addressed here is whether vergence is governed by the physical and/or the perceived depth of fixated targets. Vergence eye movements were recorded using the EyeLink II system under conditions optimized to obtain both the veridical and illusory depth percepts of a reverspective. Six gaze locations were signaled by LEDs placed at strategically selected depths on the stimulus surface. We obtained strong evidence that stable vergence fixations were governed by the percept: for the same LED position, eyes converged under veridical depth percepts and diverged under illusory percepts, thus rendering pictorial cues to be as effective as physical cues in vergence control. These results, obtained with stable fixations, do not disagree with earlier studies that found rapid fixational eye movements to be governed by physical depth cues. Together, these results allow us to speculate on the existence of at least two eye movement systems: an automatic, data-driven system for rapid successions of fixations; and a deliberate schema-driven vergence system that accounts for stable fixations based on the perceptual state of the observer.

Optimal Dioptric Value of Near Addition Lenses Intended to Slow Myopic Progression

The purpose of this study was to determine the optimal power value of near addition lenses, which would create the least error in accommodative and vergence responses. We evaluated accommodative response, phoria, and fixation disparity when the subject viewed through various addition lenses at three working distances for 30 young adults (11 emmetropic, 17 myopic, and 2 hyperopic). Accommodative response was determined with a Canon R-1 infrared optometer under binocular viewing conditions, phoria was determined by the alternating cover test with prism neutralization, and fixation disparity was measured with a Sheedy disparometer. We found that the optimal powers of near addition lenses for the young adult subjects associated with zero retinal defocus were +0.92 D, +1.04 D, and +1.28 D at three viewing distances, 50 cm, 40 cm, and 30 cm, respectively. The optimal powers associated with -3 prism diopters (Delta) near phoria were +0.58 D, +0.35 D, and +0.20 D at the three distances, 50 cm, 40 cm, and 30 cm, respectively. In addition, we found high correlations between the initial accommodative error and the optimal power of the near addition lenses and between the initial near phoria and the optimal power of the near addition lenses. The results suggest that when the effects of near addition lenses on the accommodative and vergence systems are both considered, the optimal dioptric power of the near addition lens is in a range between +0.20 D and +1.28 D for the three viewing distances. Using progressive lenses to delay the progression of myopia may have promising results if each subject's prescription is customized based on establishing a balance between the accommodative and vergence systems. Formulas derived from this study provide a basis for such considerations.

Relationships between versional and vergent quick phases of the involuntary version-vergence nystagmus

We used ground-plane motion stimuli displayed on a computer monitor positioned below eye level to induce involuntary version-vergence nystagmus (VVN). The VVN was recorded with a search coil system. It was shown that the VVN had both vertical versional and horizontal vergence components. The VVN induced by backward motion (toward subjects) had upward versional and divergence quick phases, whereas those induced by forward motion (away from subjects) had downward and biphasic divergence-convergence quick phases. The versional and vergence components of the VVN quick phases were analyzed. A temporal dissociation of about 20 ms between version velocity peak and convergence velocity peak was revealed, which supported a modified saccade-related vergence burst neuron (SVBN) model. We suggest that the temporal dissociation may be partly because of a lower-level OKN control mechanism. Vergence peak time was dependent on version peak time. Linear relationships between vergence peak velocity and versional saccadic peak velocity were demonstrated, which was in line with the new multiplicative model. Our data support the hypothesis that the vergence system and the saccadic system can act separately but interact with each other whenever their movements occur simultaneously.

Neurological Significance of Small Esodeviations

A small esodeviation detected in an adult may represent an acquired event caused by a number of different mechanisms. These deviations may be comitant or incomitant, occur with or without diplopia and appear in association with other ocular or neurological findings or in isolation.The mechanisms include lateral rectus dysfunction, supranuclear gaze disturbances, anomalies in the vergence system, the influence of the near synkinesis and certain restrictive components. The presence of a small, acquired esodeviation may have neurological significance that may influence diagnosis and management decisions.1,2 Conditions such as divergence paralysis and convergence spasm are described in the classic literature with large esodeviations and obvious clinical features.3–7 They are not a common occurrence in most strabismus practices but are recognized readily when they occur.More subtle presentations of these entities are seen far more frequently and may be so small, or co-exist with other ocular findings, as to be overlooked. It is likely that with many clinical disorders like divergence paresis and convergence spasm that they present as a spectrum of dysfunction; it is the small end of that spectrum that will be discussed.

A pulse-step model of accommodation dynamics in the aging eye

We have developed a dynamic model of accommodation that combines independent phasic-velocity and tonic-position neural signals to control position, velocity and acceleration properties of accommodative step responses. Phasic and tonic signals were obtained from neural integration of a fixed-height acceleration-pulse and variable-height velocity-step respectively to control independent acceleration and velocity properties of the step response. Duration and amplitude of the acceleration-pulse are increased with age to compensate for age-related increases of visco-elastic properties of the lens to maintain youthful velocity. The model illustrates a neural control strategy that is similar to the classical neural control model of step changes by the saccadic and vergence systems.

Short-term predictive changes in the dynamics of disparity vergence eye movements

Repetitive stimulation of the disparity vergence system to large convergent step stimuli has been shown to increase the dynamics of subsequent responses to smaller step stimuli. Here we show that decreases in the dynamics of both disparity convergence and divergence eye movements can be induced using a frequently occurring small amplitude conditioning stimulus to modify responses to a larger, occasionally presented test stimulus. In one experiment, a simple conditioning stimulus consisting of repetitive 1 degrees step stimuli was used to modify the dynamic vergence response to an occasional 4 degrees step test stimulus. An experimental trial consisted of three phases: baseline, conditioning, and recovery. The baseline and recovery phases used only the 4 degrees test stimuli. The dynamic characteristics of the responses to test stimuli were quantified by measuring the magnitude of the peak velocity. A statistically significant change was observed between the dynamics of conditioned responses compared to baseline and recovery responses indicting modification by the conditioning stimuli. During recovery, the response dynamics returned to levels near baseline levels showing that the decrease in response dynamics was caused by the conditioning stimulus, not fatigue. Another experiment showed that the response dynamics to large stimuli could be decreased whereas the dynamics of small stimuli could be increased by the same intermediate conditioning stimulus. Other experiments suggest that the modifications are due to a predictive mechanism. The results indicate that the dynamics of disparity vergence eye movements are malleable and depend to some extent on the amplitude of preceding stimuli.

Tests of Hering‐ and Helmholtz‐Type Models for Saccade‐Vergence Interactions by Comparing Visually Guided and Memory‐Guided Movements

We compared the dynamic properties of memory-guided and visually-guided saccade-vergence movements. For memory-guided responses, convergence components were slowed proportionally more than corresponding saccadic components, compared with visually-guided responses. This result is consistent with independent saccadic and vergence systems, and supports a Hering-type model for saccade-vergence interactions.

Age-related changes of vergence under natural viewing conditions

Vergence eye movements were recorded with the scleral search-coil system in 32 healthy subjects (ages 19–73 years) to characterize the age-related effects on the dynamic parameters of vergence responses to step (transient components) and ramp or sinusoidal targets (sustained components) under natural viewing conditions. Transient vergence showed an age-related increase in latency and decreases in peak velocity and acceleration in the binocular stimulus condition but not in accommodative vergence. Sustained vergence showed no age-related effect in the binocular condition, but there was an age-related decrease in accommodative vergence steady-state velocity and an increase in latency. Age-related changes of the transient and sustained components were very similar to those reported for saccades and smooth pursuit; they thus might support a distinction between a sustained and transient vergence system. Furthermore, such age-related effects have to be taken into account when assessing eye movement disorders in neurodegenerative and cerebrovascular diseases.

A pulse-step model of accommodation dynamics in the aging eye

We have developed a dynamic model of accommodation that combines independent phasic-velocity and tonic-position neural signals to control position, velocity and acceleration properties of accommodative step responses. Phasic and tonic signals were obtained from neural integration of a fixed-height acceleration-pulse and variable-height velocity-step respectively to control independent acceleration and velocity properties of the step response. Duration and amplitude of the acceleration-pulse are increased with age to compensate for age-related increases of visco-elastic properties of the lens to maintain youthful velocity. The model illustrates a neural control strategy that is similar to the classical neural control model of step changes by the saccadic and vergence systems.