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Visual Suppression in Intermittent Exotropia during Binocular Alignment

Lookup NU author(s): Dr Ignacio Serrano-PedrazaORCiD, Vina Manjunath, Michael Clarke, Professor Jenny ReadORCiD


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PURPOSE. To investigate the cortical mechanisms that prevent diplopia in intermittent exotropia (X(T)) during binocular alignment (orthotropia). METHODS. The authors studied 12 X(T) patients aged 5 to 22 years. Seventy-five percent had functional stereo vision with stereoacuity similar to that of 12 age-matched controls (0.2-3.7 min arc). Identical face images were presented to the two eyes for 400 ms. In one eye, the face was presented at the fovea; in the other, offset along the horizontal axis with up to 12 eccentricity. The task was to indicate whether one or two faces were perceived. RESULTS. All X(T) patients showed normal diplopia when the nonfoveal face was presented to nasal hemiretina, though with a slightly larger fusional range than age-matched controls. However, 10 of 12 patients never experienced diplopia when the nonfoveal face was presented to temporal hemiretina (i.e., when the stimulus simulated exodeviation). Patients showed considerable variability when the single image was perceived. Some patients suppressed the temporal stimulus regardless of which eye viewed it, whereas others suppressed a particular eye even when it viewed the foveal stimulus. In two patients, the simulated exodeviation might have triggered a shift from normal to anomalous retinal correspondence. CONCLUSIONS. Antidiplopic mechanisms in X(T) can be reliably triggered by purely retinal information during orthotropia, but the nature of these mechanisms varies between patients. (Invest Ophthalmol Vis Sci. 2011;52:2352-2364) DOI: 10.1167/iovs.10-6144

Publication metadata

Author(s): Serrano-Pedraza I, Manjunath V, Osunkunle O, Clarke MP, Read JCA

Publication type: Article

Publication status: Published

Journal: Investigative Ophthalmology & Visual Science

Year: 2011

Volume: 52

Issue: 5

Pages: 2352-2364

Print publication date: 10/01/2011

ISSN (print): 0146-0404

ISSN (electronic): 1552-5783

Publisher: Association for Research in Vision and Ophthalmology


DOI: 10.1167/iovs.10-6144


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Funder referenceFunder name
80154Medical Research Council
UF041260Royal Society