Recovery in microtropia: implications for aetiology and neurophysiology

AIMS/BACKGROUND The basis of binocular single vision in microtropia remains a matter of contention. This paper discusses the implications of recovery, in a group of primary microtropes following treatment, in relation to current concepts on the aetiology of the condition and proposed retinocortical...

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Bibliographic Details
Published in:British journal of ophthalmology 1998-03, Vol.82 (3), p.225-231
Main Authors: Cleary, Marie, Houston, Charlotte Anne, McFadzean, Robert M, Dutton, Gordon N
Format: Article
Language:English
Subjects:
anomalous retinal correspondence
Bandages
Biological and medical sciences
Child
Child, Preschool
Depth Perception
Eyeglasses
Female
Follow-Up Studies
Humans
Male
Medical sciences
Oculomotor disorders
Ophthalmology
Original articles - Clinical science
Pedigree
retinocortical connections
Scotoma - etiology
stereoacuity
Strabismus - complications
Strabismus - physiopathology
Strabismus - therapy
Treatment Outcome
Visual Acuity
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Summary:AIMS/BACKGROUND The basis of binocular single vision in microtropia remains a matter of contention. This paper discusses the implications of recovery, in a group of primary microtropes following treatment, in relation to current concepts on the aetiology of the condition and proposed retinocortical correspondence. METHODS Nine previously untreated primary microtropes whose condition resolved, were reviewed in detail to assess the patterns of change in retinal correspondence, uniocular fixation, stereoacuity, and visual acuity in response to treatment. RESULTS Anomalous retinal correspondence (ARC), a central scotoma, reduced or absent stereoacuity, amblyopia, and uniocular eccentric fixation were present in all patients before treatment. Following treatment, all cases attained normal retinal correspondence (NRC), elimination of the central scotoma, stereo acuity levels of between 20 and 40 seconds of arc, 6/5 Snellen visual acuity in both eyes, and foveal fixation in both eyes. CONCLUSION A hypothesis is put forward that for the patients described, a period of normal development is likely to have preceded the onset of microtropia, during which the retinocortical “foundations” for NRC were established. Precise pairing of foveo-foveal receptive fields was not abolished by the presence of amblyopia and a central scotoma, but this relation was temporarily suspended and binocular single vision was sustained via the neural substrate of paired receptive fields over a wide retinocortical area.
ISSN:0007-1161
1468-2079
DOI:10.1136/bjo.82.3.225