WENNER-GREN CENTER INTERNATIONAL SYMPOSIUM SERIES

VOLUME 49

STRABISMUS AND AMBLYOPIA

STRABISMUS AND AMBLYOPIA Experimental Basis for Advances

in Clinical Management

Proceedings of an International Symposium held at

The Wenner-Gren Center, Stockholm, June 24th - 26th, 1987

Edited by

Gunnar Lennerstrand Department of Ophthalmology

Karolinska Institute Stockholm, Sweden

Gunter K. von NoordenDepartment of Ophthalmology

Baylor College of Medicine Houston, Texas, USA

and

Emilio C. Campos Department of Ophthalmology,

University of Modena Modena, Italy

M MACMILLAN

PRESS Scientific & Medical

© The Wenner-Gren Center 1988 Softcover reprint of the hardcover 1st edition 1988 978-0-333-47173-9

All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission.

No paragraph of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright Act 1956 (as amended), or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 7, Ridgmount Street, London WC1E 7AE.

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First published 1988

Published in Great Britain by THE MACMILLAN PRESS LTD Houndmills, Basingstoke, Hampshire RG21 2XS and London Companies and representatives throughout the world

British Library Cataloguing in Publication Data Strabismus and amblyopia : experimental basis for advances in clinical management: proceedings of an international symposium held at the Wenner-Gren Center, Stockholm, June 24-26, 1987.-(Wenner-Gren Center international symposium series, ISSN 0083-7989; 49). 1. Strabismus I. Title II. von Noorden, Gunter K. III. Campos, E.C. IV. Series 617.7'62 RE771 ISBN 978-1-349-10405-5 ISBN 978-1-349-10403-1 (eBook)

DOI 10.1007/978-1-349-10403-1

CONTENTS

Preface Invited Contributors and Participants Opening Address: Bjorn Tengroth

Session I Oculomotor Control and Strabismus

1. Motor Dysfunction in Strabismus G. Lennerstrand

2. Aetiology, Classification and Clinical Characteristics of Esotropia in Infancy B. Harcourt

3. Morphology of the Extraocular Muscles in Relation to the Clinical Manifestation of Strabismus R.F. Spencer and K.W.McNeer

4. Motor and Sensory Functions of Normal and Strabismic Extraocular Muscle G. Lennerstrand

lX

Xl

1

5

23

37

47

5. Kinetics of the Eye H.E.A. Bicas 65

6. Phyletic Organization of Brainstem Neuronal Circuits and the Etiology of Strabismus R. Baker 77

7. Neural Basis for Changes of the Optokinetic Reflex in Animals and Men with Strabismus and Amblyopia K.-P. Hoffmann 89

8. Ocular Motor Phenomena in Infantile Strabismus G. Kommerell 99

9. Phasic-Tonic Organization of Accommodation and Vergence C.M. Schor 111

10. Clinical Aspects ofVergent Mechanisms B. Bagolini 121

11. Normative Oculomotor Development in Human Infants R.N. Aslin 133

v

VI CONTENTS

12. DISCUSSION: Oculomotor Control and Strabismus Moderator: G. Lennerstrand

Session II Normal and Abnormal Visual Development

13. Amblyopia in Humans and Clinical Relevance of Animal Models G.K. vonNoorden

14. Normal Anatomical Development of the Primate Primary

143

169

Visual Pathway L. Garey 173

15. Effects of Abnormal Visual Experience on the Morphology of Lateral Geniculate Neurons in the Infant Primate M.P. Headon,].]. Sloper and T.P.S. Powell 185

16. The Influence of the Period of Deprivation on Experimental Refractive Errors E.L. Smith III, R.S. Harwerth, M.L.]. CrawfordandG.K. vonNoorden 197

17. Electrophysiology of Cortical Neurons under different Conditions ofVisual Deprivation M.L.].Crawford 207

18. The Sensitive Periods of the Monkey's Visual Cortex C. Blakemore 219

19. Psychophysical Studies of Visual System Plasticity During Critical Periods of Development R. S. Harwerth and E.L. Smith III 235

20. Normal Visual Development and its Deviations R. Held 247

21. Neuronal Mechanisms of Deprivation Amblyopia W. Singer 259

22. Abnormal Binocular Interaction:Evidence in Humans G.K. vonNoorden 275

23. DISCUSSION: Normal and Abnormal Visual Development Moderator: G.K. von Noorden 285

Session III Psychophysics Related to Strabismus and Amblyopia

24. Visual Perception in Strabismus E. C. Campos 311

25. Role of Oculomotor Proprioception in the Visual System of the Cat L. Maffei and A. Fiorentini 319

CONTENTS VII

26. Extraocular Muscle Proprioception and Visual Function: Psychophysical Aspects M.]. Steinbach, M.A. Musarella and B.L. Gallie 327

27. Extraocular Muscle Proprioception and Visual Functions: Clinical Aspects E.C. Campos 337

28. On the Physiological Basis for Stereopsis M.L.]. Crawford 345

29. Stereopsis and Strabismus E.M. Helveston 359

30. Psychophysical Consequences of Image Degradation and Binocular Misregistration on the Developing Visual Nervous System D.M. Levi and S.A. Klein 369

31. Amblyopia: Clinical Aspects W. Haase

32. DISCUSSION: Psychophysics Related to Strabismus and Amblyopia Moderator: E. C. Campos

33. Concluding Remarks G. Westheimer

34. FINAL DISCUSSION Moderator: G. Westheimer

35. Global Stereopsis B. fulesz

Index

381

393

413

417

427

431

PREFACE

During the last two decades a large amount of experimental research has been devoted to visual and oculomotor physiology. Normal visual development in animals and humans is quite well established and the electrophysiological and behavioural effects of different forms of visual deprivation in animals are also extensively studied. Investigations on the developmental aspects of ocular motility are just beginning.

Parallel to this upsurge of experimental work, clinical research on strabismus and its effects on the visual system has been very active. However, there has been rather limited interaction and exchange of ideas between clinical and basic scientists. The relevance of the enormous body of basic knowledge for the diagnosis and treatment of strabismus and amblyopia has therefore not been properly evaluated. The present meeting has been an attempt to increase communication between the two groups, and to reduce the time-lag between laboratory findings and clinical applications.

The meeting had a workshop character with much time for discussion. It was divided into three sessions. The first dealt with oculomotor control aspects in strabismus, the second with normal and abnormal visual development, and the third part with the psychophysics of strabismus and amblyopia. Subsections of each part were reviewed by prominent workers in each field. The presentations as well as the discussions of the findings and the clinical ramifications are included in this publication.

We want to thank the participants for all the work they have invested in the preparations and during the conference, and for the help that they have given in editing the discussion parts. We are deeply indebted to Professor David Ottoson for providing support on the scientific part and for the use of the excellent conference facilities of the Wenner-Gren Center in Stockholm. We also acknowledge the generous financial support of the

ix

X PREFACE

Wenner-Gren Center Foundation, the Swedish Medical Research Council and the Swedish Government.

Stockholm, June 1987

Gunnar Lennerstrand Gunter K. von Noorden

Emilio C. Campos

INVITED CONTRIBUTORS AND PARTICIPANTS

Richard Aslin Department of Psychology University of Rochester ROCHESTER N.Y. 14627 USA

Bruno Bagolini Eye Clinic Catholic University Largo Gemelli 8 I-00168 ROMA Italy

Robert Baker Department of Physiology New York University Medi-

cal Center NEW YORK N.Y. 10016 USA

Harley Bicas Department of Ophthalmology Faculty of Medicine University of Sao Paolo 14.100 RIBEIRAO PRETO Est. Sao Paolo Brazil

Colin Blakemore University Laboratory of

Physiology Parks Road OXFORD OXl 3PT U.K.

Emilio Campos Department of Ophthalmology University of Modena Via del Pozzo 71 I-41100 MODENA Italy

M.L.J. Crawford Sensory Sciences Center and

Department of Ophthalmology The University of Texas at

Houston HOUSTON Texas 77030 USA

Howard Eggers Edward S. Harkness Eye

Institute 635 West 165th Street NEW YORK N.Y. 10032 USA

Mildred El Azazi Department of Ophthalmology Huddinge Hospital S-141 86 HUDDINGE Sweden

Juan Gallo Department of Ophthalmology Karolinska Hospital S-104 01 STOCKHOLM Sweden

Xl

xii INVITED CONTRIBUTORS and PARTICIPANTS

Laurence Garey Institute of Anatomy University of Lausanne Rue du Bugnon 9 CH-1005 LAUSANNE Switzerland

Mirdza Germanis Department of Ophthalmology Huddinge Hospital S-141 86 HUDDINGE S>V'eden

Hagen Goller Department of Ophthalmology Akademiska Hospital S-751 85 UPPSALA Sweden

Wolfgang Haase Department of Ophthalmology University Hospital Martinistrasse 52 D-2000 HAMBURG FR Germany

Brian Harcourt Department of Ophthalmology General Infirmary Great George Street LEEDS LSl 3EX U.K.

Ronald Harwerth College of Optometry University of Houston 4800 Calhoun Road HOUSTON Texas 77004 USA

Mauricio Headen Department of Human Anatomy South Parks Road OXFORD OXl 3QX U.K.

Richard Held Massachusetts Institute of

Technology 79 Amherst Street El0-145 CAMBRIDGE MA 02139 USA

Eugene Helveston Department of Ophthalmology Indiana University Medical

Center 702 Rotary Circle, 3rd fl INDIANAPOLIS Indiana 46223 USA

Klaus-Peter Hoffmann Department of Neurobiology University of Ulm P 0 Box 4066 D-7900 ULM FR Germany

Claes von Hofsten Department of Psychology University of Umea S-901 87 UMEA Sweden

Annemarie Hohmann Dietrichstrasse 58 D-4790 PADERBORN FR Germany

Gerd Holmstrom Department of Ophthalmology Danderyd Hospital S-182 88 DANDERYD Sweden

Peter Jakobsson Department of Ophthalmology University Hospital S-581 85 LINK~PING Sweden

Bela Julesz Bell Laboratories 600 Murray Hills MURRAY HILLS New Jersey 07974 USA

Guntram Kommerell Department of Ophthalmology Killianstrasse 5 D-7800 FREIBURG FR Germany

INVITED CONTRIBUTORS and PARTICIPANTS XIII

Gunnar Lennerstrand Department of Ophthalmology Huddinge Hospital S-141 86 HUDDINGE Sweden

Dennis Levi College of Optometry University of Houston 4901 Calhoun Road HOUSTON Texas 77004 USA

Sivert Lindstrom Department of Physiology University of Goteborg S-400 33 G~TEBORG Sweden

Bjorn Lundh Department of Ophthalmology University Hospital S-581 85 LINK~PING Sweden

Lamberto Maffei Department of Ophthalmology Via S. Zeno 51 I-56100 PISA Italy

Birgitta Neikter Department of Ophthalmology Danderyd Hospital S-182 88 DANDERYD Sweden

Agneta Rydberg Department of Ophthalmology Karolinska Hospital S-104 01 STOCKHOLM Sweden

Clifton Schor School of Optometry University of California BERKELEY California 94620 USA

Elisabeth Schultz Department of Ophthalmology University Hospital Martinistrasse 52 D-2000 HAMBURG FR Germany

Wolf Singer Department of Neurophysiology Max-Planck-Institut Deutschordenstrasse 46 D-6000 FRANKFURT a.M. 71 FR Germany

Johan Sjostrand Department of Ophthalmology Sahlgrenska Hospital S-413 45 G~TEBORG Sweden

John Sloper Department of Human Anatomy University of Oxford South Park Road OXFORD OXl 3QX U.K.

E . L . Smith II I College of Optometry University of Houston 4800 Calhoun Road HOUSTON Texas 77004 USA

Robert Spencer Department of Anatomy Medical College of Virginia RICHMOND Virginia 23298 USA

Martin Steinbach Atkinson College York University NORTH YORK Ontario Canada M3J 1P3

Goran Stigmar Department of Ophthalmology University Hospital S-221 85 LUND S-v1eden

XIV INVITED CONTRIBUTORS and PAK!'ICIPANTS

Bjorn Tengroth Department of Ophthalmology Karolinska Hospital S-104 01 STOCKHOLM Sweden

Per Udden Hofstrasse 1 CH-6064 KERNS Switzerland

Gunter K. von Noorden Department of Ophthalmology Texas Childrens Hospital P 0 Box 20269 HOUSTON Texas 77225 USA

Peter Wanger Department of Ophthalmology Sabbatsberg Hospital Box 6401 S-113 82 STOCKHOLM Sweden

Olof Wennhall Departme~t of Ophthalmology Central Hospital S-721 89 VASTERAS Sweden

Gerald Westheimer Department of Physiology-

Anatomy University of California BERKELEY California 94720 USA

Jan Ygge Department of Anatomy Karolinska Institute S-104 01 STOCKHOLM Sweden