The development of optokinetic nystagmus in strabismic and monocularly enucleated subjects.

Assymmetries of monocular optokinetic nystagmus (OKN) following anomalous visual experience are thought to be due to disruption at the cortical level. Visual disruption usually results from eye suture (in animals), unilateral dense and central cataracts or strabismus (in humans). Many form-deprived animals and humans frequently show a residual strabismus after lid opening (animals) or cataract extraction and optical correction (humans). We wanted to determine whether strabismus was unique in causing monocular asymmetries of OKN. Two independent observers rated eye movement videotapes of 20 normal subjects, the non-deviating eye of 25 unilateral strabismic subjects and 29 unilaterally eye-enucleated subjects, who were watching either a nasally directed square wave grating, a temporally directed square wave grating, or a blank field. Observers rated the proportion of trials where OKN occurred, the duration of OKN in each trial and the number of beats of OKN within each trial. Monocular OKN was symmetrical in normal subjects for the proportion and duration measures, but half the normal group showed small but significant asymmetries for the beats measure. Subjects in both enucleate and strabismic groups showed asymmetries of OKN favouring nasally directed stimulation, but only the early onset strabismics (as a group) showed asymmetries that were significantly greater (P less than 0.05) than the normal group. Asymmetry scores correlated significantly with age of diagnosis of strabismus for the strabismic group but not with age of enucleation for the enucleate group. The results are discussed in terms of binocular competition.