DEVELOPMENT AND MAINTENANCE OF BINOCULAR VISION

弱视、斜视和相关的双眼功能缺陷 影响了6.7%的美国儿童（根据兰德健康保险公司的数据 Experiment，1985）。在上一个赠款期间， 采用FPL、OPL 和视觉诱发电位协议本项目的继续入组和随访将 允许更精细的分析，并允许我们获得稳定的长期 感觉和运动结果数据。虽然早期治疗往往会导致 视力结果良好，但立体视力结果通常较差。难得 患者获得正常的立体视锐度，<50%获得任何立体视。两 新的治疗方案旨在提高患者的双眼效果 患有婴儿内斜视或先天性单侧白内障的患者， 在即将到来的补助期进行评估：联合手术/Oculinum 斜视的治疗和渐进的咬合治疗程序 先天性单侧白内障的早期手术后。的 眼睛对准、立体视觉和运动处理的相互依赖性 将在正常婴儿、高风险婴儿、 斜视和儿童早发性双眼 不平衡使用受试者内设计，这些研究将产生 双眼发育各方面的定量生长曲线， 将评估运动处理和/或立体视觉是否存在缺陷 在斜视发作之前。目前的斜拉桥模型和 屈光参差性弱视将在一组弱视中进行评估， 前瞻性记录的临床和视觉发育史。数据 将使用发病年龄和/或弱视深度匹配的患者 明确病因和发病年龄在脑卒中发病中的作用， 观察到的缺陷。将进行三项双眼功能的实验室检查， 适用于临床用途：婴儿和学龄前儿童的随机点立体测试 儿童和基于视频的Hirschberg测试。有效和可靠的测试 婴儿和学龄前儿童的双眼感觉和运动状态将 对临床研究方法学做出重大贡献， 病人护理 这些研究将有助于确定必要的和 立体视觉发育的充分条件。基本 科学方面，这些研究将提高我们对关键的理解， 单双眼视觉发展的因素。 临床 侧，改善双眼结果将改善对准稳定性; 也就是说，婴儿内斜视再手术率低， 先天性单侧斜视患儿斜视发生率 白内障

Amblyopia, strabismus, and associated deficits in binocular function affect 6.7% of American children (according to the Rand Health Insurance Experiment, 1985). During the previous grant period, efficacy and effectiveness of early treatment protocols were evaluated using FPL, OPL, and VEP protocols. Continued enrollment and follow-up in this project will permit a finer grain of analysis and allow us to obtain stable long-term sensory and motor outcome data. Although early treatment often results in good acuity outcomes, stereoacuity outcomes are routinely poor. Only rare patients achieve normal stereoacuity and <50% achieve any stereopsis. Two new treatment protocols designed to enhance binocular outcomes in patients with infantile esotropia or congenital unilateral cataract will be evaluated in the upcoming grant period: a combined surgery/Oculinum treatment for strabismus and a graduated occlusion therapy program following very early surgery for congenital unilateral cataract. The interdependence of eye alignment, stereopsis, and motion processing during visual development will be studied in normal infants, infants at high risk for strabismus, and pediatric patients with early onset binocular imbalance. Using a within-subjects design, these studies will yield quantitative growth curves for each aspect of binocular development and will evaluate whether deficits in motion processing and/or stereopsis precede the onset of strabismus. Current models of strabismic and anisometropic amblyopia will be evaluated in a group of amblyopes with prospectively documented clinical and visual development histories. Data from patients matched for onset age and/or depth of amblyopia will be used to define the roles of etiology and onset age in the constellation of deficits observed. Three laboratory tests of binocular function will be adapted for clinical use: random-dot stereotests for infants and preschool children and a video-based Hirschberg test. Valid and reliable tests of binocular sensory and motor status for infants and preschool children will make a significant contribution to clinical research methodology and patient care. These studies will help to define the necessary and sufficient conditions for the development of stereopsis. On the basic science side, these studies will improve our understanding of critical factors in the development of single binocular vision. On the clinical side, improved binocular outcome will improved stability of alignment; i.e., lower incidence of re-operation in infantile esotropia and lower incidence of strabismus in infants treated for congenital unilateral cataract.