DEVELOPMENT AND MAINTENANCE OF BINOCULAR VISION

弱视、斜视及其相关的双眼功能缺陷 影响6.7%的美国儿童(根据兰德健康保险 实验，1985)。在之前的资助期内，疗效和 早期治疗方案的有效性用FPL，OPL， 和视觉诱发电位协议。继续招募和跟进该项目将 允许更细粒度的分析，并允许我们获得稳定的长期 感觉和运动结果数据。尽管早期治疗通常会导致 良好的视力结果，立体视力结果通常很差。只有稀有的 患者达到正常立体视，50%达到任何立体视。二 旨在提高患者双眼疗效的新治疗方案 伴有婴幼儿内斜视或先天性单眼的白内障 在即将到来的赠款期间进行评估：A联合手术/眼科 斜视的治疗和渐进式咬合治疗方案 在先天性单眼白内障的早期手术后。这个 眼球对齐、立体视觉和运动加工的相互依赖 将对正常婴儿、高危婴儿的视觉发育进行研究 适用于斜视和早发性双眼儿童患者 不平衡。使用受试者内部设计，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/或立体视觉方面的缺陷 在斜视发作之前。目前斜视和斜视的模型 屈光参差性弱视将在一组弱视患者中进行评估， 前瞻性地记录临床和视觉发展历史。数据 弱视的起始年龄和/或深度匹配的患者将被使用 明确病因和发病年龄在疾病星座中的作用 观察到了赤字。将对双眼功能进行三项实验室测试 临床应用：婴幼儿和学龄前儿童的随机点立体测验 儿童和基于视频的赫希伯格测试。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 对临床研究方法论和 病人护理。这些研究将有助于确定必要的和 发展立体视觉的充分条件。在基础上 科学方面，这些研究将提高我们对批评的理解 影响单眼双目视觉发展的因素。浅谈临床 另一方面，改善双眼结果将提高对齐的稳定性； 即婴儿内斜视再次手术的发生率较低， 婴幼儿先天性单侧斜视的发生率 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.