Ocular Motility: Lecture 5: Fixational Eye Movements Flashcards
- Does the eye remain perfectly motionless during an attempted steady fixation on a Stationary Object?
- NO! it does not
Fixational Area Increases w/Increased Fixation Duration
- Fixation for 10 seconds?
- 20 seconds?
- for 1 minute?
- +/- 7.5 min arc
- +/- 30 min arc
- Fixation is CENTRAL and in CLOSE Proximity to the target
Eye movements During Fixation
What 3 things occur?
- Drift
- Microsaccade
- Tremor
Eye Movements
- Tremor: What is it?
a. Relation to AMPLITUDE?
b. What is it in the Oculomotor System?
c. Impact on Vision? - Freq?
- Amp?
- Vel?
- OU?
- Other?
- High Frequency movement ranging from 30-100 Hz
a. Inversely Related to Amplitude
b. Noise
c. No - 30-100 Hz
- 20 arc secs
- 30 arc min/sec
- Not correlated
- Frequency inversely related to Amplitude
Eye Movements
- Drift: What is it?
- Drift Amplitude INCREASES slightly when what is generated?
- Drift makes up more than 95% of what?
- Freq?
- Amp?
- Vel?
- OU?
- Other?
- A Low Velocity Irregular Eye Movement
- When Retinal Errors are generated from the Near and Far Retinal Periphery
- of one’s Total Fixation Time
4.
Eye Movements
- Microsaccade: What is it?
- Freq?
- Amp?
- Duration?
- OU?
- Other?
- Error Correcting
- 1-2/sec
- 1-25 min arc; Mean is 5 min arc
- 10-25 msec
- Bin & High Amp correlation
- Large Dynamic Overshoot
Ocular Drift
- Light: What happens to Ocular Drift?
- Dark: What happens to Drift Velocity?
- What are drifts?
- In the presence of Visual feedback, what happens to the Accuracy of Fixation?
- It INCREASES over a 1.6 sec period
- Drift Velocity is INCREASED
- Error producing and Microsaccades are Error Correcting
- It was GREATLY INCREASED
- Fixational Eye Movement is ROBUST to changes in response to what?
- Fixation in Darkness has the MOST what?
- Is there an Age related Effect in Overall Stability?
- to EXTERNAL STIMULI
- the Most Deleterious Effects on Accuracy of Fixation
- NO!
Neurophysiology of Fixation
- What 6 areas are involved?
- Parietal Eye Field (Lateral Interparietal Area and Area 7a in monkeys)
- V5 and V5A (MT and MST in Monkeys)
- Supplementary Eye Field
- Dorsolateral Prefrontal Cortex
- Substantia Nigra Pars Reticulata in the Basal Ganglia
- Rostral Pole of the Superior Colliculus
Anormal Fixation
- What 3 things are there?
- Nystagmus
- Saccadic Intrusion
- Slow Drift
Aberrant Tremor
- What is it?
- ABSENCE of what?
- PRESENCE of what 2 things?
- Extended periods of what?
- OVERALL REDUCTION in what?
- Different Overall Patterns b/w the 2 eyes.
- of High-Frequency Bursts
- of Irregular and Low Frequency Bursts of Latitude
- of Very Low-Frequency Movement
- in the Dominant Frequency Response
Slow Drift
- Found in Persons with what?
- Amplitude of up to what?
- Velocity less than what?
- Frequency?
- Generally not rapid enough to degrade what?
- Observed with what?
- Drift Improves with what?
- with Functional Amblyopia
- 1 degree
- than 3 degrees per second
- Irregular, Slow Frequency (
Saccadic Intrusions
- Found in what 3 things?
- What does it do?
- Is it affected by age?
- Normals, Functional Strabismus, and Cerebellar Disease
- Jerks the eye away from the object of regard via a SACCADE and Approx 200 msec later return the eye back to original position by a second opposite second (??)
- No
Square Wave Jerk
- What can they be found in?
- Amplitude
- Time Course
- Latency
- Foveation
- Presence in Darkness
- Sq-wave jerks found in Strabismus can be transiently suppressed
- 0.5-3 deg, constant
- Sporadic
- 200 msec
- Yes
- Yes
Saccadic Intrusions (2)
- Macro Square-wave Jerks are what?
a. They occur more frequently (how much)
b. They remove the eye from the target for how much time?
c. Found in what 2 things? - Amplitude
- Time Course
- Latency
- Foveation
- Presence in Darkness
- Are LARGER
a. 2-3 Hz
b. For a Shorter Period of time (100 msec)
c. Cerebellar Disease and MS - 4-30 degrees
- Bursts
- 50-150 msec
- Yes
- Yes
Saccadic Intrusions (3)
- Macrosaccadic Oscillations
a. Sequence of saccades doing what?
b. Intersaccadic Pauses or Intervals of how much time?
c. Found in what disease? - Amplitude
- Time Course
- Latency
- Foveation
- Presence in Dakness
- a. INCREASING then DECREASING Amplitude to EITHER SIDE Of the FIXATION POINT
b. 200 msec
c. Cerebellar Disease - 1-30 degrees
- Bursts
- 200 msec
- No
- No
Nystagmus
- What is it?
- % of patients w/Strabismus have Nystagmus?
- % of patients w/Congenital Nystagmus that have Strabismus?
- Head turn in a direction opposite to what?
- Rhythmic Oscillation of the Eye
- 50%
- 15%
- to their null position
Nystagmus (2)
- Early Onset Nystagmus
a. AKA?
b. What 2 are there?
- a. Congenital Nystagmus or Infantile Nystagmus Syndrome
b. Sensory Defect Nystagmus (Including Albinism) and Motor Defect Nystagmus (Congenital Idiopathic Nystagmus)
Nystagmus (3)
- Latent Nystagmus
a. AKA?
b. What 2 types?
- a. Fusion Maldevelopment Nystagmus Syndrome
b. Latent Latent Nystagmus, and Manifest Latent Nystagmus
Nystagmus (4)
- Acquired
a. AKA?
b. 6 of them
- a. Neurological Nystagmus
b. Acquired Pendular
Acquired Jerk
Convergence Retraction
Gaze Paretic (Evoked)
See-Saw
and
Vestibular Nystagmus
Characteristics and Observations
- General Observations
- Apparent Type of Nystagmus
- Direciton
- Amplitude
- Frequency
- Constancy
- Conjugacy
- Latent Component
- Position of Gaze Changes
- General Posture, Facial Asymmetries, Head Posture
- Pendular, Jerk or mixed
- Horizontal, vertical, torsional or a combo
- Small ( movements approximately parallel), Disjunctive (Eyes move independently) or monocular
- Does nystagmus increase or change w/occlusion of 1 eye. If so, does it always beat away from the covered eye (pathognomonic of latent nystagmus)
- Null point; does nystagmus increase or decrease in any field of gaze or with convergence
Pendular Nystagmus
- Velocity of Movement
- Foveation
- Null Position
- Similar in both directions
- Occurs when the eye velocity is the lowest
- Present
Jerk Nystagmus
- Velocity of Movement
- Foveation
- Null Position
- Slow in one direction and Rapid Saccade in opposite
- Occur immediately after the rapid saccade
- present
Pendular Nystagmus
- High-gain instability in what?
- What -scopy?
- Amplitude
- Frequency
- Peak Velocity
- in the Slow-Control System
- Visuoscopy
- 0.5-10 degrees
- 2-8 Hz
- up to 100 degrees/sec
Pendular Nystagmus: Congenital Pendular
- Direction
- Variability
- Systemic Disorder
- Horizontal
- Less variable b/w the 2 eyes
- Associated w/Albinism
Pendular Nystagmus: Acquired
- Direction
- Variability
- Systemic Disorder
- Vertical and Torsional
- More variable b/w the 2 eyes
- Associated with Myelin Disease
Congenital Jerk Nystagmus
- Monocular or Binocular?
- Amplitude in both eyes?
- Diminished by what?
- Increased by what?
- VA may be what @Foveation?
- Amplitude
- Frequency?
- Velocity?
- Binocular
- Similar in both eyes
- by Convergence
- by Fixation attempt
5.
Gazed Evoked Nystagmus
- Features are similar to what?
- Slow phase moves the eye towards what?
- A Saccade does what?
- Found in patients with what? (4)
- to Congenital Nystagmus w/the slow-phase velocity waveform of decreasing (rather than increasing) exponential variety
- Towards the Midline
- Corrects the position Error
- Using Certain Drugs, Cerebellar and Vestibular Problems, and MS
Latent Nystagmus
- Latent: What is it?
a. Slow phase toward what?
b. Fast phase towards what? - Manifest Latent Nystagmus: What is it?
a. Occurs with what 2 things?
b. Difficult to Observe with what?
- Form of Jerk Nystagmus that occurs only under monocular condition
a. Toward the occluded eye
b. in the other direction
- Binocular and Conjugate
a. Strabismus and head Turn
b. with Visuoscopy under binocular conditions
Peripheral Vestibular Nystagmus
- Direction of Nystagmus
- Purely Horizontal Nystagmus
- Vertical Nystagmus
- Visual Fixation
- Severity of Vertigo
- Direction of Environmental Spin
* What is Vestibular Nystagmus?
- Unidirectional
- Uncommon
- Never present
- Inhibits Nystagmus and Vertigo
- Marked
- Toward Slow Phase
* Eye moves away from the object of regard and is followed by a foveating Saccade
End Organ Vestibular Nystagmus
- Direction of Nystagmus
- Purely Horizontal Nystagmus
- Vertical Nystagmus
- Visual Fixation
- Severity of Vertigo
- Direction of Environmental Spin
- Bidirectional or Unidirectional
- Common
- May be Present
- No Inhibition
- Mild
- Variable
Treatment of Nystagmus (3)
- Base Out Prism
- Yoked Prisms
- Orthoptics, Contact Lenses & Biofeedback