VEGF is an essential retrograde trophic factor for motoneurons.

VEGF was initially discovered due to its angiogenic activity and therefore named "vascular endothelial growth factor." However, its more recently discovered neurotrophic activity may be evolutionarily more ancient. Our previous work showed that all the changes produced by axotomy on the firing activity and synaptic inputs of abducens motoneurons were completely restored after VEGF administration. Therefore, we hypothesized that the lack of VEGF delivered by retrograde transport from the periphery should also affect the physiology of otherwise intact abducens motoneurons. For VEGF retrograde blockade, we chronically applied a neutralizing VEGF antibody to the lateral rectus muscle. Recordings of extracellular single-unit activity and eye movements were made in alert cats before and after the application of the neutralizing antibody. Our data revealed that intact, noninjured abducens motoneurons retrogradely deprived of VEGF exhibited noticeable changes in their firing pattern. There is a general decrease in firing rate and a significant reduction in eye position and eye velocity sensitivity (i.e., a decrease in the tonic and phasic components of their discharge, respectively). Moreover, by means of confocal immunocytochemistry, motoneurons under VEGF blockade showed a marked reduction in the density of afferent synaptic terminals contacting with their cell bodies. Altogether, the present findings demonstrate that the lack of retrogradely delivered VEGF renders abducens motoneurons into an axotomy-like state. This indicates that VEGF is an essential retrograde factor for motoneuronal synaptic drive and discharge activity.

Functional anatomy of the orbit in strabismus surgery: Connective tissues, pulleys, and the modern surgical implications of the "arc of contact" paradigm.

Oculomotricity is a multidimensional domain characterised by a delicate interplay of anatomical structures and physiological processes. This manuscript meticulously dissects the nuances of this interplay, bringing to the fore the integral role of the extraocular muscles (EOMs) and their intricate relationship with the myriad orbital connective tissues as it harmoniously orchestrates binocular movements, ensuring synchronised and fluid visual tracking. Historically, the peripheral oculomotor apparatus was conceptualised as a rudimentary system predominantly driven by neural directives. While widely accepted, this perspective offered a limited view of the complexities inherent in ocular movement mechanics. The twentieth century heralded a paradigm shift in this understanding. With advances in anatomical research and imaging techniques, a much clearer picture of the gross anatomy of the EOMs emerged. This clarity challenged traditional viewpoints, suggesting that the inherent biomechanical properties of the EOMs, coupled with their associated tissue pulleys, play a pivotal role in dictating eye movement dynamics. Central to this revised understanding is the "arc of contact" paradigm. This concept delves deep into the mechanics of eye rotation, elucidating the significance of the point of contact between the EOMs and the eyeball. The arc of contact is not just a static anatomical feature; its length and orientation play a crucial role in determining the effective torque generated by a muscle, thereby influencing the amplitude and direction of eye rotation. The dynamic nature of this arc, influenced by the position and tension of the muscle pulleys, offers a more comprehensive model for understanding ocular kinematics. Previously overlooked in traditional models, muscle pulleys have now emerged as central players in the biomechanics of eye movement. These anatomical structures, formed by dense connective tissues, guide the paths of the EOMs, ensuring that their pulling angles remain optimal across a range of gaze directions. The non-linear paths resulting from these pulleys provide a more dynamic and intricate understanding of eye movement, challenging two-dimensional, linear models of orbital anatomy. The implications of these revelations extend beyond mere theoretical knowledge. The insights garnered from this research promise transformative potential in the realm of strabismus surgery. Recognising the pivotal role of muscle pulleys and the "arc of contact" paradigm allows for more precise surgical interventions, ensuring better post-operative outcomes and minimising the risk of complications. Surgical procedures that previously relied on basic mechanical principles now stand to benefit from a more nuanced understanding of the underlying anatomical and physiological dynamics. In conclusion, this manuscript serves as a testament to the ever-evolving nature of scientific knowledge. Challenging established norms and introducing fresh perspectives pave the way for more effective and informed clinical interventions in strabismus surgery.

Proprioceptors in extraocular muscles.

Proprioception is the sense that lets us perceive the location, movement and action of the body parts. The proprioceptive apparatus includes specialized sense organs (proprioceptors) which are embedded in the skeletal muscles. The eyeballs are moved by six pairs of eye muscles and binocular vision depends on fine-tuned coordination of the optical axes of both eyes. Although experimental studies indicate that the brain has access to eye position information, both classical proprioceptors (muscle spindles and Golgi tendon organ) are absent in the extraocular muscles of most mammalian species. This paradox of monitoring extraocular muscle activity in the absence of typical proprioceptors seemed to be resolved when a particular nerve specialization (the palisade ending) was detected in the extraocular muscles of mammals. In fact, for decades there was consensus that palisade endings were sensory structures that provide eye position information. The sensory function was called into question when recent studies revealed the molecular phenotype and the origin of palisade endings. Today we are faced with the fact that palisade endings exhibit sensory as well as motor features. This review aims to evaluate the literature on extraocular muscle proprioceptors and palisade endings and to reconsider current knowledge of their structure and function.

Extreme Tolerance of Extraocular Muscles to Diseases and Aging: Why and How?

The extraocular muscles (EOMs) possess unique characteristics that set them apart from other skeletal muscles. These muscles, responsible for eye movements, exhibit remarkable resistance to various muscular dystrophies and aging, presenting a significant contrast to the vulnerability of skeletal muscles to these conditions. In this review, we delve into the cellular and molecular underpinnings of the distinct properties of EOMs. We explore their structural complexity, highlighting differences in fiber types, innervation patterns, and developmental origins. Notably, EOM fibers express a diverse array of myosin heavy-chain isoforms, retaining embryonic forms into adulthood. Moreover, their motor innervation is characterized by a high ratio of nerve fibers to muscle fibers and the presence of unique neuromuscular junctions. These features contribute to the specialized functions of EOMs, including rapid and precise eye movements. Understanding the mechanisms behind the resilience of EOMs to disease and aging may offer insights into potential therapeutic strategies for treating muscular dystrophies and myopathies affecting other skeletal muscles.

Proprioceptive contribution to oculomotor control in humans.

Stretch receptors in the extraocular muscles (EOMs) inform the central nervous system about the rotation of one's own eyes in the orbits. Whereas fine control of the skeletal muscles hinges critically on proprioceptive feedback, the role of proprioception in oculomotor control remains unclear. Human behavioural studies provide evidence for EOM proprioception in oculomotor control, however, behavioural and electrophysiological studies in the macaque do not. Unlike macaques, humans possess numerous muscle spindles in their EOMs. To find out whether the human oculomotor nuclei respond to proprioceptive feedback we used functional magnetic resonance imaging (fMRI). With their eyes closed, participants placed their right index finger on the eyelid at the outer corner of the right eye. When prompted by a sound, they pushed the eyeball gently and briefly towards the nose. Control conditions separated out motor and tactile task components. The stretch of the right lateral rectus muscle was associated with activation of the left oculomotor nucleus and subthreshold activation of the left abducens nucleus. Because these nuclei control the horizontal movements of the left eye, we hypothesized that proprioceptive stimulation of the right EOM triggered left eye movement. To test this, we followed up with an eye-tracking experiment in complete darkness using the same behavioural task as in the fMRI study. The left eye moved actively in the direction of the passive displacement of the right eye, albeit with a smaller amplitude. Eye tracking corroborated neuroimaging findings to suggest a proprioceptive contribution to ocular alignment.

Functional diversity of motoneurons in the oculomotor system.

Extraocular muscles contain two types of muscle fibers according to their innervation pattern: singly innervated muscle fibers (SIFs), similar to most skeletal muscle fibers, and multiply innervated muscle fibers (MIFs). Morphological studies have revealed that SIF and MIF motoneurons are segregated anatomically and receive different proportions of certain afferents, suggesting that while SIF motoneurons would participate in the whole repertoire of eye movements, MIF motoneurons would contribute only to slow eye movements and fixations. We have tested that proposal by performing single-unit recordings, in alert behaving cats, of electrophysiologically identified MIF and SIF motoneurons in the abducens nucleus. Our results show that both types of motoneuron discharge in relation to eye position and velocity, displaying a tonic-phasic firing pattern for different types of eye movement (saccades, vestibulo-ocular reflex, vergence) and gaze-holding. However, MIF motoneurons presented an overall reduced firing rate compared with SIF motoneurons, and had significantly lower recruitment threshold and also lower eye position and velocity sensitivities. Accordingly, MIF motoneurons could control mainly gaze in the off-direction, when less force is needed, whereas SIF motoneurons would contribute to increase muscle tension progressively toward the on-direction as more force is required. Anatomically, MIF and SIF motoneurons distributed intermingled within the abducens nucleus, with MIF motoneurons being smaller and having a lesser somatic synaptic coverage. Our data demonstrate the functional participation of both MIF and SIF motoneurons in fixations and slow and phasic eye movements, although their discharge properties indicate a functional segregation.

How Lingering Fusional Adaptation Influences the Bielschowsky Head Tilt Test in Superior Oblique Paresis.

BACKGROUND: The lack of a positive Bielschowsky head tilt test (BHTT) is commonly seen as an indicator that superior oblique paresis (SOP) is not present. This study investigated the influence of fusion on the BHTT in unilateral SOP. PATIENTS/METHODS AND MATERIAL: We analyzed vertical fusional vergence using our eye-tracking haploscope and the value of BHTT difference (BHTTD) in 11 patients who were diagnosed with congenital unilateral SOP and able to fuse. RESULTS: Patients used one of three different mechanisms of vertical vergence to achieve fusion. The three fusional mechanisms were associated with a significantly different BHTTD (p < 0.05). Seven of the eleven patients used vertical recti-mediated fusion and had a mean BHTTD ± SD of 21.7 ± 6.3 prism diopters (PD). Three of these patients whom we measured after a patch test for at least 30 min showed a decreased BHTTD (12.7 ± 3.8 PD). Three of the eleven patients used a mixed (oblique/rectus) fusional mechanism and had a mean BHTTD ± SD of 9.3 ± 8.6 PD. Of these patients, the one whom we measured after patching showed an increase of 11 PD in BHTTD. The remaining patient used oblique muscle-mediated fusion and had a BHTTD of only 3 PD that increased to 21 PD after patching. One explanation for this BHTT behavior in the latter patient involves lingering vergence adaptation of the "paretic" superior oblique muscle (SOM) and contralateral inferior oblique muscle, which makes these muscles more effective when activated, as is the case on ipsilateral head tilt (part of the ocular counter-roll mechanism), lessening the expected increase in hyperdeviation. Similarly, in our patients with mixed fusion, the vergence-adapted "paretic" SOM and contralateral superior rectus muscle are activated on ipsilateral and contralateral tilt, respectively, lessening the hyperdeviation in both directions. In the other seven patients, however, the vergence-adapted ipsilateral inferior rectus muscle and contralateral superior rectus muscle are activated on contralateral tilt, accentuating the BHTTD. CONCLUSION: Depending upon the specific muscles used for vertical fusion, the BHTTD is decreased or increased. The presence of a large BHTTD points to lingering or persisting fusional tonus involving the vertical rectus muscles. The lack of a positive BHTT does not rule out the diagnosis of SOP, but rather may be caused by lingering or persevering fusional tonus involving the oblique muscles. Performing the BHTT after a patch test for a minimum of 30 minutes may be necessary to reveal the BHTTD, supporting the diagnosis of SOP.

Oculomotor target selection is mediated by complex objects.

Oculomotor target selection often requires discriminating visual features, but it remains unclear how oculomotor substrates encoding saccade vectors functionally contribute to this process. One possibility is that oculomotor vector representations (observed directly as physiological activation or inferred from behavioral interference) of potential targets are continuously reweighted by task relevance computed elsewhere in specialized visual modules, whereas an alternative possibility is that oculomotor modules use local featural analyses to actively discriminate potential targets. Strengthening the former account, oculomotor vector representations have longer onset latencies for ventral- (i.e., color) than dorsal-stream features (i.e., luminance), suggesting that oculomotor vector representations originate from featurally relevant specialized visual modules. Here, we extended this reasoning by behaviorally examining whether the onset latency of saccadic interference elicited by visually complex stimuli is greater than is commonly observed for simple stimuli. We measured human saccade metrics (saccade curvature, endpoint deviations, saccade frequency, and error proportion) as a function of time after abrupt distractor onset. Distractors were novel, visually complex, and had to be discriminated from targets to guide saccades. The earliest saccadic interference latency was ∼110 ms, considerably longer than previous experiments, suggesting that sensory representations projected into the oculomotor system are gated to allow for sufficient featural processing to satisfy task demands. Surprisingly, initial oculomotor vector representations encoded features, as we manipulated the visual similarity between targets and distractors and observed increased vector modulation response magnitude and duration when the distractor was highly similar to the target. Oculomotor vector modulation was gradually extinguished over the time course of the experiment.NEW & NOTEWORTHY We challenge the role of the oculomotor system in discriminating features during saccadic target selection. Our data suggest that the onset latency of oculomotor vector representations is scaled by task difficulty and featural complexity, suggesting that featural computations are performed outside of the oculomotor system, which receives the output of these computations only after sufficient visual and cognitive processing. We also challenge the convention that initial oculomotor vector representations are feature invariant, as they encoded task relevance.

Oculomotor inhibition during smooth pursuit and its dependence on contrast sensitivity.

Our eyes are never still, but tend to "freeze" in response to stimulus onset. This effect is termed "oculomotor inhibition" (OMI); its magnitude and time course depend on the stimulus parameters, attention, and expectation. We previously showed that the time course and duration of microsaccade and spontaneous eye-blink inhibition provide an involuntary measure of low-level visual properties such as contrast sensitivity during fixation. We investigated whether this stimulus-dependent inhibition also occurs during smooth pursuit, for both the catch-up saccades and the pursuit itself. Observers followed a target with continuous back-and-forth horizontal motion while a Gabor patch was briefly flashed centrally with varied spatial frequency and contrast. Catch-up saccades of the size of microsaccades had a similar pattern of inhibition as microsaccades during fixation, with stronger inhibition onset and faster inhibition release for more salient stimuli. Moreover, a similar stimulus dependency of inhibition was shown for pursuit latencies and peak velocity. Additionally, microsaccade latencies at inhibition release, peak pursuit velocities, and latencies at minimum pursuit velocity were correlated with contrast sensitivity. We demonstrated the generality of OMI to smooth pursuit for both microsaccades and the pursuit itself and its close relation to the low-level processes that define saliency, such as contrast sensitivity.

Binocular Eye Movements Are Adapted to the Natural Environment.

Humans and many animals make frequent saccades requiring coordinated movements of the eyes. When landing on the new fixation point, the eyes must converge accurately or double images will be perceived. We asked whether the visual system uses statistical regularities in the natural environment to aid eye alignment at the end of saccades. We measured the distribution of naturally occurring disparities in different parts of the visual field. The central tendency of the distributions was crossed (nearer than fixation) in the lower field and uncrossed (farther) in the upper field in male and female participants. It was uncrossed in the left and right fields. We also measured horizontal vergence after completion of vertical, horizontal, and oblique saccades. When the eyes first landed near the eccentric target, vergence was quite consistent with the natural-disparity distribution. For example, when making an upward saccade, the eyes diverged to be aligned with the most probable uncrossed disparity in that part of the visual field. Likewise, when making a downward saccade, the eyes converged to enable alignment with crossed disparity in that part of the field. Our results show that rapid binocular eye movements are adapted to the statistics of the 3D environment, minimizing the need for large corrective vergence movements at the end of saccades. The results are relevant to the debate about whether eye movements are derived from separate saccadic and vergence neural commands that control both eyes or from separate monocular commands that control the eyes independently.SIGNIFICANCE STATEMENT We show that the human visual system incorporates statistical regularities in the visual environment to enable efficient binocular eye movements. We define the oculomotor horopter: the surface of 3D positions to which the eyes initially move when stimulated by eccentric targets. The observed movements maximize the probability of accurate fixation as the eyes move from one position to another. This is the first study to show quantitatively that binocular eye movements conform to 3D scene statistics, thereby enabling efficient processing. The results provide greater insight into the neural mechanisms underlying the planning and execution of saccadic eye movements.

Oculometric signature of switch into awareness? Pupil size predicts sudden insight whereas microsaccades predict problem-solving via analysis.

According to the Gestalt theorists, restructuring is an essential component of insight problem-solving, contributes to the "Aha!" experience, and is similar to the perceptual switch experienced when reinterpreting ambiguous figures. Previous research has demonstrated that pupil diameter increases during the perceptual switch of ambiguous figures, and indexes norepeinephrine functioning mediated by the locus coeruleus. In this study, we investigated if pupil diameter similarly predicts the switch into awareness people experience when solving a problem via insight. Additionally, we explored eye movement dynamics during the same task to investigate if the problem-solving strategies used are linked to specific oculomotor behaviors. In 38 participants, pupil diameter increased about 500 msec prior to solution only in trials for which subjects report having an insight. In contrast, participants increased their microsaccade rate only prior to non-insight solutions. Pupil dilation and microsaccades were not reliably related, but both appear to be robust markers of how people solve problems (with or without insight). The pupil size change seen when people have an "Aha!" moment represents an indicator of the switch into awareness of unconscious processes humans depend upon for insight, and suggests important involvement of norepinephrine, via the locus coeruleus, in sudden insight.

Eye and head movements and vestibulo-ocular reflex in the context of indirect, referent control of motor actions.

Conventional explanations of the vestibulo-ocular reflex (VOR) and eye and head movements are revisited by considering two alternative frameworks addressing the question of how the brain controls motor actions. Traditionally, biomechanical and/or computational frameworks reflect the views of several prominent scholars of the past, including Helmholtz and von Holst, who assumed that the brain directly specifies the desired motor outcome and uses efference copy to influence perception. However, empirical studies resulting in the theory of referent control of action and perception (an extension of the equilibrium-point hypothesis) revealed that direct specification of motor outcome is inconsistent with nonlinear properties of motoneurons and with the physical principle that the brain can control motor actions only indirectly, by changing or maintaining the values of neurophysiological parameters that influence, but can remain independent of, biomechanical variables. Some parameters are used to shift the origin (referent) points of spatial frames of reference (FRs) or system of coordinates in which motor actions emerge without being predetermined. Parameters are adjusted until the emergent motor actions meet the task demands. Several physiological parameters and spatial FRs have been identified, supporting the notion of indirect, referent control of movements. Instead of integration of velocity-dependent signals, position-dimensional referent signals underlying head motion can likely be transmitted to motoneurons of extraocular muscles. This would produce compensatory eye movement preventing shifts in gaze during head rotation, even after bilateral destruction of the labyrinths. The referent control framework symbolizes a shift in the paradigm for the understanding of VOR and eye and head movement production.

T2 mapping of the extraocular muscles in healthy volunteers: preliminary research on scan-rescan and observer-observer reproducibility.

BACKGROUND: T2-mapping technique and derived T2 relaxation time allows quantitative assessment of extraocular muscles; however, the reproducibility of T2 mapping-derived parameters was seldom studied till now. PURPOSE: To evaluate the scan-rescan and observer-observer reproducibility of T2 relaxation time measurements of extraocular muscles in young healthy volunteers. MATERIAL AND METHODS: Fourteen volunteers underwent T2-mapping examinations of the extraocular muscles three times within one month on a 3.0-T MR system. Scan-rescan and observer-observer reproducibility of T2 relaxation time measurements of the extraocular muscles were assessed using intraclass correlation coefficient and coefficient of variation. RESULTS: Both scan-rescan (short-term and long-term) and observer-observer could achieve good to excellent reproducibility, while better short-term than long-term scan-rescan reproducibility was obtained. The coefficient of variation of the T2 relaxation time of each extraocular muscles during both scan-rescan and observer-observer reproducibility assessment were <6%. CONCLUSION: T2 relaxation time measurement of the extraocular muscles is proven to be highly reproducible at 3.0 T. T2 mapping may be a potential imaging technique in the diagnosis and follow-up of orbital diseases involved extraocular muscles in further studies.

Utility of a novel perceptual-motor control test for identification of sport-related concussion beyond current clinical assessments.

Clinically feasible metrics, that can inform the concussion recovery decision making process by evaluating a unique domain beyond current testing domains (e.g., balance, neurocognition, symptoms, vestibular/ocular function) are still in need. The purpose of this study was to compare perceptual-motor control in adolescent athletes ≤21 days of sport-related concussion and healthy controls and evaluate the association of perceptual-motor control to the outcomes of commonly-used sport-related concussion clinical assessments. Athletes (age: 12-18 years) with sport-related concussion (n = 48) and healthy controls (n = 24) completed the Perception-Action Coupling Task (PACT), whose outcomes are mean reaction, movement, initiation, response time, and accuracy. ImPACT outcomes are verbal/visual memory scores, motor processing speed, and reaction time. Vestibular-Ocular Motor Screen (VOMS) outcomes are symptoms from: smooth pursuit, horizontal/vertical saccades, near-point of convergence, horizontal/vestibular ocular-reflex, and visual motion sensitivity. CONCUSSED demonstrated ~5% deficit in overall perceptual-motor accuracy during PACT compared to CONTROLS (p = 0.03). PACT accuracy negatively correlated with smooth pursuits(r = -0.29), and horizontal (r = -0.35)/vertical (r = -0.30) saccades. The C5.0 decision tree determined PACT accuracy was the most relevant predictor of sport-related concussion when no visual motion sensitivity symptoms were reported and Visual Memory was >66. Perceptual-motor control tests may complement current sport-related concussion assessments when neurocognition and vestibular/ocular motor system are not grossly impaired.

Investigating short latency subcortical vestibular projections in humans: what have we learned?

Vestibular evoked myogenic potentials (VEMPs) are now widely used for the noninvasive assessment of vestibular function and diagnosis in humans. This review focuses on the origin, properties, and mechanisms of cervical VEMPs and ocular VEMPs; how these reflexes relate to reports of vestibular projections to brain stem and cervical targets; and the physiological role of (otolithic) cervical and ocular reflexes. The evidence suggests that both VEMPs are likely to represent the effects of excitation of irregularly firing otolith afferents. While the air-conducted cervical VEMP appears to mainly arise from excitation of saccular receptors, the ocular VEMP evoked by bone-conducted stimulation, including impulsive bone-conducted stimuli, mainly arises from utricular afferents. The surface responses are generated by brief changes in motor unit firing. The effects that have been demonstrated are likely to represent otolith-dependent vestibulocollic and vestibulo-ocular reflexes, both linear and torsional. These observations add to previous reports of short latency otolith projections to the target muscles in the neck (sternocleidomastoid and splenius) and extraocular muscles (the inferior oblique). New insights have been provided by the investigation and application of these techniques.

Motor functions of the superior colliculus.

The mammalian superior colliculus (SC) and its nonmammalian homolog, the optic tectum, constitute a major node in processing sensory information, incorporating cognitive factors, and issuing motor commands. The resulting action-to orient toward or away from a stimulus-can be accomplished as an integrated movement across oculomotor, cephalomotor, and skeletomotor effectors. The SC also participates in preserving fixation during intersaccadic intervals. This review highlights the repertoire of movements attributed to SC function and analyzes the significance of results obtained from causality-based experiments (microstimulation and inactivation). The mechanisms potentially used to decode the population activity in the SC into an appropriate movement command are also discussed.

In vivo experimental study on the resistance and stiffness of orbital suspension tissues with/without the extraocular muscles.

BACKGROUND: The accuracy of the surgical amount of extraocular muscle (EOM) is key to the success of strabismus surgery. To establish an accurate eye movement model, it is of great theoretical value and clinical significance to determine the surgical amount of EOM. At present, only resistance and stiffness data of orbital suspension tissues with EOMs exist, while those of orbital suspension tissues without EOMs, which is critical information for eye movement modeling, have not been reported. The aim of this research is to study the resistance and stiffness of orbital suspension tissues with/without EOMs. METHODS: Fifteen healthy New Zealand white rabbits with body weights of 2.41 ± 0.13 kg were used in the study. Two recti (two horizontal recti of the left eye or two vertical recti of the right eye) or all EOMs were detached from each eye under general anesthesia. Then, a 5-0 silk suture was attached to the stump of the detached rectus insertion (two horizontal recti insertions of the left eye and two vertical recti insertions of the right eye) on the isolated eyeball. The 5-0 silk suture was connected to the INSTRON 5544 tester to facilitate the horizontal rotations of the left eyes and the vertical rotations of the right eyes, respectively. RESULTS: The resistance and stiffness of orbital suspension tissues with superior rectus, inferior rectus, superior oblique, and inferior oblique EOMs were obtained during horizontal eye movement. Similarly, the resistance and stiffness of orbital suspension tissues with lateral rectus, medial rectus, superior oblique, and inferior oblique EOMs were obtained during vertical eye movement. Then, the resistance and stiffness of orbital suspension tissues without EOMs were obtained during horizontal and vertical eye movements. The resistance and stiffness data of orbital suspension tissues with EOMs were compared with those of orbital suspension tissues without EOMs. The comparison results showed no significant difference in the resistance values between these two cases. In addition, the stiffness values of these two cases statistically differed. CONCLUSIONS: The two horizontal recti play a major role in passive horizontal eye movement. In addition, when the eye is passively moved vertically, the two vertical recti play major roles. The stiffness of orbital suspension tissues with EOMs, which has been used in eye movement modeling, is not accurate. The results of this work may serve as a reference for improving the accuracy in eye movement modeling, and then it will be beneficial for determining the surgical amount of EOMs in clinical surgery.

Adhesion after Y-split procedure can affect its mechanism for treating overshoots in Duane's syndrome.

PURPOSE: To investigate the extent of adhesion and changes in the Y configuration after the Y-split procedure, compared with the posterior fixation suture. METHODS: Twelve New Zealand white rabbits were included in the study. The 10-mm Y-split procedure was performed in the superior rectus muscle (SR) of one eye, and the 10-mm posterior fixation suture was made in the SR of the other eye. Six weeks after surgery, the Y arm lengths and lengths of adherence to the sclera were measured. If the adhesion involved the whole Y arm, the distance between the original SR insertion and most proximal part of the adhered SR was measured. In the eyes with posterior fixation suture, the distance between the SR insertion and most proximal part of the adhered SR was evaluated. RESULTS: The average nasal and temporal Y arm lengths were 6.37 ± 0.65 and 6.54 ± 0.63 mm, respectively, a significant decrease from those measured immediately after surgery (P = 0.002 and 0.002, respectively). Adhesions involved the entire Y arms in 11 of 12 SRs (91.7%), with an average adhesion length of 7.01 ± 1.04 mm. In SRs with posterior fixation sutures, the average adhesion was 9.18 ± 0.62 mm from the insertion, which was only 2.17 mm posterior to proximal portion of adhesion in Y-split SR (P < 0.001). CONCLUSIONS: Healing process reduces the Y arm length. Adhesion may involve the entire Y arm and could weaken or alter the therapeutic mechanism after the Y-split procedure.

A novel method for quantifying the biomechanical parameters of orbital soft tissue using a corneal dynamic scheimpflug analyser: a retrospective study.

BACKGROUND: To demonstrate that the Corvis ST could be used to quantify the biomechanical parameters of the orbital soft tissues by measuring and comparing whole eye movement (WEM) using the Corvis in normal eyes and in eyes of patients with Graves ophthalmopathy. METHODS: Forty four eyes of 44 ophthalmologically normal subjects and 28 eyes of 28 patients with Graves ophthalmopathy were included in the study. After Corvis test, the examiners recorded WEM by air puff. In the patients with Graves ophthalmopathy, the partial correlation coefficient adjusted for age and gender was calculated to analyze the correlation between exopthalmometry and WEM. Same analysis was repeated for the correlation between and the cross sectional area (%) of the extraocular muscles in the orbit CT and WEM. RESULTS: WEM was 0.314 ± 0.083 mm in the normal subjects and 0.227 ± 0.079 mm in the Graves ophthalmopathy group (p = 0.000). The exophthalmometry was not significantly correlated with WEM after adjusting for age and gender (R = 0.083, p = 0.688). In the 21 Graves ophthalmopathy patients examined by orbit CT, after adjusting for age and gender, WEM significantly decreased as the cross sectional area (%) of the extraocular muscles in the orbit increased (R = - 0.461, p = 0.047). CONCLUSIONS: WEM by Corvis could be used to quantify the biomechanical parameters of the orbital soft tissue. However, it is unclear whether WEM effectively represents the orbital biomechanical parameters, because WEM is only 0.6% of the orbital depth.

Free-choice saccades and their underlying determinants: Explorations of high-level voluntary oculomotor control.

Models of eye-movement control distinguish between different control levels, ranging from automatic (bottom-up, stimulus-driven selection) and automatized (based on well-learned routines) to voluntary (top-down, goal-driven selection, e.g., based on instructions). However, one type of voluntary control has yet only been examined in the manual and not in the oculomotor domain, namely free-choice selection among arbitrary targets, that is, targets that are of equal interest from both a bottom-up and top-down processing perspective. Here, we ask which features of targets (identity- or location-related) are used to determine such oculomotor free-choice behavior. In two experiments, participants executed a saccade to one of four peripheral targets in three different choice conditions: unconstrained free choice, constrained free choice based on target identity (color), and constrained free choice based on target location. The analysis of choice frequencies revealed that unconstrained free-choice selection closely resembled constrained choice based on target location. The results suggest that free-choice oculomotor control is mainly guided by spatial (location-based) target characteristics. We explain these results by assuming that participants tend to avoid less parsimonious recoding of target-identity representations into spatial codes, the latter being a necessary prerequisite to configure oculomotor commands.