Neural Mechanisms in Infantile Esotropia: What Goes Wrong?

Abstract

To determine the neural mechanisms underlying the sensory and motor deficits of infantile strabismus, behavioral and neuroanatomic experiments were performed on macaque monkeys who had natural, alternating infantile-onset esotropia. The animals were found to have structural and metabolic abnormalities of visual cortex that help explain their sensory and motor deficits. Experiments were also conducted on normal infant monkeys to show that absence of binocular experience from birth can produce the motor deficits of infantile strabismus. Studies of strabismic human infants using the motion VEP suggest that some of the cortical wiring defects of infantile strabismus can be repaired by early strabismus surgery. What we cannot predict at present is which strabismic infants will respond favorably to early therapy: some infants appear to have the esotropia of Worth, and others that of Chavasse.

• visual cortex
• macaque monkey
• ocular dominance columns
• binocular connections
• motion processing
• pursuit
• esotropia
• infantile esotropia