A Neural Model for Cyclovertical Eye Movements and Their Disorders

Abstract

Both see-saw nystagmus and dissociated vertical divergence are cyclovertical eye movements characterized by vertical disconjugation and torsional conjugation. See-saw nystagmus is known to occur with chiasmal disorders and bitemporal hemianopia. Dissociated vertical divergence is commonly encountered in the infantile strabismus syndrome. A hypothetical model is presented in which both conditions are explained. The basic organization of the oculomotor system is most likely monocular and synchronous eye movements may have developed by neuronal coupling of the symmetrical oculomotor structures. The vertical dissociation of both eye movement disorders is explained by insufficiently developed neuronal coupling between the superior colliculi. A functional differentiation between crossed and uncrossed retinal ganglion cells fibers is assumed to cause this diminished binocular coupling in the case of see-saw nystagmus. The interstitial nucleus of Cajal may well play a pivotal role in explaining the distinct torsional eye movements in both conditions.

Keywords::

• See-saw nystagmus
• dissociated vertical divergence
• superior colliculus
• uncrossed retinal ganglion cell fibers

Declaration of interest: The author declares no conflict of interest.