OKN asymmetries and binocular function in amblyopia.

Asymmetrical optokinetic nystagmus (OKN) means that OKN has a lower gain (slow-phase eye velocity/stimulus velocity) for monocular temporalward than nasalward visual field motion. OKN tends to be asymmetric in amblyopia, leading to suggestions of a link between OKN asymmetry and binocularity in the literature. The present study measured OKN in 13 amblyopes and five normal subjects. In an attempt to identify those binocular cells used in the OKN response, the degree of OKN asymmetry was compared with binocularity assessed by two different techniques: (1) stereopsis and (2) interocular transfer of threshold elevation (IOT). Horizontal monocular OKN was recorded for three different stimulus velocities in each subject. All the amblyopes were found to be stereoblind, although three amblyopes showed OKN asymmetries close to those found for the normal group. More association was seen between interocular transfer of the threshold elevation and OKN asymmetry; not all amblyopes demonstrated reduced IOT, but those amblyopes with no IOT all had OKN asymmetries more than 125% of the mean of the normal group. However, no association was seen between the amount of OKN asymmetry and the degree of IOT. The results are discussed in terms of the role of different groups of binocular neurones for OKN and the effect of the sensitive periods of development on these binocular neurones.