Binocular Eye Movements in Health and Disease

Binocular eye movements form a finely-tuned system that requires accurate coordination of the oculomotor dynamics and supports the vergence movements for tracking the fine binocular disparities required for 3D vision, and are particularly susceptible to disruption by brain injury and other neural dysfunctions. Saccadic dynamics for a population of 84 diverse participants show tight coefficients of variation of 2-10% of the mean value of each parameter. Significantly slower dynamics were seen for vertical upward saccades. Binocular coordination of saccades was accurate to within 1-4%, implying the operation of brainstem coordination mechanisms rather than independent cortical control of the two eyes. A new principle of oculomotor control - reciprocal binocular inhibition - is introduced to complement Sherrington's and Hering's Laws. This new law accounts for the fact that symmetrical vergence responses are about five times slower than saccades of the same amplitude, although a comprehensive analysis of asymmetrical vergence responses revealed unexpected variety in vergence dynamics. This analysis of the variety of human vergence responses thus contributes substantially to the understanding of the oculomotor control mechanisms underlying the generation of vergence movements and of the deficits in the oculomotor control resulting from mild traumatic brain injury.