Schizophrenia and eye movement - a new diagnostic and therapeutic concept

In the present article, conclusions are drawn from four papers on the genesis of schizophrenia, published in Medical Hypotheses between 1999 and 2002, knowledge of which is required to understand this paper in greater depth. For these, the author had developed two sight tests in which schizophrenic patients revealed a stronger fusional reactivity of the nasal than of the temporal foveal halves and a disconnection between peripheral and foveal vision. Both phenomena could be explained by a reversed crossing of foveal projections in the chiasma opticum constituting a genetic vulnerability which, in case of additional defects of binocular balance, could result in a foveal convergence stimulus being executed as a divergence movement by one of the eyes. The author has now succeeded in finding a very simple standardized method to discover the described vergence, abnormality, the Hook test, part of the ZEISS Near Pola Test, which would therefore be suitable for detecting schizophrenic vulnerability in screening tests so that the outbreak of schizophrenia could be prevented by an early correction of the additional visual defects. The movement impulses resulting from the erraneous vergence are analyzed and explain the phenomenon of the schizophrenic's "mad look". The connection between the somatic component and the patient's psycho-social problems is shown and a detailed description given of non-neuroleptic methods of rectifying both. (C) 2003 Elsevier Ltd. All rights reserved.