title: Regulation of static and dynamic ocular alignment in patients with trochlear nerve pareses.
abstract: Ocular alignment and saccades were studied in seven patients with trochlear nerve pareses, before and after strabismus surgery. Prior to surgery, a position-dependent vertical ocular misalignment was present, and downward saccades were hypometric in the paretic eye. Strabismus surgery reduced the magnitude and position-dependence of the static misalignment. Saccade conjugacy improved in the patients with congenital pareses, and in the patient with a gradual-onset acquired paresis, but less improvement occurred in subjects with traumatic pareses. The post-operative change in saccade conjugacy relative to the change in static alignment correlated with pre-operative vertical vergence, suggesting that changes in saccade yoking depend on an interaction between saccades and vertical vergence.
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Lewis
authors.forename: D S
authors.initials: DS
authors.lastname: Zee
authors.forename: M X
authors.initials: MX
authors.lastname: Repka
authors.forename: D L
authors.initials: DL
authors.lastname: Guyton
authors.forename: N R
authors.initials: NR
authors.lastname: Miller
mesh_terms: D000221:Adaptation, Ocular / Q000502:physiology; D000328:Adult; D000368:Aged; D003290:Convergence, Ocular / Q000502:physiology*; D003389:Cranial Nerve Diseases / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery; D009886:Ophthalmoplegia / Q000503:physiopathology* / Q000601:surgery; D012438:Saccades / Q000502:physiology*; D013285:Strabismus / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D013997:Time Factors; D014321:Trochlear Nerve; D015348:Vision, Binocular / Q000502:physiology