Fixation Patterns in Maculopathy: From Binocular to Monocular Viewing

Purpose. The goal of this study was to explore binocular coordination during fixation in patients with age-related macular degeneration (AMD) and to investigate whether there is a shift in eye position when the viewing condition changes from binocular to monocular. Methods. Sixteen people with normal vision and 12 patients with AMD were asked to look at a 3 deg fixation target with both eyes and with each eye individually while the fellow eye was covered by an infrared filter. Fixational eye movements were recorded for both eyes with an EyeLink eye-tracker in all conditions. The shift in eye position at the end of every fixation period was calculated for each eye. Results. All people with normal vision as well as the majority of patients had good binocular coordination during fixation in the binocular viewing condition. When the viewing condition changed from binocular to monocular, three patients (25%) had atypical shifts in their eye position. The shift was related to (1) loss of fixational control when the better eye was covered and the worse eye viewed the target or (2) a slow drift of the viewing eye that was associated with a large phoria in the covered eye. Conclusions. Patients with AMD have good binocular ocular motor coordination during fixation. A change in viewing condition from binocular to monocular can lead to disturbances in ocular motor control for some patients, especially in the worse eye. (Optom Vis Sci 2012;89:277-287)