A homonymous hemianopia can be compensated by a strabismus in the direction of the visual field defect if the deviated eye has a harmonious anomalous localization. This compensation is only partial; its extent corresponds to the angle of deviation. We report on two patients with a hemianopia to the left. Under binocular conditions the visual field defect was reduced by an exotropia of the left eye with panoramic vision. Unfortunately, up to now it has not been possible to induce such a sensory-motor compensation in cases of homonymous hemianopia with normal retinal correspondence in an adult visual system.

Infantile exotropia with homonymous hemianopia: a rare contraindication for strabismus surgery.

In anomalous retinal correspondence (ARC), retinal points in the right and left eyes which receive stimuli from one object in space have the same visual direction despite a manifest motor deviation. The mode of cooperation of these anomalously corresponding retinal points depends on their relative eccentricity or their relative functional level. If there is a great difference, as for the most part in large angle strabismus, the retinal point with less eccentricity and better resolution will prevail, while the other will be suppressed. This leads to a second area of high resolution in the binocular visual field with a possibly irritating effect. In microtropia, anomalous corresponding retinal points have functionally different levels only in the very centre of the visual field. ARC provides in this case a binocular cooperation very similar to normal fusion. To an individually different degree, ARC can adapt to new squint angles, which makes squint surgery possible without postoperative diplopia, but a change to normal binocularity with stable interocular connections can not be achieved. ARC enables the heterotropic patient to see with both eyes simultaneously without diplopia by a regionally changing use of inhibition and anomalous fusion in the interest of the best possible perception.

/pdf/how-useful-is-anomalous-correspondence-1d81cjc3bd.pdf

How useful is anomalous correspondence

https://journals.viamedica.pl/ophthalmology_journal/article/download/OJ.2016.0003/31236

Glaucoma: Confrontation visual field test using Bagolini striated glasses — a new screening method for detecting visual field defects

BACKGROUND To propose a quick test using striated lens according to Bagolini for detecting quadrantanopic and hemianopic visual field defects. PATIENTS AND METHODS The results of this test are presented and compared with Goldmann perimetry in five patients suffering from quadrantanopic and hemianopic visual field defects in hypophyseal adenoma (2 x quadrantanopia, 1 x bitemporal hemianopia) and occipital process (2 x homonymous hemianopia). To examine the visual field the patient has to fixate a light at 50 cm distance. Due to the striated glasses two light stripes are generated along the 45 degrees diagonal, crossing in the fixated light in normal binocular vision. The temporal lower and nasal upper quadrants of both eyes and after switch the striated glasses around the horizontal axis, the nasal lower and temporal upper quadrant of both eyes can be tested along the 45 degrees axis. While fixating the lamp the patient is asked (in normal binocularity identical with the crossing point), if one or more of the four light stripes, beginning at the crossing point is shorter or weaker than the others, or interrupted or missing totally. RESULTS Shortened or absent light stripe indicating quadrantanopic visual field defect agrees with the location of visual field defect in kinetic Goldmann Perimetry. An absent light stripe indicates a complete quadrantanopia, a shortened light stripe an incomplete quadrantanopia. Fixation is warranted easily by the crossing light stripes. CONCLUSION The dissociation with the aid of striated glasses allows a simultaneous test of both eyes in the 45 degrees-axis of all four quadrants in combination with the location of the visual field defect in this axis. The proposed confrontation test is a simple and quick test without extensive equipment. This test seems to be a useful tool in detecting homonymous or heteronymous quadrantanopic and hemianopic visual field defects for quick screening purposes, especially in immobile patients.

Konfrontationstest mit Hilfe der Streifengläser nach Bagolini - eine neue Screeningmethode zur Erkennung von Quadrantenausfällen und Hemianopsien

The processes of sensory adaptation in strabismus have engaged scientists and eye therapists repeatedly since the middle of the last century. For the former, they express an experiment on the part of nature, and so provide an insight into the manner in which the human visual system functions: for the latter, they are a challenge to his therapeutical abilities, inasmuch as the sensory anomalies of strabismus in early childhood place an often insurmountable obstacle in the way of his efforts to bring about normal binocular vision: even when a normal correspondence is achieved and suppression is eliminated, the ability to coordinate both eyes in normal sensorimotor fashion remains lacking. In strabismus with small deviation, the anomalous retinal correspondence (ARC) is particularly deeprooted, and renders a true, if quantitively subnormal, binocular vision possible. The purpose of the following is to demonstrate the extent to which binocular processing of images exists in strabismus with large angle of deviation. The exposition relies chiefly on data arrived at through psychophysical examinations (8) by the use of a modified phase-difference haploscope according to Aulhorn (1). These studies sum up and confirm the classical observations on the binocular visual activity of squinters (4, 6, 11, 12). In Fig. 1, the profiles of monocular function for the light difference sensitivity during the act of binocular vision in a case of strabismus alternans are presented schematically for one meridian of the visual field. Such curves emerge when a static light 3 0 ~ 20 ~ 10 ~ :D-

Aspects of sensory adaptation in strabismus.

Bei 20 Patienten mit fruhkindlichem Begleitschielen und einer Horizontalabweichung zwischen 10 und 30 Grad (13 konvergent, 7 divergent) wurde mit Schweiftestglasern nach Arealen mit binokularem Simultansehen auf dem Boden einer harmonisch anomalen Korrespondenz gesucht. - Ein derartiger Bereich konnte bei 18 Patienten in einer Zone zwischen den Gesichtsfeldzentren beider Augen ermittelt werden. Die Befunde lassen vermuten, dass die harmonisch anomale Korrespondenz nur dort ein anomales Binokularsehen erlaubt, wo abbildungsgleiche Netzhautstellen keine wesentliche Funktionsunterschiede aufweisen. In allen anderen Bereichen dient sie im Interesse einer optimalen Detailerkennbarkeit der Hemmung des jeweils peripherer gelegenen Netzhautortes. Twenty patients with concomitant strabismus, ARC and a horizontal deviation of between 10 and 30 degrees (13 convergent, seven divergent) were examined with striated glasses to determine areas of anomalous simultaneous binocular vision. Such an area was found in a zone between the visual field centers of the two eyes in 18 cases. On the basis of these findings the authors suspect that harmonious ARC permits anomalous binocular vision only in field areas where retinal points with identical images have no significant difference in function. In the other areas of the binocular visual field, ARC provides for optimal perception of detail by suppression of the more peripherally situated retinal points.

[Anomalous bilateral single vision in cases of severe squint deviation: investigations with Bagolini glasses (author's transl)]

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[Anomalous bilateral single vision in cases of severe squint deviation: investigations with Bagolini glasses (author's transl)]