Benefit of Bi-Ocular Visual Stimulation for Postural Control in Children with Strabismus.docVIP

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Benefit of Bi-Ocular Visual Stimulation for Postural Control in Children with Strabismus.doc

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Benefit of Bi-Ocular Visual Stimulation for Postural Control in Children with Strabismus

BenefitofBi-OcularVisualStimulationforPostural ControlinChildrenwithStrabismus ChrystalGaertner1*,CharlotteCreux2,Marie-Andre′eEspinasse-Berrod2,ChristopheOrssaud2 ,Jean- LouisDufier2,Zo?¨Kapoula1* 1IRISGroup,Centred’EtudesSensoriMotricesUMR8194,CNRS,Universite′ ParisDescartes,Paris,France,2Serviced’Ophtalmologie,Ho?pitalpourenfantsNecker,Paris, France Abstract Vision is important for postural control as is shown by the Romberg quotient (RQ): with eyes closed, postural instability increasesrelativetoeyesopen(RQ=2).Yetwhilefixatingatfardistance,posturalstabilityissimilarwitheyesopenandeyes closed (RQ=1). Postural stability can be better with both eyes viewing than one eye, but such effect is not consistent amonghealthysubjects.ThefirstgoalofthestudyistotesttheRQasafunctionofdistanceforchildrenwithconvergent versus divergent strabismus. The second goal is to test whether vision from two eyes relative to vision from one eye provides better postural stability. Thirteen children with divergent strabismus and eleven with convergent strabismus participatedinthisstudy.PosturtographywasdonewiththeTechnoconceptdevice.Experiment1,fourconditions:fixation at40cmandat200cmbothwitheyesopenandeyescovered(evaluationofRQ).Experiment2,sixconditions:fixationat 40cm and at 200cm, with both eyes viewing or under monocular vision (dominant and non-dominant eye). For convergentstrabismus,thegroupsmeanvalueofRQwas1.3atnearand0.94atfardistance;fordivergent,itwas1.06at near and 1.68 at far. For all children, the surface of body sway was significantly smaller under both eyes viewing than monocularviewing(eithereye).IncreasedRQvalueatnearforconvergentandatfarfordivergentstrabismusisattributed totheinfluenceofthedefaultstrabismusangleandtobetteruseofocularmotorsignals.Visionwiththetwoeyesimproves posturalcontrolforbothviewingdistancesandforbothtypesofstrabismus.Suchbenefitcanbeduetocomplementary mechanisms:largervisualfield,betterqualityoffixationandvergenceangleduetotheuseofvisualinputsf