Vertical latent nystagmus component and vertical saccadic asymmetries in subjects with dissociated vertical deviation

Abstract Purpose: This study was conducted to quantify the vertical component of a latent nystagmus observed in subjects with dissociated vertical deviation (DVD), as well as to provide further evidence for vertical saccadic asymmetries in these individuals. Methods: Binocular eye movements of subjects with DVD were recorded in two dimensions using a noninvasive video-based eye tracker while cover/uncover tests, alternate cover tests, and vertical saccades were performed. Results: A small amplitude (1.5 degrees or less) vertical component of latent nystagmus can be observed in some subjects with DVD and is larger in the deviating eye than in the viewing eye. The frequency of the vertical nystagmus component is the same in each eye for any given fixation condition but may change depending on which eye is fixating. DVD in the presence of a vertical component of latent nystagmus can be adequately modeled by the algebraic sum of an exponentially decreasing velocity DVD and a nystagmus with an exponentially decreasing slow phase velocity. In general, the occluded eyes of DVD subjects make smaller downward saccades than the viewing eyes. Conclusions: It is possible but not obligatory that DVD subjects will have a vertical component of latent nystagmus. Algebraic summation of an exponentially decreasing velocity DVD and a vertical component of latent nystagmus provides a more parsimonious explanation of the observed saccadic eye movements than modeling the DVD itself as a combination of vergence and saccadic movements. Subjects with DVD show a range of saccadic yoking from nearly complete saccadic conjugacy to nearly complete dissociation.