Vertical saccades in children: a developmental study

Driving Factors in the Development of Eye Movement Patterns in Chinese Reading: The Roles of Linguistic Ability and Oculomotor Maturation

The mechanisms driving the development of eye movement patterns is an unresolved debate in children during reading, with three competing hypotheses: the oculomotor-tuning hypothesis, the linguistic-proficiency hypothesis, and the combined hypothesis that incorporates both. This study examined eye movement patterns in 215 Chinese children from first to fifth grade using sentence-reading tasks. Oculomotor maturation was measured through saccade tasks, and linguistic abilities were assessed using Chinese character recognition and vocabulary knowledge tests. Path analysis explored how these factors predict temporal and spatial eye movement measures. Results indicated that temporal measures were primarily driven by linguistic abilities, supporting the linguistic-proficiency hypothesis. Spatial measures, however, were influenced by both linguistic abilities and oculomotor maturation, supporting the combined hypothesis. These findings diverge from predictions of the E-Z Reader model in alphabetic scripts, likely due to the unique visual complexity of Chinese characters.

Binocular coordination of children with dyslexia and typically developing children in linguistic and non-linguistic tasks: evidence from eye movements

Given the increased evidence suggesting the presence of binocular coordination deficits in dyslexia, investigations of binocular eye movements are beneficial to clarify the underlying causes of reading difficulties. This systematic review aims to (a) synthesize the literature through the examination of binocular coordination in children with dyslexia by describing the normative development of stable binocular control and (b) outline future directions. Boolean expressions in the PubMed search were used to define papers. Following a literature search and selection process, 25 papers were included. Studies using binocular eye tracking during linguistic and nonlinguistic tasks in children with dyslexia and typical development 5-17 years of age are reviewed. The studies reviewed provided consistent evidence of poor binocular coordination in children with dyslexia, but the results associated with different task characteristics were less consistent. The relation between binocular coordination deficits and reading difficulties needs to be further elucidated in longitudinal studies which may provide future treatments targeting the binocular viewing system in dyslexia.

Quantification of gaze reaction time in infants with Pediatric Perimeter

Purpose

We quantified the eye/head (gaze) reaction time in infants to establish a normative database for the Pediatric Perimeter device. Additionally, we tested the hypothesis that gaze reaction time will reduce with age.

Methods

A cross-sectional study was conducted. Healthy infants between 3 to 10 months of age were recruited. Peripheral visual field stimuli (hemifield and quadrant stimuli) were presented in the Pediatric Perimeter device. Infant’s gaze to these stimuli was observed, documented in real time, and video recorded for offline analysis.

Results

A total of 121 infants were tested in three age group bins [3–5 months, n = 44; >5–7 months, n = 30 and >7–10 months, n = 47]. Overall, 3–5 months old had longer reaction time when compared to the older infants particularly for stimuli presented in the quadrants (Kruskal-Wallis, p<0.038). A significantly asymmetric difference (p = 0.025) in reaction time was observed between the upper (median = 820ms, IQR = 659-1093ms) and lower quadrants (median = 601ms, IQR = 540-1052ms) only for the 3–5 months old infants.

Conclusion

This study provides the normative gaze reaction time of healthy infants. With increase in age, there is reduction in reaction time and disappearance of reaction time asymmetry in quadrant stimuli. The longer reaction time for upward gaze could be due to delayed maturation of neural mechanisms and/or decreased visual attention.

Preseason Vestibular Ocular Motor Screening in Children and Adolescents

OBJECTIVES

The primary purpose of this study was to examine vestibular/ocular motor screening (VOMS) test performance in a sample of healthy youth ice hockey players. A particular focus was to investigate the potential effects of age and pre-existing health conditions, including concussion history, attention-deficit/hyperactivity disorder (ADHD), learning disability (LD), headaches/migraines, and depression/anxiety on preseason baseline VOMS performance, including the near point of convergence (NPC) distance.

DESIGN

Cross-sectional cohort.

SETTING

Outpatient physiotherapy clinic.

PARTICIPANTS

Three hundred eighty-seven male youth hockey players, with an average age of 11.9 years (SD = 2.2, range = 8-17), completed the VOMS and responded to self- or parent-reported demographic and medical history questionnaires during preseason baseline assessments.

INDEPENDENT VARIABLES ASSESSED

Age, sex, and mental and physical health history including ADHD, headaches, depression, anxiety, migraine, and LD.

OUTCOME MEASURE

Vestibular/ocular motor screening.

RESULTS

The large majority of boys scored within normal limits on the VOMS, ie, they reported no symptom provocation of more than 2 points on any VOMS subset (89%) and had a normal NPC distance, ie, <5 cm (78%). The individual VOMS subtests had low abnormality rates, and demographic and pre-existing health conditions, such as age, headache or migraine history, previous neurodevelopmental conditions, or mental health problems, were not associated with clinically meaningful symptom provocation during the VOMS.

CONCLUSIONS

There was a low rate of abnormal findings for the individual VOMS subtests, with the exception of NPC distance, among male youth hockey players during preseason assessment.

Development and validation of a high-speed video system for measuring saccadic eye movement

Laboratory-based retroreflective and magnetic scleral search-coil technologies are the current standards for collecting saccadometric data, but such equipment is costly and cumbersome. We have validated a novel, portable, high-speed video camera-based system (Exilim EX-FH20, Casio, Tokyo, Japan) for measuring saccade reaction time (RT) and error rate in a well-lit environment. This system would enable measurements of pro- and antisaccades in athletes, which is important because antisaccade metrics provide a valid tool for concussion diagnosis and determining an athlete's safe return to play. A total of 529 trials collected from 15 participants were used to compare saccade RT and error rate measurements of the high-speed camera system to a retroreflective video-based eye tracker (Eye-Trac 6: Applied Sciences Laboratories, Bedford, MA). Bland-Altman analysis revealed that the RT measurements made by the high-speed video system were 11 ms slower than those made by the retroreflective system. Error rate measurements were identical between the two systems. An excellent degree of reliability was found between the system measurements and in the ratings of independent researchers examining the video data. A strong association (r = .97) between the RTs determined via the retroreflective and high-speed camera systems was observed across all trials. Our high-speed camera system is portable and easily set up, does not require extensive equipment calibration, and can be used in a well-lit environment. Accordingly, the camera-based capture of saccadometric data may provide a valuable tool for neurological assessment following a concussive event and for the continued monitoring of recovery.

Oculomotor behavior in children with autism spectrum disorders

To identify quantitative indicators of social communication dysfunctions, we explored the oculomotor performances in subjects with autism spectrum disorders. Discordant findings in the literature have been reported for oculomotor behavior in subjects with autism spectrum disorders. This study aimed to explore reflexive and voluntary saccadic performance in a group of 32 children with autism spectrum disorders (mean age: 12.1 ± 0.5 years) compared to 32 age-, sex-, and IQ-matched typically developing children (control group). We used different types of reflexive and voluntary saccades: gap, step, overlap, and anti-saccades. Eye movements were recorded using an eye tracker (Mobile EBT^®) and we measured latency, percentage of anticipatory and express saccades, errors of anti-saccades and gain. Children with autism spectrum disorders reported similar latency values with respect to typically developing children for reflexive and voluntary saccades; in contrast, they made more express and anticipatory saccades overall, as shown in paradigm testing (gap, step, overlap, and anti-saccades). Our findings support previous evidence of the atypicality of the cortical network, which is involved in saccade triggering and attentional processes in children with autism spectrum disorders.

Quantitative Characterization of Smooth Pursuit Eye Movements in School-Age Children Using a Child-Friendly Setup

PURPOSE

It could be argued that current studies investigating smooth pursuit development in children do not provide an optimal measure of smooth pursuit characteristics, given that a significant number have failed to adjust their setup and procedures to the child population. This study aimed to characterize smooth pursuit in children using child-friendly stimuli and procedures.

METHODS

Eye movements were recorded in 169 children (4-11 years) and 10 adults, while a customized, animated stimulus was presented moving horizontally and vertically at 6°/s and 12°/s. Eye movement recordings from 43 children with delayed reading, two with nystagmus, two with strabismus, and two with unsuccessful calibration were excluded from the analysis. Velocity gain, proportion of smooth pursuit, and the number and amplitude of saccades during smooth pursuit were calculated for the remaining participants. Median and quartiles were calculated for each age group and pursuit condition. ANOVA was used to investigate the effect of age on smooth pursuit parameters.

RESULTS

Differences across ages were found in velocity gain (6°/s P < 0.01; 12°/s P < 0.05), as well as the number (12°/s P < 0.05) and amplitude of saccades (12°/s P < 0.05), for horizontal smooth pursuit. Post hoc tests showed that these parameters were different between children aged 7 or younger and adults. No significant differences were found across ages in any smooth pursuit parameter for the vertical direction (P > 0.05).

CONCLUSIONS

Using child-friendly methods, children over the age of 7 to 8 years demonstrated adultlike smooth pursuit.

TRANSLATIONAL RELEVANCE

Child-friendly procedures are critical for appropriately characterizing smooth pursuit eye movements in children.

Age dependent normative data of vertical and horizontal reflexive saccades

Purpose

There is some controversy whether or not saccades change with age. This cross-sectional study aims to clarify the characteristics of reflexive saccades at various ages to establish a normative cohort in a standardized set-up. Second objective is to investigate the feasibility of saccadometry in daily ophthalmological practice.

Methods

One hundred healthy participants aged between 6 and 76 years underwent an ophthalmologic examination and saccadometry, using an infrared video-oculography device, sampling at 220 Hz. The reflexive saccades were evoked in four directions and three target displacements each (5°/15°/30° horizontally and of 5°/10°/20° vertically). Saccadic peak velocity, gain (amplitude/target displacement) and latency were measured.

Results

Mean peak velocity of saccades was 213°/s (± 29°/s), 352°/s (± 50°/s) and 455°/s (± 67°/s) to a target position 5°, 15°and 30° horizontally, respectively, and 208°/s (± 36°/s), 303°/s (± 50°/s) and 391°/s (± 71°/s) to a target position 5°, 10° and 20° vertically. The association between peak velocity and eccentricity proved to be present at any age in all four directions. We found no relevant effect of age on peak velocity, gain and latency in a fitted linear mixed model. However, latency becomes shorter during childhood and adolescence, while in adulthood it is relatively stable with a slight trend to increase in the elderly. Saccades are more precise when the target displacement is small. Isometric saccades are most common, followed by hypometric ones. All children and elderly were able to perform good quality saccadometry in a recording time of approximately 10 minutes.

Conclusion

The presented data may serve as normative control for further studies using such a video-oculography device for saccadometry. The means of peak velocity and the gain can be used independently from age respecting the target displacement. Latency is susceptible to age.

Differences between Dyslexic and Non-Dyslexic Children in the Performance of Phonological Visual-Auditory Recognition Tasks: An Eye-Tracking Study

The object of this study was to explore further phonological visual-auditory recognition tasks in a group of fifty-six healthy children (mean age: 9.9 ± 0.3) and to compare these data to those recorded in twenty-six age-matched dyslexic children (mean age: 9.8 ± 0.2). Eye movements from both eyes were recorded using an infrared video-oculography system (MobileEBT® e(y)e BRAIN). The recognition task was performed under four conditions in which the target object was displayed either with phonologically unrelated objects (baseline condition), or with cohort or rhyme objects (cohort and rhyme conditions, respectively), or both together (rhyme + cohort condition). The percentage of the total time spent on the targets and the latency of the first saccade on the target were measured. Results in healthy children showed that the percentage of the total time spent in the baseline condition was significantly longer than in the other conditions, and that the latency of the first saccade in the cohort condition was significantly longer than in the other conditions; interestingly, the latency decreased significantly with the increasing age of the children. The developmental trend of phonological awareness was also observed in healthy children only. In contrast, we observed that for dyslexic children the total time spent on the target was similar in all four conditions tested, and also that they had similar latency values in both cohort and rhyme conditions. These findings suggest a different sensitivity to the phonological competitors between dyslexic and non-dyslexic children. Also, the eye-tracking technique provides online information about phonological awareness capabilities in children.

Impaired Oculomotor Behavior of Children with Developmental Dyslexia in Antisaccades and Predictive Saccades Tasks

Analysis of eye movement patterns during tracking tasks represents a potential way to identify differences in the cognitive processing and motor mechanisms underlying reading in dyslexic children before the occurrence of school failure. The current study aimed to evaluate the pattern of eye movements in antisaccades, predictive saccades and visually guided saccades in typical readers and readers with developmental dyslexia. The study included 30 children (age M = 11; SD = 1.67), 15 diagnosed with developmental dyslexia (DG) and 15 regular readers (CG), matched by age, gender and school grade. Cognitive assessment was performed prior to the eye-tracking task during which both eyes were registered using the Tobii® 1750 eye-tracking device. The results demonstrated a lower correct antisaccades rate in dyslexic children compared to the controls (p < 0.001, DG = 25%, CC = 37%). Dyslexic children also made fewer saccades in predictive latency (p < 0.001, DG = 34%, CG = 46%, predictive latency within −300–120 ms with target as 0 point). No between-group difference was found for visually guided saccades. In this task, both groups showed shorter latency for right-side targets. The results indicated altered oculomotor behavior in dyslexic children, which has been reported in previous studies. We extend these findings by demonstrating impaired implicit learning of target's time/position patterns in dyslexic children.

Origins of strabismus and loss of binocular vision

Strabismus is a frequent ocular disorder that develops early in life in humans. As a general rule, it is characterized by a misalignment of the visual axes which most often appears during the critical period of visual development. However other characteristics of strabismus may vary greatly among subjects, for example, being convergent or divergent, horizontal or vertical, with variable angles of deviation. Binocular vision may also vary greatly. Our main goal here is to develop the idea that such “polymorphy” reflects a wide variety in the possible origins of strabismus. We propose that strabismus must be considered as possibly resulting from abnormal genetic and/or acquired factors, anatomical and/or functional abnormalities, in the sensory and/or the motor systems, both peripherally and/or in the brain itself. We shall particularly develop the possible “central” origins of strabismus. Indeed, we are convinced that it is time now to open this “black box” in order to move forward. All of this will be developed on the basis of both presently available data in literature (including most recent data) and our own experience. Both data in biology and medicine will be referred to. Our conclusions will hopefully help ophthalmologists to better understand strabismus and to develop new therapeutic strategies in the future. Presently, physicians eliminate or limit the negative effects of such pathology both on the development of the visual system and visual perception through the use of optical correction and, in some cases, extraocular muscle surgery. To better circumscribe the problem of the origins of strabismus, including at a cerebral level, may improve its management, in particular with respect to binocular vision, through innovating tools by treating the pathology at the source.