Yes / Although their eyes are pointing in different directions, people with long-standing strabismic amblyopia typically do not experience double-vision or indeed any visual symptoms arising from their condition. It is generally believed that the phenomenon of suppression plays a major role in dealing with the consequences of amblyopia and strabismus, by preventing images from the weaker/deviating eye from reaching conscious awareness. Suppression is thus a highly sophisticated coping mechanism. Although suppression has been studied for over 100 years the literature is equivocal in relation to the extent of the retina that is suppressed, though the method used to investigate suppression is crucial to the outcome. There is growing evidence that some measurement methods lead to artefactual claims that suppression exists when it does not. Methodology/Results: Here we present the results of an experiment conducted with a new method to examine the prevalence, depth and extent of suppression in ten individuals with strabismic amblyopia. Seven subjects (70%) showed no evidence whatsoever for suppression and in the three individuals who did (30%), the depth and extent of suppression was small. Conclusions: Suppression may play a much smaller role in dealing with the negative consequences of strabismic amblyopia than previously thought. Whereas recent claims of this nature have been made only in those with micro-strabismus our results show extremely limited evidence for suppression across the central visual field in strabismic amblyopes more generally. Instead of suppressing the image from the weaker/deviating eye, we suggest the visual system of individuals with strabismic amblyopia may act to maximise the possibilities for binocular co-operation. This is consistent with recent evidence from strabismic and amblyopic individuals that their binocular mechanisms are intact, and that, just as in visual normals, performance with two eyes is better than with the better eye alone in these individuals.

Abstract Purpose: Interocular inhibitory interactions appear to underlie the establishment of ocular dominance. The inhibitory effect leads to suppression of the non dominant eye in certain conditions. While these processes are not fully understood, the relative differences in image contrast appear to be fundamental. By titrating the relative contrast presented to each eye, a balance in the relative inhibitory effects of each eye can be defined. This research looked at whether the interocular contrast ratio at perceptual balance could be used as an index of the ocular dominance in binocular normal population, and the suppression typically found in the amblyopic population. Contrast variation was compared to luminance variation as well as the application of neutral density filters. Methods: Balance point measures were obtained by varying the interocular levels of contrast for a global motion task viewed dichoptically. One eye received signal dots moving in a given direction while the other eye received noise dots moving randomly. Subjects were tasked with determining the direction of movement of the signal dots. Balanced dichoptic motion sensitivity was achieved under a specific contrast ratio (or the balance point), depending on the observer’s binocular functions. This test was conducted on a control group (n=23) having normal vision and a strabismic amblyopic group (n=10). In addition, a variation of this test was designed with interocular luminance (rather than interocular contrast) serving as the independent variable was conducted to both the control (n=5) and amblyopic groups (n=8). Concurrent eye tracking measures measured changes in eye alignment at the balance point. Results: Although most normal vision subjects showed a balance point at close to equal levels of contrast between the eyes, a minority of them were significantly imbalanced. The suppression measured in the strabismic amblyopic group was significantly greater than that of the control group. Varying the interocular luminance instead of contrast failed to affect the coherence motion thresholds. Ocular alignment was not changed when the balance point was reached. Conclusion: Consistent with the current model of binocular integration, interocular contrast are uniquely important in establishing sensory dominance and suppression. This suggests that the interocular suppression found in amblyopia could be attenuated by methods that allow the reduction of contrast to the fellow fixing eye. Amblyopia therapy might then be improved where such contrast balancing methods are employed instead of the complete patching of the fellow eye.

Abstract Purpose: Interocular inhibitory interactions appear to underlie the establishment of ocular dominance. The inhibitory effect leads to suppression of the non dominant eye in certain conditions. While these processes are not fully understood, the relative differences in image contrast appear to be fundamental. By titrating the relative contrast presented to each eye, a balance in the relative inhibitory effects of each eye can be defined. This research looked at whether the interocular contrast ratio at perceptual balance could be used as an index of the ocular dominance in binocular normal population, and the suppression typically found in the amblyopic population. Contrast variation was compared to luminance variation as well as the application of neutral density filters. Methods: Balance point measures were obtained by varying the interocular levels of contrast for a global motion task viewed dichoptically. One eye received signal dots moving in a given direction while the other eye received noise dots moving randomly. Subjects were tasked with determining the direction of movement of the signal dots. Balanced dichoptic motion sensitivity was achieved under a specific contrast ratio (or the balance point), depending on the observer’s binocular functions. This test was conducted on a control group (n=23) having normal vision and a strabismic amblyopic group (n=10). In addition, a variation of this test was designed with interocular luminance (rather than interocular contrast) serving as the independent variable was conducted to both the control (n=5) and amblyopic groups (n=8). Concurrent eye tracking measures measured changes in eye alignment at the balance point. Results: Although most normal vision subjects showed a balance point at close to equal levels of contrast between the eyes, a minority of them were significantly imbalanced. The suppression measured in the strabismic amblyopic group was significantly greater than that of the control group. Varying the interocular luminance instead of contrast failed to affect the coherence motion thresholds. Ocular alignment was not changed when the balance point was reached. Conclusion: Consistent with the current model of binocular integration, interocular contrast are uniquely important in establishing sensory dominance and suppression. This suggests that the interocular suppression found in amblyopia could be attenuated by methods that allow the reduction of contrast to the fellow fixing eye. Amblyopia therapy might then be improved where such contrast balancing methods are employed instead of the complete patching of the fellow eye.