Monocular geometry is selectively distorted in the central visual field of strabismic amblyopes

Strabismic amblyopia is associated with a distorted perception of visual space. The aim of our study was to investigate the monocular space perception of strabismic observers at several locations in the central and peripheral visual field. We tested nine observers with strabismic and/or anisometropic amblyopia, two strabismic subjects with alternating fixation and two normal control subjects. The task was to align a light stimulus with two vertically arranged reference marks. Testing conditions included three separations of the references along the vertical meridian (10 degrees, 20 degrees and 40 degrees) as well as several presentation sites of the vertical references in the nasal and temporal peripheral visual field (5 degrees, 10 degrees and 20 degrees from fixation). Performance with the amblyopic eye was clearly impaired as compared to the nonamblyopic eye. For alignment along the vertical meridian, all amblyopic eyes showed increased uncertainty in their position judgements. Most of the squinting eyes of amblyopes also displayed a systematic lateral displacement of the test stimulus in relation to the reference marks, in the most extreme case up to almost 7 degrees. Usually, larger errors were found with wider separations of the reference marks. In the peripheral field, the differences between the amblyopic and the nonamblyopic eye diminished or disappeared. Thus, monocular geometry appears to be selectively impaired in the central visual field of the deviated eye of strabismic amblyopes. These spatial distortions might be related to the different states of binocular correspondence in the central vs. peripheral visual field, shown by some strabismic amblyopes.