Evidence map›Paper›PMID 30006273›Full record

ArticleExperimental eye research2019

Fixation instability during binocular viewing in anisometropic and strabismic children.

Krista R Kelly, Christina S Cheng-Patel, Reed M Jost, Yi-Zhong Wang, Eileen E Birch

Registry-linked trialOpen access · greenAbstract read
In one paragraph

Article in Experimental eye research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07226141 (Valproate for the Treatment of Residual Amblyopia), which is not on this map. Cited by 54 papers.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07226141 phase1 / phase2recruitingnot on this mapstarted 2026, after this paper: background citation

Valproate for the Treatment of Residual Amblyopia

TypeinterventionalSponsorBoston Children's HospitalRan2026 to 2027Enrolled28ConditionsAmblyopia, Amblyopia Unilateral, Amblyopia, Anisometropic, Amblyopia StrabismicArmsValproate, Placebo, Patch
3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 77 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Severity-dependent Disruption of Binocular Accommodative Amplitude And Near Fusional Reserves in Children with Hyperopic Anisometropia.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026
    Article
  5. Article
  6. Review
  7. The Changing Natural History of Anisometropia: A Scoping Review.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026
    Article
  8. Article
  9. Article
  10. Article
  11. Article
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  13. Article
  14. Article
  15. Review
  16. Article
  17. Differential Impacts of Strabismic and Anisometropic Amblyopia on the Mesoscale Functional Organization of the Human Visual Cortex.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2025
    Article
  18. Article
  19. Article
  20. Fixation Stability Deficits in Anisometropic Amblyopia.Investigative ophthalmology & visual science · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Krista R KellyRetina Foundation of the Southwest, Dallas, TX, USA. Electronic address: kkelly@rfsw.org.
Christina S Cheng-PatelRetina Foundation of the Southwest, Dallas, TX, USA.
Reed M JostRetina Foundation of the Southwest, Dallas, TX, USA.
Yi-Zhong WangRetina Foundation of the Southwest, Dallas, TX, USA; Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA.
Eileen E BirchRetina Foundation of the Southwest, Dallas, TX, USA; Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA.
Retina Foundation of the Southwest · USSouthwestern Medical Center · US

Funding

Binocular Vision, Amblyopia, and Refractive Development in EsotropiaR01EY022313 · NEI · RETINA FOUNDATION OF THE SOUTHWEST · PI Eileen Elizabeth Birch · 2012 to 2026
$7.0M
Reading and eye-hand coordination in amblyopic childrenR00EY028224 · NEI · RETINA FOUNDATION OF THE SOUTHWEST · PI KELLY, KRISTA ROSE · 2019 to 2021
$781k
Reading and eye-hand coordination in amblyopic childrenK99EY028224 · NEI · RETINA FOUNDATION OF THE SOUTHWEST · PI KELLY, KRISTA ROSE · 2017 to 2018
$208k
NEI NIH HHS K99 EY028224NEI NIH HHS R00 EY028224NEI NIH HHS R01 EY022313
6 · The paper itself

Abstract

purposeStrabismus or anisometropia disrupts binocularity and results in fixation instability, which is increased with amblyopia. Fixation instability has typically been assessed for each eye individually. Recently, vergence instability was reported in exotropic adults and monkeys during binocular viewing. We evaluated fixation instability during binocular viewing in children treated for anisometropia and/or strabismus.

methods160 children age 4-12 years with treated esotropia and/or anisometropia (98 amblyopic, 62 nonamblyopic) were compared to 46 age-similar controls. Fixation instability was recorded during binocular fixation of a 0.3 deg diameter dot for 20 s using a 500 Hz remote video binocular eye tracker (EyeLink 1000; SR Research). The bivariate contour ellipse area (BCEA; log deg

resultsWhen binocularly viewing, both amblyopic and nonamblyopic children treated for anisometropia and/or strabismus had larger fixation instability and vergence instability than controls. Amblyopia primarily added to the instability of the nonpreferred eye. Anisometropic children had less nonpreferred eye instability and vergence instability than those with strabismus or combined mechanism. Nonpreferred eye instability and vergence instability were related to poorer stereoacuity and a larger suppression scotoma. Preferred eye instability was not related to any visual outcome measure. No relationships were found with visual acuity.

conclusionsFixation instability and vergence instability during binocular viewing suggests that discordant binocular visual experience during childhood, especially strabismus, interferes with ocular motor development. Amblyopia adds to instability of the nonpreferred eye. Vergence instability may limit potential for recovery of binocular vision in these children.

Indexed as

Visual AcuityAmblyopiaAnisometropiaChildChild, PreschoolEye MovementsFemaleFixation, OcularHumansMaleStrabismusVision, BinocularVisual Field TestsAmblyopiaAnisometropiaFixation instabilityOcular motor developmentStrabismusVergence

Identifiers

PMID30006273
PMCPMC7323568
OpenAlexW2850921230

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.