From this investigation, we believe that a basic three-level feedback control system exists for the maintenance of ocular alignment. Central to... » More

From this investigation, we believe that a basic three-level feedback control system exists for the maintenance of ocular alignment. Central to this theory is our hypothesis that extraocular muscle lengths are primarily regulated by vergence stimulation, as opposed to version stimulation. Even though we have treated the mechanisms involving ocular torsion in a black-box fashion in the beginning, we have been able to use the resulting interactions and consequences to hypothesize plausible explanations for previously enigmatic phenomena such as so-called primary overaction/underaction of the oblique extraocular muscles and the development of “A” and “V” patterns. Dissociated vertical deviation can be explained using these hypotheses, strengthening our belief that it serves a purpose after all. And we are beginning to appreciate previously unexplained patterns of misalignment such as the basic cyclovertical deviation that we believe masquerades as congenital superior oblique paresis.

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