• Pediatric Ophth/Strabismus

    This prospective study found a strong limbic reaction in observers viewing strabismic eyes, suggesting that strabismus not only affects the visual function of the patient but also has a negative effect on the observer as well.

    The authors used functional magnetic resonance imaging (fMRI) to compare the limbic response of 31 healthy volunteers viewing images of strabismic versus normally aligned eyes. After undergoing the fMRI, each observer answered the question, “Did the pictures evoke any emotions?”

    Viewing strabismus images led to significant activation of the left amygdala, the hippocampus, the fusiform gyri and the parahippocampal gyri when compared with viewing normal eye images in 30 of the 31 subjects.

    They write that because the amygdala is the fundamental structure in the processing of negative, fearful and aversive emotions, the results of this study strongly suggest that healthy individuals are reacting in a negative fashion to strabismus. This reaction seems to be based on a system for face recognition hardwired during early infancy.

    They noted that the fMRI results contrasted with the subjective answers of some of the candidates. Although they found activation in the amygdala and parahippocampus in virtually all volunteers (30 of 31), one quarter of them reported experiencing no emotions while viewing the images of strabismic eyes. Whether this is conscious or unconscious needs further investigation. They speculate that efforts to be politically correct or understanding may have played a role.

    They conclude that this study demonstrates for the first time the organic effect of strabismus on the observer. The strong reaction in the limbic system confirms that strabismus is indeed viewed negatively. Therefore, strabismus is a significant interpersonal problem, and this study helps elucidate why those with strabismus may have social and psychological difficulties, as well as difficulty gaining employment.