Is infantile esotropia subcortical in origin?

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations


Essential infantile esotropia (EIE) is often attributed to a primary disturbance within the visual cortex based upon the findings of monocular horizontal optokinetic asymmetry and correlative horizontal motion detection asymmetry. However, these physiologic aberrations conform to what would be observed if the visual cortex secondarily reconfigured itself to the preexisting subcortical optokinetic motion template. This analysis examines the perspective that the measured cortical aberrations can be explained by prolonged subcortical neuroplasticity, leading to a secondary rewiring of cortical motion pathways. Evolutionary evidence indicates that EIE is generated by subcortical ocular motor centers that subserve nasalward optokinesis. These phylogenetically older subcortical visuo-vestibular pathways include the nucleus of the optic tract, accessory optic system, inferior olive, cerebellar flocculus, and vestibular nucleus. In normal humans, the subcortical visual system becomes inactivated after the first few months of infancy. Mutations or other perturbations that prolong subcortical neuroplasticity may create a persistent simultaneous nasalward optokinetic bias in both eyes to generate infantile esotropia.

Original languageEnglish (US)
Title of host publicationMathematical Modelling in Motor Neuroscience
Subtitle of host publicationState of the Art and Translation to the Clinic. Ocular Motor Plant and Gaze Stabilization Mechanisms
EditorsStefano Ramat, Aasef G. Shaikh
PublisherElsevier B.V.
Number of pages11
ISBN (Print)9780444642332
StatePublished - 2019

Publication series

NameProgress in Brain Research
ISSN (Print)0079-6123
ISSN (Electronic)1875-7855


  • Infantile esotropia
  • Monocular nasotemporal optokinetic asymmetry
  • Subcortical

ASJC Scopus subject areas

  • Neuroscience(all)


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