A Dichoptic Optokinetic Nystagmus Paradigm for Interocular Suppression Quantification in Intermittent Exotropia

Purposes: To investigate the effectiveness of a dichoptic optokinetic nystagmus (dOKN) test to objectively quantify interocular suppression in intermittent exotropia (IXT) patients during the states of orthotropia and exodeviation.Methods: The OKN motion in subjects (15 controls and 59 IXT subjects) who viewed dichoptic oppositely moving gratings with different contrast ratios was monitored and recorded by an eye tracker. Interocular suppression in control subjects was induced using neutral density (ND) filters. The OKN direction ratios were fitted to examine the changes of interocular suppression in subjects under different viewing states. Two established interocular suppression tests (phase and motion) were conducted for a comparative study.Results: The dOKN test, which requires a minimal response from subjects, could accurately quantify the interocular suppression in both IXT and control subjects, which is in line with the established interocular suppression tests. Overall, although comparative, the strength of interocular suppression detected by the dOKN test (0.171 ± 0.088) was stronger than those of the phase (0.293 ± 0.081) and the motion tests (0.212 ± 0.068) in the control subjects with 1.5 ND filters. In IXT patients, when their eyes kept aligned, the dOKN test (0.58 ± 0.09) measured deeper visual suppression compared with the phase (0.73 ± 0.17) or the motion test (0.65 ± 0.14). Interestingly, strong interocular suppression (dOKN: 0.15 ± 0.12) was observed in IXT subjects during the periods of exodeviation, irrespective of their binocular visual function as measured by synoptophore.Conclusion: The dOKN test provides efficient and objective quantification of interocular suppression in IXT, and demonstrates how it fluctuates under different eye positions.

Alpha Oscillations and Feedback Processing in Visual Cortex for Conscious Perception

Variability in perception between individuals may be a consequence of different inherent neural processing speeds. To assess whether alpha oscillations systematically reflect a feedback pacing mechanism for cortical processing during visual perception, comparisons were made between alpha oscillations, visual suppression from TMS, visual evoked responses, and metacontrast masking. Peak alpha oscillation frequencies, measured through scalp EEG recordings, significantly correlated with the optimum latencies for visual suppression from TMS of early visual cortex. Individuals with shorter alpha periods (i.e., higher peak alpha frequencies) processed visual information faster than those with longer alpha periods (i.e., lower peak alpha frequencies). Moreover, peak alpha oscillation periods and optimum TMS visual suppression latencies predicted the latencies of late but not early visual evoked responses. Together, these findings demonstrate an important role of alpha oscillatory and late feedback activity in visual cortex for conscious perception. They also show that the timing for visual awareness varies across individuals, depending on the pace of one's endogenous oscillatory cycling frequency.

Continuous flash suppression and monocular pattern masking impact subjective awareness similarly

Peters & Lau (2015) found that when criterion bias is controlled for, there is no evidence for unconscious visual perception in normal observers, in the sense that they cannot directly discriminate a target above chance without knowing it. One criticism of that study is that the visual suppression method used, forward and backward masking (FBM), may be too blunt in the way it interferes with visual processing to allow for unconscious forced-choice discrimination. To investigate this question we compared FBM directly to continuous flash suppression (CFS) in a two-interval forced choice task. Although CFS is popular, and may be thought of as a more powerful visual suppression technique, we found no difference in the degree of perceptual impairment between the two suppression types. To the extent that CFS impairs perception, both objective discrimination and subjective awareness are impaired to similar degrees under FBM. This pattern was consistently observed across 3 experiments in which various experimental parameters were varied. These findings provide evidence for an ongoing debate about unconscious perception: normal observers cannot perform forced-choice discrimination tasks unconsciously.