Time Course of Perceived Visual Distortion and Axial Length Growth in Myopic Children Undergoing Orthokeratology.

Purpose: To establish the time course of the subjective visual function changes during the first month of orthokeratology treatment in myopic children, and to investigate how the time course variations are associated with the objective optical quality changes and the axial length growth (ALG) after 1 year of treatment. Methods: A total of 58 myopic children aged from 8 to 16 years participated in this self-controlled prospective study. All subjects were fitted with designed spherical four-zone orthokeratology lenses. Subjective visual function was evaluated with orientation discrimination threshold (ODT), and objective optical quality was quantified with the high-order aberration root-mean-square (HOA-RMS) and the changing speed of HOA. The measurements were done before the lens fitting and 1 day, 1-, 2-, and 4-weeks after lens wear. Axial length was obtained at baseline and 1-year follow-up, and ALG was defined as the difference. One-way ANOVA was conducted to compare the difference for statistical analysis. Results: After lens fitting, the ODT time courses peaked on day 1 in 28 children, 1 week in 15 children, 2 weeks in 11 children, and 4 weeks in 4 children. In contrast, the HOA-RMS steadily rose during the first month, and the changing speed of HOA was only transiently elevated on day 1 after the initial lens wear. The ALG was 0.12 ± 0.20 mm in subjects whose ODT peaked at day 1, 0.08 ± 0.09 mm in subjects whose ODT peaked on 1-week, and 0.12 ± 0.15 mm in subjects whose ODT peaked on 2-week or later. There was no difference in axial growth among the subjects whose ODT peaked at different days (P = 0.734). Conclusion: While half ODT time course resembled the changing speed of HOA with a transient elevation on day 1, about a quarter of the ODT time course resemble the steadily rising of HOA-RMS, and the rest was located in the middle. The ALGs in children with different types of ODT time courses were similar.

The Associations among Metamorphopsia, Orientation Discrimination Threshold, and Retinal Layer Thickness in Patients with Idiopathic Epiretinal Membrane.

PURPOSE: To explore the association among the metamorphopsia identified by Amsler grid test, orientation discrimination threshold (ODT), and retinal layer thickness in patients with idiopathic epiretinal membrane (ERM). METHODS: A total of 48 ERM patients were divided into a fovea-spared (FS) group (n = 12) and a fovea-involved (FI) group (n = 36). A total of 23 visually normal people served as controls. Metamorphopsia was first assessed with an Amsler grid. The ODT was quantified with groups of briefly displayed short line segments. Inner and outer retinal layer thickness (IRLT and ORLT) was measured with spectral domain optical coherence tomography. RESULTS: A total of 12 patients with ERM (1 in FS and 11 in FI) reported abnormalities in the Amsler grid test. The ODT values were significantly elevated in patients in both FS (7.48 ± 1.94°, p < 0.001) and FI groups (10.14 ± 2.28°, p < 0.001) when compared to normal (4.22 ± 0.80). Receiver operating characteristic (ROC) analyses of ODT to distinguish Amsler positive and negative patients yielded an area under the curve (AUC) of 0.829. The IRLT was significantly thicker (386.6 ± 95.1 µm vs. 127.5 ± 17.6 in normal) and ORLT were significantly thinner (88.11 ± 8.24 vs. 94.39 ± 5.66 in normal) in the FI group. ROC analyses to distinguish Amsler positive and negative patients yield an AUC of 0.917 using IRLT and 0.719 using ORLT. ODT correlated tightly with the thicker IRLT in both the FS and FI groups, and with the thinner ORLT in the FI group. CONCLUSIONS: In patients with ERM, ODT reflects functional changes that are not detected by the Amsler grid test and correlates with changes in inner retina layer thickness well.

Relationships of orientation discrimination threshold and visual acuity with macular lesions in age-related macular degeneration.

PURPOSE: To measure visual acuity and metamorphopsia in patients with age-related macular degeneration (AMD) and to explore their relationship with macular lesions. METHODS: In this cross-sectional study, a total of 32 normal subjects (32 eyes) and 35 AMD patients (35 eyes) were recruited. They were categorized into 4 groups: normal, dry AMD, non-active wet AMD, and active wet AMD. Best-corrected visual acuity (BCVA) was measured using the Early Treatment Diabetic Retinopathy Study protocol. Metamorphopsia was quantified with the orientation discrimination threshold (ODT). Macular lesions, including drusen, sub-retinal fluid (SRF), intra-retinal fluid (IRF), pigmented epithelium detachment (PED), and scarring, were identified with spectral-domain optical coherence tomography (SD-OCT). A linear regression model was established to identify the relationships between the functional and structural changes. RESULTS: BCVA progressively worsened across the normal, dry AMD, non-active wet AMD, and active wet AMD groups (P < 0.001), and ODT increased across the groups (P < 0.001). The correlation between BCVA and ODT varied among the groups. The partial correlation between BCVA and ODT was -0.61 (P < 0.001). Linear regression showed that ODT significantly depended on IRF (ß = 0.61, P < 0.001), SRF (ß = 0.34, P = 0.003), and scarring (ß = 0.26, P = 0.050), while BCVA significantly depended only on scarring (ß = -0.52, P < 0.001), and IRF (ß = -0.36, P = 0.016). CONCLUSIONS: From dry AMD to active wet AMD, BCVA gradually worsened while ODT increased. The correlation between BCVA and ODT varied among these groups, indicating that AMD lesions affect them differently. ODT and BCVA should be used concurrently for better monitoring of the disease.

Degradation of Binocular Coordination during Sleep Deprivation.

To aid a clear and unified visual perception while tracking a moving target, both eyes must be coordinated, so the image of the target falls on approximately corresponding areas of the fovea of each eye. The movements of the two eyes are decoupled during sleep, suggesting a role of arousal in regulating binocular coordination. While the absence of visual input during sleep may also contribute to binocular decoupling, sleepiness is a state of reduced arousal that still allows for visual input, providing a context within which the role of arousal in binocular coordination can be studied. We examined the effects of sleep deprivation on binocular coordination using a test paradigm that we previously showed to be sensitive to sleep deprivation. We quantified binocular coordination with the SD of the distance between left and right gaze positions on the screen. We also quantified the stability of conjugate gaze on the target, i.e., gaze-target synchronization, with the SD of the distance between the binocular average gaze and the target. Sleep deprivation degraded the stability of both binocular coordination and gaze-target synchronization, but between these two forms of gaze control the horizontal and vertical components were affected differently, suggesting that disconjugate and conjugate eye movements are under different regulation of attentional arousal. The prominent association found between sleep deprivation and degradation of binocular coordination in the horizontal direction may be used for a fit-for-duty assessment.

Potential role for microfluctuations as a temporal directional cue to accommodation.

The goal was to revisit an important, yet unproven notion that accommodative microfluctuations facilitate the determination of direction (sign) of abrupt focus changes in the stimulus to accommodation. We contaminated the potential temporal cues from natural accommodative microfluctuations by presenting uncorrelated external (screen) temporal defocus noise that combined with the retinal image effects of natural microfluctuations. A polychromatic Maltese spoke pattern thus either modulated defocus at a combination of two temporal frequencies (on-screen noise condition) or was static (control condition). The on-screen conditions were combined with step changes in optical vergence that were randomized in direction and magnitude. Five subjects monocularly viewed stimuli through a Badal optical system in a Maxwellian view. An artificial 4-mm aperture was imaged at the entrance pupil of the eye. Wavefront aberrations were measured dynamically at 50 Hz using a custom Shack-Hartmann aberrometer. Dynamic changes in the Zernike defocus term with step changes in optical vergence were analyzed. We calculated the percentage of correct directional responses for 1, 2, and 3 D accommodative and disaccommodative step stimuli using preset criteria for latency, velocity, and persistence of the response. The on-screen noise condition reduced the percent-correct responses compared to the static stimulus, suggesting that this manipulation affected the detectability of the sign of the accommodative stimulus. Several possible reasons and implications of this result are discussed.

The impact of higher-order aberrations on the strength of directional signals produced by accommodative microfluctuations.

It has been proposed that the accommodation system could perform contrast discrimination between the two dioptric extremes of accommodative microfluctuations to extract directional signals for reflex accommodation. Higher-order aberrations (HOAs) may have a significant influence on the strength of these contrast signals. Our goal was to compute the effect HOAs may have on contrast signals for stimuli within the upper defocus limit by comparing computed microcontrast fluctuations with psychophysical contrast increment thresholds (Bradley & Ohzawa, 1986). Wavefront aberrations were measured while subjects viewed a Maltese spoke stimulus monocularly. Computations were performed for accommodation or disaccommodation stimuli from a 3 Diopter (D) baseline. Microfluctuations were estimated from the standard deviation of the wavefronts over time at baseline. Through-focus Modulation Transfer, optical contrast increments (ΔC), and Weber fractions (ΔC/C) were derived from point spread functions computed from the wavefronts at baseline for 2 and 4 cycles per degree (cpd) components, with and without HOAs. The ΔCs thus computed from the wavefronts were compared with psychophysical contrast increment threshold data. Microfluctuations are potentially useful for extracting directional information for defocus values within 3 D, where contrast increments for the 2 or 4 cpd components exceed psychophysical thresholds. HOAs largely reduce contrast signals produced by microfluctuations, depending on the mean focus error, and their magnitude in individual subjects, and they may shrink the effective stimulus range for reflex accommodation. The upper defocus limit could therefore be constrained by discrimination of microcontrast fluctuations.

Adaptation of visual tracking synchronization after one night of sleep deprivation.

The temporal delay between sensory input and motor execution is a fundamental constraint in interactions with the environment. Predicting the temporal course of a stimulus and dynamically synchronizing the required action with the stimulus are critical for offsetting this constraint, and this prediction-synchronization capacity can be tested using visual tracking of a target with predictable motion. Although the role of temporal prediction in visual tracking is assumed, little is known of how internal predictions interact with the behavioral outcome or how changes in the cognitive state influence such interaction. We quantified and compared the predictive visual tracking performance of military volunteers before and after one night of sleep deprivation. The moment-to-moment synchronization of visual tracking during sleep deprivation deteriorated with sensitivity changes greater than 40 %. However, increased anticipatory saccades maintained the overall temporal accuracy with near zero phase error. Results suggest that acute sleep deprivation induces instability in visuomotor prediction, but there is compensatory visuomotor adaptation. Detection of these visual tracking features may aid in the identification of insufficient sleep.

The effect of perceptual grouping on perisaccadic spatial distortions.

Perisaccadic spatial distortion (PSD) occurs when a target is flashed immediately before the onset of a saccade and it appears displaced in the direction of the saccade. In previous studies, the magnitude of PSD of a single target was affected by multiple experimental parameters, such as the target's luminance and its position relative to the central fixation target. Here we describe a contextual effect in which the magnitude of the PSD for a target was influenced by the synchronous presentation of another target: PSD for simultaneously presented targets was more uniform than when each was presented individually. Perisaccadic compression was ruled out as a causal factor, and the results suggest that both low- and high-level perceptual grouping mechanisms may account for the change in PSD magnitude. We speculate that perceptual grouping could play a key role in preserving shape constancy during saccadic eye movements.

Short-term adaptation of accommodation, accommodative vergence and disparity vergence facility.

Previous studies have found that subjects can increase the velocity of accommodation using visual exercises such as pencil push ups, flippers, Brock strings and the like and myriad papers have shown improvement in accommodation facility (speed) and sufficiency (amplitude) using subjective tests following vision training but few have objectively measured accommodation before and after training in either normal subjects or in patients diagnosed with accommodative infacility (abnormally slow dynamics). Accommodation is driven either directly by blur or indirectly by way of neural crosslinks from the vergence system. Until now, no study has objectively measured both accommodation and accommodative-vergence before and after vision training and the role vergence might play in modifying the speed of accommodation. In the present study, accommodation and accommodative-vergence were measured with a Purkinje Eye Tracker/optometer before and after normal subjects trained in a flipper-like task in which the stimulus stepped between 0 and 2.5 diopters and back for over 200 cycles. Most subjects increased their speed of accommodation as well as their speed of accommodative vergence. Accommodative vergence led the accommodation response by approximately 77 ms before training and 100 ms after training and the vergence lead was most prominent in subjects with high accommodation and vergence velocities and the vergence leads tended to increase in conjunction with increases in accommodation velocity. We surmise that volitional vergence may help increase accommodation velocity by way of vergence-accommodation cross links.

Does ethnicity influence the short-term adaptation to first reading correction?

PURPOSE: Ethnic variations in accommodative amplitude (AA) are not uncommon. Accommodation can become reduced in response to short-term wear of first near spectacles. Whether ethnicity has an influence on the magnitude of this adaptation is not well understood. We investigated the impact of first near spectacles on changes in AA and on convergence cross-link interactions in incipient presbyopes of Chinese and Caucasian ethnicities. METHODS: Forty-one subjects (22 Caucasians and 19 Chinese) aged 36 to 44 years completed the study. Accommodative stimulus response function, AA, and AC/A and CA/C ratios were measured before and after single vision reading spectacles were used for near tasks over a 2-month period and then again 2 months after discontinuing near spectacle wear. RESULTS: After wearing reading spectacles for 2 months, the accommodative stimulus response slopes and AC/A and CA/C ratios remained invariant irrespective of ethnicity. The accommodative, but not vergence, bias decreased (p < 0.05). The nearpoint of accommodation shifted distally producing an average decrease in AA of 0.52 D from baseline (p < 0.05). Recovery to near baseline values occurred after discontinuing the reading glasses for 2 months. Differences based on ethnicity were not significant. The baseline AA vs. age plots showed steeper slopes for Chinese than the Caucasian subjects in the sample. CONCLUSIONS: The pattern of adaptation by accommodation and cross-link interactions to short-term first reading spectacles is not influenced by ethnicity.

Training the brain to overcome the effect of aging on the human eye.

Presbyopia, from the Greek for aging eye, is, like death and taxes, inevitable. Presbyopia causes near vision to degrade with age, affecting virtually everyone over the age of 50. Presbyopia has multiple negative effects on the quality of vision and the quality of life, due to limitations on daily activities - in particular, reading. In addition presbyopia results in reduced near visual acuity, reduced contrast sensitivity, and slower processing speed. Currently available solutions, such as optical corrections, are not ideal for all daily activities. Here we show that perceptual learning (repeated practice on a demanding visual task) results in improved visual performance in presbyopes, enabling them to overcome and/or delay some of the disabilities imposed by the aging eye. This improvement was achieved without changing the optical characteristics of the eye. The results suggest that the aging brain retains enough plasticity to overcome the natural biological deterioration with age.

The perception of motion smear during eye and head movements.

Because the visual system integrates information across time, an image that moves on the retina would be expected to be perceived as smeared. In this article, we summarize the previous evidence that human observers perceive a smaller extent of smear when retinal image motion results from an eye or head movement, compared to when a physically moving target generates comparable image motion while the eyes and head are still. This evidence indicates that the reduction of perceived motion smear is asymmetrical, occurring only for targets that move against the direction of an eye or head movement. In addition, we present new data to show that no reduction of perceived motion smear occurs for targets that move in either direction during a visually-induced perception of self motion. We propose that low-level extra-retinal eye- and head-movement signals are responsible for the reduction of perceived motion smear, by decreasing the duration of the temporal impulse response. Although retinal as well as extra-retinal mechanisms can reduce the extent of perceived motion smear, available evidence suggests that improved visual functioning may occur only when an extra-retinal mechanism reduces the perception of smear.

The first and second order dynamics of accommodative convergence and disparity convergence.

Main sequences, the function describing the relationship between eye movement amplitude and velocity, have been used extensively in oculomotor research as an indicator of first-order dynamics yet it is difficult to find main sequence analyses for accommodative vergence or for disparity vergence in isolation when all mitigating factors have been well controlled and there are no studies in which accommodative vergence and disparity vergence main sequences have been generated for the same group of subjects. The present study measured main sequences in: (1) accommodative vergence with disparity vergence open loop, (2) disparity vergence with accommodation open loop, and (3) combinations of accommodative and disparity vergence. A dynamic AC/A ratio was defined and was found to be similar to the traditional static AC/A ratio. Vergence acceleration was measured for all conditions. A pulse-step model of accommodation and convergence was constructed to interpret the dynamics of the crosslinked interactions between the two systems. The model supports cross-coupling of both the pulse and step components and simulates the primary empirical findings that: (1) disparity vergence has a higher main sequence slope than accommodative vergence, (2) both accommodative and disparity vergence acceleration increase with response amplitude whereas accommodation acceleration does not.

The temporal impulse response function during smooth pursuit.

Recent studies indicate that the extent of perceived motion smear is attenuated asymmetrically during smooth pursuit eye movements, based on the relative directions of the target and eye motion. We conducted two experiments to determine if the reduction of perceived smear during pursuit might be associated with an acceleration of the temporal impulse response function (TIRF). In Experiment 1, two-pulse increment sensitivity was determined during fixation and rightward pursuit for sequential flashes of a long horizontal line, presented with stimulus-onset asynchronies between 5.9 and 234 ms. In Experiment 2, temporal contrast sensitivity was measured during fixation and rightward pursuit for a vertical 1 cpd grating with retinal image velocities between 4 and 30 Hz. During pursuit, grating motion was either in the same or the opposite direction as the eye movement. TIRFs were modeled as the impulse responses of a second-order, low-pass linear system, fit to the two-pulse increment sensitivity data by an optimization procedure and to the temporal contrast sensitivity results by iterative Fourier synthesis. The results indicate that the natural temporal frequency of the fitted TIRFs was approximately 10% higher during pursuit than fixation. In Experiment 2, the increased natural frequency of the TIRF was restricted to the condition in which the grating moved spatially in the opposite direction of the pursuit eye movement. The results are consistent with the hypothesis that extra-retinal signals reduce the extent of perceived motion smear during pursuit, in part by increasing the speed of visual processing preferentially for one direction of image motion.

Orientation discrimination with macular changes associated with early AMD.

PURPOSE: Age-related macular degeneration (AMD) is a condition that progressively reduces central vision in elderly individuals, resulting in a reduced capacity to perform many daily activities and a diminished quality of life. Recent studies identified clinical treatments that can slow or reverse the progression of exudative (wet) AMD and ongoing research is evaluating earlier interventions. Because early diagnosis is critical for an optimal outcome, the goal of this study is to assess psychophysical orientation discrimination for randomly positioned short line segments as a potential indicator of subtle macular changes in eyes with early AMD. METHODS: Orientation discrimination was measured in a sample of 74 eyes of patients aged 47 to 82 years old, none of which had intermediate or advanced AMD. Amsler-grid testing was performed as well. A masked examiner graded each eye as level 0, 1, 2, or 3 on a streamlined version of the Age-Related Eye Disease Study (AREDS) scale for AMD, based on the presence and extent of macular drusen or retinal pigment epithelium (RPE) changes. Visual acuity in the 74 eyes ranged from 20/15 to 20/40, with no significant differences among the grading levels. Humphrey 10-2 and Nidek MP-1 micro-perimetry were used to assess retinal sensitivity at test locations 1 degrees from the locus of fixation. RESULTS: Average orientation-discrimination thresholds increased systematically from 7.4 degrees to 11.3 degrees according to the level of macular changes. In contrast, only 3 of 74 eyes exhibited abnormalities on the Amsler grid and central-field perimetric defects occurred with approximately equal probability at all grading levels. CONCLUSIONS: In contrast to Amsler grid and central-visual-field testing, psychophysical orientation discrimination has the capability to distinguish between eyes with and without subtle age-related macular changes.

Asymmetrical perception of motion smear in infantile nystagmus.

Normal observers perceive less motion smear if a target moves in the opposite direction of a smooth eye movement than if the target moves to produce the same retinal image speed in the same direction as the eye movement. This study investigated whether a similar asymmetrical attenuation of perceived motion smear occurs in observers with infantile nystagmus (IN). Observers (N=3) viewed a laser spot that moved for 100 or 125ms to the right or left at a speed between 5 and 60 degrees /s during the slow phase of jerk IN. After each trial, the observer adjusted the length of a bright line to match the extent of the perceived smear. Across observers, the average duration of perceived smear was 39 and 106ms, respectively, for relative motion of the laser spot in the opposite vs. the same direction as the IN slow phase. In one observer with periodic alternating nystagmus, the direction of spot motion that produced less perceived smear reversed with an alternation in the direction of the IN slow phase. The reduction of perceived motion smear for relative target motion in the opposite direction of IN slow phases is attributed to extra-retinal signals that accompany IN. As during normal eye movements, the reduction of perceived smear for this direction of relative motion should foster the perception of clarity in the stationary visual world.

The temporal impulse response function in infantile nystagmus.

Despite rapid to-and-fro motion of the retinal image that results from their incessant involuntary eye movements, persons with infantile nystagmus (IN) rarely report the perception of motion smear. We performed two experiments to determine if the reduction of perceived motion smear in persons with IN is associated with an increase in the speed of the temporal impulse response. In Experiment 1, increment thresholds were determined for pairs of successively presented flashes of a long horizontal line, presented on a 65-cd/m2 background field. The stimulus-onset asynchrony (SOA) between the first and second flash varied from 5.9 to 234 ms. In experiment 2, temporal contrast sensitivity functions were determined for a 3-cpd horizontal square-wave grating that underwent counterphase flicker at temporal frequencies between 1 and 40 Hz. Data were obtained for 2 subjects with predominantly pendular IN and 8 normal observers in Experiment 1 and for 3 subjects with IN and 4 normal observers in Experiment 2. Temporal impulse response functions (TIRFs) were estimated as the impulse response of a linear second-order system that provided the best fit to the increment threshold data in Experiment 1 and to the temporal contrast sensitivity functions in Experiment 2. Estimated TIRFs of the subjects with pendular IN have natural temporal frequencies that are significantly faster than those of normal observers (ca. 13 vs. 9 Hz), indicating an accelerated temporal response to visual stimuli. This increase in response speed is too small to account by itself for the virtual absence of perceived motion smear in subjects with IN, and additional neural mechanisms are considered.

Motion sensitivity during fixation in straight-ahead and lateral eccentric gaze.

Despite motion of the entire retinal image that results from fixational eye-movements, the visual scene is perceived as stationary. One hypothesis to account for this observation is that normal motion sensitivity is limited by the variability of fixational eye velocity. The present experiments tested this hypothesis by comparing motion sensitivity and the variability of fixational eye velocity in corresponding meridians. Speed thresholds to detect horizontal, vertical, and rotary motion in a set of eight random-dot patches were measured, while normal observers monocularly viewed the stimulus with gaze either straight-ahead or deviated to the left by 45 degrees. Eye-movement recordings using the search-coil technique were used to estimate the variability of eye velocity in the horizontal, vertical, and torsional meridians during fixation. As reported previously by Murakami (2004), the averaged thresholds for horizontal and vertical motion correlated with the averaged variability of eye velocity in the horizontal and vertical meridians when observers looked straight-ahead. However, no relationship existed between the threshold for rotary motion and the variability of eye velocity in the torsional meridian. Furthermore, no relationship existed between the motion threshold and the variability of eye velocity in any meridian during fixation in lateral eccentric gaze. These results are only partly consistent with the hypothesis that fixation variability limits motion sensitivity.

Effects of fixation instability on multifocal VEP (mfVEP) responses in amblyopes.

The cortical activity of subjects with compromised central vision (e.g., amblyopes) is thought to be much weaker for stimulation of the affected eye than in the fellow eye. Because these subjects are known to exhibit considerable difficulties in keeping steady fixation, we investigated the effects of anomalous fixation on their multifocal visual-evoked potential (mfVEP) responses using a dual Purkinje image (dPi) eye tracker. Our results show that mfVEP responses to stimulation of the central 5 degrees were depressed in the affected eye compared to those in the normal eye and the magnitude of response reductions was proportional to the degree of visual acuity loss in amblyopic subjects. Fixation was far less stable while viewing with the affected eye than with the fellow eye, some exhibiting jerk nystagmus and/or saccadic oscillations. Normal subjects with artificially imposed nystagmus showed similar reductions of VEP responses. The relative magnitudes of the deficits in mfVEP responses were tightly correlated with the degree of fixation instability. These results suggest that the interpretation of anomalous neural or perceptual processing in amblyopic subjects must take the effects of unsteady fixation during measurements into consideration in order to reveal the true nature and extent of sensory neural deficits.

Signals of eye-muscle proprioception modulate perceived motion smear.

Achieving clear perception during eye movements is one of the major challenges that the human visual system has to face every day. Like most light sensitive mechanisms, the human visual system has a finite integration time that may cause moving images to appear smeared. By comparing the perceived motion smear during ongoing eye movements and fixation, previous studies indicated that smear is reduced by a neural compensation mechanism that uses "extra-retinal information" about eye movements. However, it is not clear whether eye-muscle proprioception (afferent input), internal copies of efferent oculomotor commands (efference copy), or both contribute to the smear reduction. The present study found that similar reductions of perceived motion smear occur during passive eye movement (which is signaled only by eye-muscle proprioception) and during active pursuit tracking (for which efference copy signals exist as well). These results reveal a novel neural contribution for maintaining visual clarity and stand in contrast to previous reports that eye-muscle proprioception makes only a minor contribution to visual perception.