For normally sighted observers, the centre of the macula—the fovea—provides the sharpest vision and serves as the reference point for the oculomotor system. Typically, healthy observers have precise oculomotor control and binocular visual performance that is superior to monocular performance. These functions are disturbed in patients with macular disease who lose foveal vision. An adaptation to central vision loss is the development of a preferred retinal locus (PRL) in the functional eccentric retina, which is determined with a fixation task during monocular viewing. Macular disease often affects the two eyes unequally, but its impact on binocular function and fixational control is poorly understood. Given that patients’ natural viewing condition is binocular, the aim of this article was to review current research on binocular visual function and fixational oculomotor control in macular disease. Our findings reveal that there is no overall binocular gain across a range of visual functions, although clear evidence exists for subgroups of patients who exhibit binocular summation or binocular inhibition, depending on the clinical characteristics of their two eyes. The monocular PRL of the better eye has different characteristics from that of the worse eye, but during binocular viewing the PRL of the better eye drives fixational control and may serve as the new reference position for the oculomotor system. We conclude that evaluating binocular function in patients with macular disease reveals important clinical aspects that otherwise cannot be determined solely from examining monocular functions, and can lead to better disease management and interventions.

中文翻译：

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黄斑病患者的双眼视觉功能和注视控制：综述

对于正常视力的观察者来说，黄斑中心——中央凹——提供最清晰的视野，并作为动眼神经系统的参考点。通常，健康的观察者具有精确的动眼神经控制和优于单眼性能的双眼视觉性能。这些功能在失去中心凹视力的黄斑病患者中受到干扰。对中心视力丧失的适应是在功能性偏心视网膜中形成首选视网膜轨迹 (PRL)，这是在单眼观察期间通过固定任务确定的。黄斑疾病常常对两只眼睛造成不均等的影响，但它对双眼功能和注视控制的影响却知之甚少。鉴于患者的自然观察条件是双眼，本文的目的是回顾目前关于黄斑病双眼视觉功能和注视性动眼神经控制的研究。我们的研究结果表明，在一系列视觉功能中没有整体双眼增益，尽管存在明显证据表明表现出双眼总和或双眼抑制的患者亚组，这取决于他们两只眼睛的临床特征。较好眼的单眼 PRL 与较差眼的具有不同的特征，但在双眼观察期间，较好眼的 PRL 驱动注视控制并可能作为动眼神经系统的新参考位置。我们得出结论，评估黄斑病患者的双眼功能揭示了重要的临床方面，否则这些方面不能仅通过检查单眼功能来确定，