Purpose.: To investigate whether binocular information provides benefits for programming and guidance of reach-to-grasp movements in normal children and whether these eye–hand coordination skills are impaired in children with amblyopia and abnormal binocularity. Methods.: Reach-to-grasp performance of the preferred hand in binocular versus monocular (dominant or nondominant eye occluded) conditions to different objects (two sizes, three locations, and two to three repetitions) was quantified by using a 3D motion-capture system. The participants were 36 children (age, 5–11 years) and 11 adults who were normally sighted and 21 children (age, 4–8 years) who had strabismus and/or anisometropia. Movement kinematics and error rates were compared for each viewing condition within and between subject groups. Results.: The youngest control subjects used a mainly programmed (ballistic) strategy and collided with the objects more often when viewing with only one eye, while older children progressively incorporated visual feedback to guide their reach and, eventually, their grasp, resulting in binocular advantages for both movement components resembling those of adult performance. Amblyopic children were the worst performers under all viewing conditions, even when using the dominant eye. They spent almost twice as long in the final approach to the objects and made many (1.5–3 times) more errors in reach direction and grip positioning than their normal counterparts, these impairments being most marked in those with the poorest binocularity, regardless of the severity or cause of their amblyopia. Conclusions.: The importance of binocular vision for eye–hand coordination normally increases with age and use of online movement guidance. Restoring binocularity in children with amblyopia may improve their poor hand action control.

Purpose. To examine factors contributing to eye–hand coordination deficits in children with amblyopia and impaired stereovision. Methods. Participants were 55 anisometropic or strabismic children aged 5.0 to 9.25 years with different degrees of amblyopia and abnormal binocularity, along with 28 age-matched visually-normal controls. Pilot data were obtained from four additional patients studied longitudinally at different treatment stages. Movements of the preferred hand were recorded using a 3D motion-capture system while subjects reached-to-precision grasp objects (two sizes, three locations) under binocular, dominant eye, and amblyopic/nonsighting eye conditions. Kinematic and “error” performance measures were quantified and compared by viewing condition and subject group using ANOVA, stepwise regression, and correlation analyses. Results. Movements of the younger amblyopes (age 5–6 years; n = 30) were much slower, particularly in the final approach to the objects, and contained more spatial errors in reaching (∼×1.25–1.75) and grasping (∼×1.75–2.25) under all three views (P < 0.05) than their age-matched controls (n = 13). Amblyopia severity was the main contributor to their slower movements with absent stereovision a secondary factor and the unique determinant of their increased error-rates. Older amblyopes (age 7–9 years; n = 25) spent longer contacting the objects before lifting them (P = 0.015) compared with their matched controls (n = 15), with absence of stereovision still solely related to increases in reach and grasp errors, although these occurred less frequently than in younger patients. Pilot prospective data supported these findings by showing positive treatment-related associations between improved stereovision and reach-to-grasp performance. Conclusions. Strategies that children with amblyopia and abnormal binocularity use for reach-to-precision grasping change with age, from emphasis on visual feedback during the “in-flight” approach at ages 5 to 6 years to more reliance on tactile/kinesthetic feedback from object contact at ages 7 to 9 years. However, recovery of binocularity confers increasing benefits for eye–hand coordination speed and accuracy with age, and is a better predictor of these fundamental performance measures than the degree of visual acuity loss.

Objective: To determine the diagnostic agreement of non‐cycloplegic and cycloplegic refraction in children. Method: The study methodology followed Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Electronic databases were searched for comparative studies exploring refraction performed on children under non‐cycloplegic and cycloplegic conditions. There was no restriction on the year of publication; however, only publications in the English language were eligible. Inclusion criteria consisted of children aged ≤12 years, any degree or type of refractive error, either sex and no ocular or binocular co‐morbidities. The QUADAS‐2 tool was used to evaluate the risk of bias. Meta‐analysis was conducted to synthesise data from all included studies. Subgroup and sensitivity analyses were undertaken for those studies with a risk of bias. Results: Ten studies consisting of 2724 participants were eligible and included in the meta‐analysis. The test for overall effect was not significant when comparing non‐cycloplegic Plusoptix and cycloplegic autorefractors ( Z = 0.34, p = 0.74). The pooled mean difference (MD) was −0.08 D (95% CI −0.54 D, +0.38 D) with a prediction interval of −1.72 D to +1.56 D. At less than 0.25 D, this indicates marginal overestimation of myopia and underestimation of hyperopia under non‐cycloplegic conditions. When comparing non‐cycloplegic autorefraction with a Retinomax and Canon autorefractor to cycloplegic refraction, a significant difference was found ( Z = 9.79, p < 0.001) and ( Z = 4.61, p < 0.001), respectively. Discussion: Non‐cycloplegic Plusoptix is the most useful autorefractor for estimating refractive error in young children with low to moderate levels of hyperopia. Results also suggest that cycloplegic refraction must remain the test of choice when measuring refractive error ≤12 years of age. There were insufficient data to explore possible reasons for heterogeneity. Further research is needed to investigate the agreement between non‐cycloplegic and cycloplegic refraction in relation to the type and level of refractive error at different ages.

Visual evoked potentials (VEPs) may be analyzed by examination of the morphology of their components, such as negative (N) and positive (P) peaks. However, methods that rely on component identification may be unreliable when dealing with responses of complex and variable morphology; therefore, objective methods are also useful. One potentially useful measure of the VEP is the correlation dimension. Its relevance to the visual system was investigated by examining its behavior when applied to the transient VEP in response to a range of chromatic contrasts (42%, two times psychophysical threshold, at psychophysical threshold) and to the visually unevoked response (zero contrast). Tests of nonlinearity (e.g., surrogate testing) were conducted. The correlation dimension was found to be negatively correlated with a stimulus property (chromatic contrast) and a known linear measure (the Fourier-derived VEP amplitude). It was also found to be related to visibility and perception of the stimulus such that the dimension reached a maximum for most of the participants at psychophysical threshold. The latter suggests that the correlation dimension may be useful as a diagnostic parameter to estimate psychophysical threshold and may find application in the objective screening and monitoring of congenital and acquired color vision deficiencies, with or without associated disease processes.