Neural motor ocular strategies associated with the development of a pseudofovea following laser induced macular damage and artificial macular occlusion. Is the fovea replaceable?

Loss of visual acuity following acute photic injury and subsequent recovery is well known. The mechanisms that underlie foveal neural plasticity were assessed in this study. In two patients that recovered to 20/15 Snellen visual acuity following accidental induced foveal damage, contrast sensitivity measurements made under ophthalmoscopic visualization of the retina revealed a preferred retinal location that was superior and temporal to the damaged fovea. This area was used especially for smaller contrast sensitivity targets requiring foveal resolution. Similar preferred retinal location sites were obtained in similar investigations using a Purkinje Eye-Tracker to simulate a small central scotoma. Measures of ocular accommodation obtained in these experiments suggest that a central scotoma may induce an accommodative shift as the oculomotor system shifts to a new PRL for smaller targets that require foveal resolution.