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A conjugate eye movement is a movement of both eyes in the same direction to maintain binocular gaze (also referred to as “yoked” eye movement). This is in contrast to vergence eye movement, where binocular gaze is maintained by moving eyes in opposite directions, such as going “cross eyed” to view an object moving towards the face.
The conjugate gaze is the motion of both eyes in the same direction at the same time, and conjugate gaze palsy refers to an impairment of this function. The conjugate gaze is controlled by four different mechanisms: [4] the saccadic system that allows for voluntary direction of the gaze; the pursuit system that allows the subject to follow a ...
Conjugate gaze palsies are neurological disorders affecting the ability to move both eyes in the same direction. These palsies can affect gaze in a horizontal, upward, or downward direction. [ 1 ] These entities overlap with ophthalmoparesis and ophthalmoplegia .
An alternative anatomical cause is a lesion of the abducens nucleus (VI) on one side (resulting in a failure of abduction of the ipsilateral eye and adduction of the contralateral eye = conjugate gaze palsy towards affected side), with interruption of the ipsilateral medial longitudinal fasciculus after it has crossed the midline from its site ...
A horizontal gaze palsy is a subtype of gaze palsy in which conjugate, horizontal eye movements are limited by neurologic deficits. Horizontal gaze palsies typically result from an ipsilateral pontine lesion or a contralateral frontal lobe lesion.
Intermediate directions are controlled by simultaneous actions of multiple muscles. When one shifts the gaze horizontally, one eye will move laterally (toward the side) and the other will move medially (toward the midline). This may be neurally coordinated by the central nervous system, to make the eyes move together and almost involuntarily.
With the abducens nucleus it makes up the horizontal gaze centre. [1] It is situated in the pons adjacent to the abducens nucleus . [ 2 ] It projects to the ipsilateral abducens (cranial nerve VI) nucleus, and contralateral oculomotor (cranial nerve III) nucleus [ note 1 ] to mediate conjugate horizontal gaze and saccades .
Paralysis of upwards gaze: Downward gaze is usually preserved. This vertical palsy is supranuclear, so doll's head maneuver should elevate the eyes, but eventually all upward gaze mechanisms fail. In the extreme form, conjugate down gaze in the primary position, or the "setting-sun sign" is observed.