eMedicine Specialties > Ophthalmology > Extraocular Muscles

Nystagmus, Congenital: Follow-up

Author: Theodore Curtis, MD, Assistant Professor, Department of Ophthalmology, University of Colorado; Consulting Staff, Rocky Mountain Lions Eye Institute
Coauthor(s): David T Wheeler, MD, Associate Professor, Departments of Ophthalmology and Pediatrics, Oregon Health & Science University
Contributor Information and Disclosures

Updated: Oct 13, 2006

Follow-up

Complications

  • Strabismus surgery carries anesthesia risks, as well as the risk of vision loss. This consideration becomes more important when potential benefits are less certain.
  • Alternative therapy is probably harmless at worst but should not delay diagnosis or treatment of an underlying disorder.

Prognosis

  • Nystagmus intensity (frequency x amplitude) often improves spontaneously with increasing age but depends on etiology.

Miscellaneous

Medicolegal Pitfalls

  • Patients with chiasmal gliomas can present with nystagmus identical to that seen in spasmus nutans. Consideration should be given to neuroimaging in these patients.
  • Sensory deprivation nystagmus can be associated with CNS disease that extends beyond the retina or optic nerve. Lesions affecting the visual pathways or occipital cortex may only be discovered with neuroimaging.
  • Diffuse CNS disease as well as that specific to the brainstem and other areas rarely causes nystagmus in infants. Consultation with a pediatric neurologist may be indicated, especially if nystagmus has atypical features.
 


More on Nystagmus, Congenital

Overview: Nystagmus, Congenital
Differential Diagnoses & Workup: Nystagmus, Congenital
Treatment & Medication: Nystagmus, Congenital
Follow-up: Nystagmus, Congenital
References
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References

  1. Arnoldi KA, Tychsen L. Prevalence of intracranial lesions in children initially diagnosed with disconjugate nystagmus (spasmus nutans) [published erratum appears in J Pediatr Ophthalmol Strabismus 1995 Nov- Dec;32(6):347]. J Pediatr Ophthalmol Strabismus. Sep-Oct 1995;32(5):296-301. [Medline].

  2. Cabot A, Rozet JM, Gerber S, et al. A gene for X-linked idiopathic congenital nystagmus (NYS1) maps to chromosome Xp11.4-p11.3. Am J Hum Genet. Apr 1999;64(4):1141-6. [Medline].

  3. Golubovic S, Marjanovic S, Cvetkovic D, Manic S. The application of hard contact lenses in patients with congenital nystagmus. Fortschr Ophthalmol. 1989;86(5):535-9. [Medline].

  4. Harris C, Berry D. A developmental model of infantile nystagmus. Semin Ophthalmol. 2006;21:63-9. [Medline].

  5. Helveston EM, Ellis FD, Plager DA. Large recession of the horizontal recti for treatment of nystagmus. Ophthalmology. Aug 1991;98(8):1302-5. [Medline].

  6. Hertle RW, Zhu X. Oculographic and clinical characterization of thirty-seven children with anomalous head postures, nystagmus, and strabismus: the basis of a clinical algorithm. J AAPOS. Feb 2000;4(1):25-32. [Medline].

  7. Hertle RW, Dell'Osso LF, FitzGibbon EJ. Horizontal rectus muscle tenotomy in children with infantile nystagmus syndrome: a pilot study. J AAPOS. Dec 2004;8(6):539-48. [Medline].

  8. Lennerstrand G, Nordbo OA, Tian S, et al. Treatment of strabismus and nystagmus with botulinum toxin type A. An evaluation of effects and complications. Acta Ophthalmol Scand. Feb 1998;76(1):27-7. [Medline].

  9. Mezawa M, Ishikawa S, Ukai K. Changes in waveform of congenital nystagmus associated with biofeedback treatment. Br J Ophthalmol. Aug 1990;74(8):472-6. [Medline].

  10. Miura K, Hertle RW, FitzGibbon EJ. Effects of tenotomy surgery on congenital nystagmus waveforms in adult patients. Part II. Dynamical systems analysis. Vision Res. Oct 2003;43(22):2357-62. [Medline].

  11. Pratt-Johnson JA. Results of surgery to modify the null-zone position in congenital nystagmus. Can J Ophthalmol. Jun 1991;26(4):219-23. [Medline].

  12. Reinecke RD. Costenbader Lecture. Idiopathic infantile nystagmus: diagnosis and treatment. J AAPOS. Jun 1997;1(2):67-82. [Medline].

  13. Sarvananthan N, Proudlock FA, Choudhuri I. Pharmacologic treatment of congenital nystagmus. Arch Ophthalmol. 2006;124:916-8. [Medline].

  14. Sprunger DT, Wasserman BN, Stidham DB. The relationship between nystagmus and surgical outcome in congenital esotropia. J AAPOS. Feb 2000;4(1):21-4. [Medline].

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Further Reading

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Keywords

congenital nystagmus, infantile nystagmus

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Contributor Information and Disclosures

Author

Theodore Curtis, MD, Assistant Professor, Department of Ophthalmology, University of Colorado; Consulting Staff, Rocky Mountain Lions Eye Institute
Theodore Curtis, MD is a member of the following medical societies: American Academy of Ophthalmology and American Association for Pediatric Ophthalmology and Strabismus
Disclosure: Nothing to disclose.

Coauthor(s)

David T Wheeler, MD, Associate Professor, Departments of Ophthalmology and Pediatrics, Oregon Health & Science University
David T Wheeler, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Michael J Bartiss, OD, MD, Medical Director, Ophthalmology, Family Eye Care of the Carolinas
Michael J Bartiss, OD, MD is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, American College of Surgeons, and North Carolina Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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