Podcast
Questions and Answers
What is the typical presentation of congenital idiopathic nystagmus (CIN)?
What is the typical presentation of congenital idiopathic nystagmus (CIN)?
- It is associated with large roving eye movements. (correct)
- It presents primarily with vertical eye movements.
- It is usually detected later in life.
- It is characterized by decreasing intensity over time.
Which of the following is associated with manifest latent nystagmus (MLN)?
Which of the following is associated with manifest latent nystagmus (MLN)?
- It remains stable regardless of eye occlusion.
- It worsens when one eye is covered. (correct)
- It is only present in one eye.
- It is caused by intrinsic ocular pathology.
What is a key characteristic of acquired nystagmus?
What is a key characteristic of acquired nystagmus?
- It is primarily due to genetic factors.
- It is usually linked with known intracranial pathology. (correct)
- It does not cause oscillopsia.
- It presents with a long-term history.
How may the waveform of congenital nystagmus change during infancy?
How may the waveform of congenital nystagmus change during infancy?
What is the most likely management approach for congenital nystagmus in childhood?
What is the most likely management approach for congenital nystagmus in childhood?
What condition may be associated with head nodding in patients with congenital nystagmus?
What condition may be associated with head nodding in patients with congenital nystagmus?
What is oscillopsia and how does it relate to congenital nystagmus?
What is oscillopsia and how does it relate to congenital nystagmus?
Which statement is true about the frequency of nystagmus in congenital cases?
Which statement is true about the frequency of nystagmus in congenital cases?
Which type of nystagmus is characterized by rapid back-to-back saccades?
Which type of nystagmus is characterized by rapid back-to-back saccades?
What anatomical feature is commonly unchanged in patients with congenital nystagmus?
What anatomical feature is commonly unchanged in patients with congenital nystagmus?
What characterizes jerk nystagmus?
What characterizes jerk nystagmus?
Which type of nystagmus only becomes apparent when one eye is covered?
Which type of nystagmus only becomes apparent when one eye is covered?
What is the primary cause of congenital nystagmus?
What is the primary cause of congenital nystagmus?
What does the null zone refer to in nystagmus?
What does the null zone refer to in nystagmus?
Which of the following describes the amplitude of nystagmus?
Which of the following describes the amplitude of nystagmus?
Vestibular nystagmus is triggered by what type of event?
Vestibular nystagmus is triggered by what type of event?
Which of the following is NOT a characteristic of physiological nystagmus?
Which of the following is NOT a characteristic of physiological nystagmus?
What is the primary distinction between pendular and jerk nystagmus?
What is the primary distinction between pendular and jerk nystagmus?
Which condition is least likely to cause acquired nystagmus?
Which condition is least likely to cause acquired nystagmus?
What is the intent of measuring both the frequency and amplitude of nystagmus?
What is the intent of measuring both the frequency and amplitude of nystagmus?
Study Notes
Overview of Nystagmus
- Rhythmic oscillation of one or both eyes, which can be physiological or pathological.
- Variants include horizontal, vertical, torsional, or mixed forms.
- Can be congenital (present at birth) or acquired (develops later).
- Manifest nystagmus is visible with both eyes open but may increase when one eye is covered; latent nystagmus only appears when one eye is covered.
Prevalence and Impact
- Occurs in approximately 1 in 1,000 individuals.
- A significant cause of visual impairment in children.
Types of Nystagmus
Physiological Nystagmus
- Includes opto-kinetic nystagmus (responds to moving scenes), vestibular nystagmus (head rotation response), end point nystagmus (notable in extreme lateral gaze), and voluntary nystagmus (observed in about 5% of the population).
Pathological Nystagmus
- Congenital or early onset can be idiopathic or secondary to conditions like albinism and retinal dystrophies.
- Acquired nystagmus is often linked to neurological issues, including intra-cranial lesions and drug toxicity.
Waveforms in Nystagmus
- Nystagmus can be classified into two primary waveforms: jerk (fast phase followed by a slow phase) and pendular (smooth oscillation without a distinct fast phase).
- Waveform characteristics can vary in gaze direction and may be complex, exhibiting combinations of jerk and pendular movements.
Key Terminology
- Amplitude refers to the 'excursion' of the nystagmus measured in degrees or arc minutes.
- Frequency is the number of oscillations per minute, classified as coarse, medium, or fine.
- Intensity is defined as frequency multiplied by amplitude.
Features of Congenital Nystagmus
- Typically manifests from age 2 to 6 months.
- Two main forms: sensory deficit nystagmus (SDN) linked to ocular anomalies affecting vision) and congenital idiopathic nystagmus (CIN) involving motor pathway anomalies.
- Diagnosing requires careful examination and may need electrodiagnostic tests due to potential misdiagnosis.
Presentation and Symptoms
- Congenital nystagmus often presents as horizontal eye movements, may be associated with strabismus, and increases during fixation, stress, or fatigue.
- Oscillopsia (awareness of eye wobbling) is generally not experienced in congenital nystagmus but can occur in fatigue or darkness.
Manifest Latent Nystagmus (MLN)
- A separate diagnosis from congenital nystagmus, often linked to early onset strabismus.
- Worsens when one eye is occluded, typically detected around 2 years of age.
Acquired Nystagmus
- Distinct clinical features compared to congenital nystagmus, often indicating intracranial pathology (e.g., multiple sclerosis, tumors, head trauma).
- Accompanied by oscillopsia, suggesting a known onset of symptoms.
Voluntary Nystagmus
- Psychogenic in origin, exhibits rapid saccades and potential head nodding.
- Confirmatory eye movement recordings are necessary for diagnosis.
Management Strategies
- Effective management of congenital nystagmus includes correcting even small refractive errors and monitoring visual acuity with binocular assessments.
- Referring to an ophthalmologist for further evaluation is crucial, especially for pedagogical implications in children.
- Surgical options may involve repositioning extraocular muscles to align the null zone with the primary gaze.
Treatment Options
- Prisms can aid in moving the visual environment to the null point or reduce nystagmus through forced convergence.
- The effectiveness of treatment may be limited if compensatory head posture (CHP) is present.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
