Nystagmus in Infancy

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Questions and Answers

Which characteristic of nystagmus indicates how much eye movement occurs?

Amplitude (correct)

Direction

Frequency

Waveform

What does the 'null point' refer to in nystagmus?

The frequency of eye movement cycles

The intensity of the fast phase

The position of greatest oscillation

The position of gaze with minimal intensity (correct)

Which type of nystagmus is characterized by eye movements that are equal and simultaneous?

Conjugate (correct)

Pendular

Jerk

Disconjugate

What does foveation in the context of nystagmus specifically allow for?

Slower eye movements for clearer vision Signup and view all the answers

In nystagmus, what defines the 'fast phase'?

The direction of the quicker eye movement Signup and view all the answers

Which of the following describes the visual impact of nystagmus on a normal eye?

Eyes are always moving, impairing vision Signup and view all the answers

What is typically observed in Congenital Motor Nystagmus regarding the waveform?

It can vary but is typically either pendular or jerky Signup and view all the answers

Which of the following conditions is associated with Latent Nystagmus?

Congenital esotropia Signup and view all the answers

What defines Sensory Nystagmus?

Linked to vision worse than 20/200 Signup and view all the answers

Which of the following is NOT a characteristic of Spasmus Nutans?

High amplitude, low frequency Signup and view all the answers

What does a null point in nystagmus refer to?

A fixation point that minimizes nystagmus Signup and view all the answers

Which treatment is specifically used when convergence dampens nystagmus significantly?

Yoked prism for eccentric null point Signup and view all the answers

What type of nystagmus is found in patients with Down syndrome?

Latent Nystagmus Signup and view all the answers

Which type of nystagmus requires neurologic evaluation when acquired?

Pathologic Nystagmus Signup and view all the answers

Which of the following is a common cause of Sensory Nystagmus?

Cataracts Signup and view all the answers

What visual acuity range is typical in individuals with Congenital Motor Nystagmus?

20/40 to 20/80 Signup and view all the answers

Study Notes

Definition and Characteristics of Nystagmus

Nystagmus is characterized by involuntary, rhythmic eye oscillations disrupting steady fixation and affecting visual acuity.
Normal eye appearance, but constant movement results in poor vision.
Key parameters include:
- Direction: fast phase orientation (horizontal, vertical, cyclorotary)
- Amplitude: size of oscillation
- Frequency: number of cycles per second
- Intensity: product of amplitude and frequency
- Waveform types: jerk, pendular, complex
- Conjugacy: can be conjugate (associated) or disconjugate (dissociated)
- Null point: position where nystagmus intensity is minimal; induces compensatory head posture.
- Foveation: slow eye movements allowing for better visual acuity.

Congenital Motor Nystagmus

Onset occurs within the first six months of life, can be sporadic or autosomal dominant.
Usually presents as purely horizontal in all gaze positions, and vision often remains relatively good without oscillopsia.
Waveform can be pendular or jerk, with dampening upon convergence.
Patients may develop a null point, leading to compensatory head turns.
Visual acuity typically ranges from 20/40 to 20/80, depending on intensity and frequency.

Funblocs and Latent Nystagmus

Funblocs involve factors like worsening fixation and maintaining horizontal gaze, often requiring subtle head movements.
Latent nystagmus typically occurs in cases of congenital esotropia or early vision loss; it manifests more clearly when one eye is occluded.

Sensory Nystagmus

Occurs due to severely impaired vision (worse than 20/200), often presents as a pendular pattern but can be jerky.
Associated with various conditions: cataracts, corneal opacity, chorioretinal coloboma, retinopathy of prematurity (ROP), aniridia, optic nerve hypoplasia, albinism, and cone dysfunction.

Pathologic Nystagmus

Acquired nystagmus in children should prompt neurological evaluation to rule out underlying issues.

Causes of Sensory Nystagmus

Common etiological factors include congenital cataracts, corneal opacity, aniridia, Leber's congenital amaurosis, optic atrophy, achromatopsia, and ROP.

Types of Nystagmus

Spasmus Nutans:
- Occurs after six months of age and typically resolves by ages four to five.
- Features include pendular nystagmus, head nodding, and torticollis.
- Presents as disconjugate and can be mistaken for monocular involvement, with a low amplitude and high frequency, described as "shimmering."
- Considered benign but requires ruling out all pathologic causes.

Treatment Options for Nystagmus

Optical Treatment:
- Base-out (BO) prisms utilized if convergence dampens nystagmus significantly.
- Yoked prisms can assist with eccentric null points.
- Contact lenses may be prescribed.
Surgical Treatment:
- Anderson-Kestenbaum procedure and Cuppers artificial divergence procedure.
- Large recessions of the horizontal rectus muscles are implemented.
- Hertle-Del’Osso procedure for additional corrective measures.
Pharmacological Treatment:
- Botulinum toxin injections are considered for management in specific cases.

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Description

This quiz explores nystagmus, a condition characterized by involuntary, rhythmic oscillation of the eyes, particularly as it presents in infancy. Understand the implications for visual acuity and diagnosis, as well as the differences between normal eye movement and nystagmus. Gain insights into how this condition affects infants and the speed of eye movements.