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Clinical and ocular motor analysis of the infantile nystagmus syndrome in the first 6 months of life

¹ Laboratory of Sensorimotor Research, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
² Department Of Ophthalmology, Washington Hospital Center, Washington, DC, USA
³ Department of Ophthalmology, National Children's Medical Center, Washington, DC, USA

Correspondence to:
Correspondence to:
Richard W Hertle, MD, Pediatric Ophthalmology, Columbus Children's Hospital, 555 South 18th Street, Suite 4C, Columbus, OH 43205, USA;
hertler{at}chi.osu.edu

Background/aims: The infantile nystagmus syndrome (INS) usually begins in infancy and may or may not be associated with visual sensory system abnormalities. Little is known about its specific waveforms in the first 6 months of life or their relation to the developing visual system. This study identifies the clinical and ocular motility characteristics of the INS and establishes the range of waveforms present in the first 6 months of life.

Methods: 27 infants with involuntary ocular oscillations typical of INS are included in this analysis. They were evaluated both clinically and with motility recordings. Eye movement analysis was performed off line from computer analysis of digitised data. Variables analysed included age, sex, vision, ocular abnormalities, head position, and null zone, neutral zone characteristics, symmetry, conjugacy, waveforms, frequencies, and foveation times.

Results: Ages ranged from 3 to 6.5 months (average 4.9 months). 15 patients (56%) had abnormal vision for age, nine (33%) had strabismus, five (19%) had an anomalous head posture, 13 (48%) had oculographic null and neutral positions, nine (33%) had binocular asymmetry, and only two showed consistent dysconjugacy. Average binocular frequency was 3.3 Hz, monocular frequency 6.6 Hz. Average foveation periods were longer and more "jerk" wave forms were observed in those patients with normal vision.

Conclusions: Common clinical characteristics and eye movement waveforms of INS begin in the first few months of infancy and waveform analysis at this time may help with both diagnosis and visual status.

Keywords: infantile nystagmus; eye movements

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