Which clinical history findings are characteristic of congenital nystagmus?

Updated: Oct 08, 2019
  • Author: Mark Ventocilla, OD, FAAO; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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There is often a known family history of this disorder. The pattern of heredity is usually sex-linked, with dominant being more common.

Establishing the precise age of onset is helpful in differentiating between sensory deficit and idiopathic infantile forms. Spasmus nutans rarely is seen prior to age 4 months. Onset prior to age 2 months, particularly in the setting of gaze-associated variable intensity and torticollis, strongly suggests idiopathic infantile nystagmus.

Patients with infantile nystagmus due to albinism may have a positive family history and often appear photosensitive. A history of infantile strabismus increases the likelihood of latent or manifest latent nystagmus.

A history of abnormal head movements (bobbing or nodding) or torticollis raises the possibility of spasmus nutans.

CNS disease can produce many other forms of nystagmus and always must be considered. A history of failure to thrive or other evidence of neurologic dysfunction should prompt immediate investigation.

Older children and adults with a history of infantile nystagmus typically deny oscillopsia but frequently may have signs and symptoms of accommodative dysfunction. These signs and symptoms include asthenopia, headaches, avoidance of near tasks, tearing, and blurry vision.

Both idiopathic infantile nystagmus and many forms of sensory deficit nystagmus have a familial pattern. X-linked, autosomal dominant, and autosomal recessive modes of inheritance have been reported.

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