What is the role of strabismus surgery in the treatment of congenital nystagmus?

Updated: Oct 08, 2019
  • Author: Mark Ventocilla, OD, FAAO; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

Strabismus surgery is used in patients with certain forms of nystagmus with varying degrees of success.

Anderson or Kestenbaum procedures are used to move the eyes into the null zone to diminish an anomalous head position in the setting of idiopathic infantile nystagmus.

Recession or simple tenotomy of all 4 horizontal rectus muscles has been advocated; however, preliminary results have been mixed. A pilot study has been completed that showed some improvement, but the definitive study is still pending. [8]

Surgery occasionally is used in the treatment of superior oblique myokymia.

Hertle et al conducted a prospective interventional case study to determine the effects of early eye muscle surgery on 19 patients younger than 24 months who had infantile nystagmus syndrome. [9] Outcome measures included acuity, head position, strabismic deviation, and eye movement recordings, including waveform types and a nystagmus optimal foveation fraction (NOFF). Improvements were noted in all outcomes measured. Hertle et al concluded that early eye muscle surgery in patients with oculographically infantile nystagmus syndrome improves the oscillation and visual functions. Increases in foveation periods and the NOFF were measureable.


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