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I noticed that my baby’s
eyes are wobbly. What do you call this condition? Will this disappear as he
grows older?
The term nystagmus is used
to describe an involuntary rhythmic movement or oscillations of the eye. These
movements can be characterized as either pendular or jerky. The pendular type
is present when the movements have equal velocity in each direction. On the
other hand, jerk nystagmus is present when a fast eye movement is seen in one
direction and a slow movement in the opposite direction. Nystagmus may also be
characterized as horizontal, vertical or rotatory. In most cases there is a
position of gaze where the nystagmus diminishes and this is referred to as the
null point. Patients with nystagmus often adopt a compensatory face turn to
maintain the eyes at the null point, thereby improving visual acuity. Patients
with nystagmus should be referred to an ophthalmologist for a full eye
evaluation.
It is helpful to classify
nystagmus as either congenital or acquired. It is important to recognize
acquired nystagmus, as it may be a sign of significant central nervous system
disease.
Congenital nystagmus
As the name implies, the
onset of congenital nystagmus is early, usually by 6-8 weeks of life.
Because of this early onset,
the brain is able to suppress the motion. Therefore these babies do not
perceive oscillopsia or the cyclic motion associated with nystagmus. There are
2 basic subtypes of congenital nystagmus: congenital motor, and sensory.
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Congenital Motor
Congenital motor nystagmus
is usually presents in both eyes and symmetric. It occurs during the first
month of life and is often inherited as an x-linked trait. The compensatory
face turn used to minimize the nystagmus is usually established by 2-4 months
of age. These children have relatively good visual potential (usually around
20/50 or better), particularly when face turning is used by the
patient. However, face turning produces physical as well as social
discomfort. Is there something that can be done about the face turn? There
are several surgical procedures that can be done to move the attachments of
the eye muscles to shift the null point to primary gaze. However, the long
term results of this surgery is variable, as many patients readopt the
abnormal head posture after surgery.
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Sensory
Sensory nystagmus is due
to the lack of the fixation reflex secondary to neonatal blindness. Any
disease that results in bilateral neonatal blindness such as congenital
cataracts, corneal opacities, congenital optic nerve atrophy or hypoplasia,
and congenital retinal disorders, can cause this form of congenital
nystagmus. The pattern of sensory nystagmus is usually indistinguishable from
congenital motor nystagmus, except that the nystagmus has a larger amplitude
and the movements show poor fixation with a searching character. The onset is
later than congenital motor, usually occurring after 6-8 weeks of life.
Patients with sensory nystagmus rarely adopt a compensatory face turn.
Acquired Nystagmus
Nystagmus acquired in
infancy, may be a sign of a serious neurological condition, and therefore
warrants a neurology consult. Neurologic disease involving the any part of the
brain can cause nystagmus. In contrast to congenital, acquired nystagmus is
often associated with the perception of the environment moving, or oscillopsia.
Oscillopsia, therefore, is an important indication that the nystagmus is
acquired. Only patients with acquired nystagmus will experience oscillopsia; as
these patients do not have the plasticity to suppress the shaking image.
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EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
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EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
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(632) 771-9253
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EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
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Mobile: (63917) 537-2020
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EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
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CLINIC HOURS
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All clinics are closed on Sundays and Holidays
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NYSTAGMUS information compiled by
Dr. Barbara L. Roque
and initially uploaded on May 1, 2005.
Last updated on
September 13, 2007. |
