A simplified approach to diagnosing and managing infantile nystagmus syndrome

Abstract

Infantile nystagmus syndrome usually presents around 3–6 months of age, is usually horizontal across gazes and is often characterised by the presence of a null zone. If the null zone does not coincide with the primary position, patients adopt a face turn to optimise their visual acuity. This is utilised to our advantage in nystagmus surgeries that aim to make the null zone coincide with the primary position. However, for this to be successful, a careful evaluation has to be performed to weed out neurological causes of nystagmus and nystagmoid movements. The article aimed to give some tips to ophthalmologists for a comprehensive nystagmus evaluation. It also discusses the broad principles of nystagmus surgeries, viz the Kestenbaum–Anderson procedure, artificial divergence, tenotomy and reattachment and retroequatorial recession. An overview of potential complications is also presented.