Surgical Treatment of Congenital Nystagmus

ABSTRACT

Congenital nystagmus is an involuntary, rhythmic oscillation of the eyes noted during the first months of life. The nystagmus may diminish in a particular pasition of gaze referred to as the null point or neutral zone. If the null point is located in the primary position, there is no need for a compensatory head posture, But, if a patient has an eccentric null point, torticollis occurs in which the head is rotated so that the eyes have a minimal nystagmus. This abnormal head posture can be very marked, cosmetically disturbing and disadvantageous both to the body posture and psyche. Attempts at surgical management were reported by Kestenbaum and Anderson in early 1950's. We obtained following results in 4 cases operated on utilizing similar procedures of Park's method and Dyer's principles of strabismus operations that recession of a medial rectus and lateral rectus muscle must not exceed 4.5mm - 5.5mm and 6.5mm - 7.5mm, respectively. One week after the operation, the head turn disappeared in 3 of 4 cases, and one revealed mild residual turn. Two months after the operation, 2 of 4 cases kept their head straight, and the other two showed a return of head turn in about one half amount of the preoperative condition.