I. Signs and symptoms of congenital nystagmus.
1, The most prominent clinical features are: early onset, involuntary and continuous beating or oscillation of the eyeballs.
2. Amblyopia: Amblyopia is common in patients with congenital nystagmus, and it is mostly binocular and more severe. If there are no comorbidities such as strabismus or refractive error, the degree of amblyopia in both eyes is mostly similar. The visual function of patients with congenital nystagmus, in addition to reduced visual acuity on the visual acuity chart, also has reduced sensitivity to figures and motion. However, color vision is generally normal.
Abnormal head position: 66.2% of patients with congenital nystagmus have an abnormal head position, often manifesting as a face turned to one side, with the jaw raised or tilted inward or with the head tilted to one side of the shoulder.
4. Head shaking: Some patients with congenital nystagmus also shake their heads involuntarily.
Diagnosis
To distinguish congenital nystagmus or non-congenital nystagmus, there must be clear diagnostic criteria. According to the existing diagnostic techniques, the following criteria are generally stipulated.
1.Early onset of nystagmus, which occurs since childhood.
2.No sense of wobbly vision: i.e., no sense of wobbly vision, even if the nystagmus is quite severe.
3.No obstruction of eye rotation: no restriction of movement.
4.No balance disorders, vertigo and other central nervous system disorders and vestibular dysfunction symptoms.
Treatment
1.Non-surgical treatment
Pharmacological treatment of congenital nystagmus has not been widely or formally adopted in clinical practice. The main non-surgical therapies are
(1) Wearing refractive correction glasses and amblyopia training to improve visual acuity.
(2) Wearing trigeminal lenses to eliminate abnormal head position.
2.Surgical treatment
There are two main types of surgery for congenital nystagmus.
(1) Intermediate band transposition, which is suitable for patients with abnormal head position. The surgery not only eliminates the abnormal head position and significantly improves the appearance, but also improves the patient’s visual acuity in the frontal view.
(2) For patients with congenital nystagmus without abnormal head position, an extraocular muscle proprioceptor resection can be performed to reduce nystagmus and enhance the patient’s fixation ability, thus helping to improve visual acuity.