Is nystagmus just an eye problem? Hi, I’m Dr. Gang Yu, a pediatric ophthalmologist, and today I’m going to talk to you about what diseases can cause nystagmus. We believe that many diseases can cause nystagmus, including otogenic nystagmus, as well as nystagmus caused by the center of the brain. If a child develops nystagmus later in life, there should be a high suspicion of comorbidities with other systems, so nystagmus is not just a problem of the eyes! Such diseases should be treated as early as possible, to avoid delays! Nystagmus can be seen in children with viral or bacterial meningitis. This problem is very critical, after the child is born, if the mother found that there is nystagmus, do not wait until the child is older and then go to the hospital for examination, many children with congenital bilateral cataracts, early in the newborn, he is no nystagmus, when the child’s eyesight began to develop, the eyesight is extremely low, which will lead to nystagmus, if nystagmus occurs, to do the surgery to remove the cataracts, the eyesight is still very poor, but the child can not see, the eyesight is still very poor. If nystagmus occurs, after the cataract is removed, the visual acuity will still be very low. Therefore, the earlier the surgery, the better, and the early surgery can control the occurrence of nystagmus. After surgery, those without nystagmus will be able to achieve a visual acuity of 0.6 or even 0.8 or more. Summarize: Nystagmus can be caused by ear disease or intracranial disease, parents should pay great attention to it. Why does a child with cataracts develop nystagmus? This question is very critical, after the child was born, if the mother found the child’s eyes are not right, regardless of whether there is nystagmus, do not wait until the child is older and then go to the hospital for examination, a lot of congenital bilateral cataracts in the early days of the child was just born, he was no nystagmus, when the child’s eyesight began to develop, the visual acuity is extremely low, which will lead to nystagmus, and if the nystagmus, surgery is performed, the nystagmus is not a problem. If nystagmus occurs, after surgery to remove the cataract, the vision will still be very low, so the earlier the surgery, the better, early surgery will be able to control the occurrence of nystagmus, we found that congenital cataracts, if nystagmus occurs before the surgery, his visual acuity is often unable to reach more than 0.1, while no nystagmus congenital cataracts can reach 0.6, 0.6, 0.6, 0.6, 0.6 or 0.6 after the surgery after the later treatment. After the surgery without nystagmus, the visual acuity can reach 0.6 or even 0.8 or above. Summarize: Many children with congenital cataracts are found late and have nystagmus at the time of surgery. Even if they are operated on, it is very difficult to correct and restore their vision after the surgery. Is nystagmus hereditary? I have a lot of nystagmus moms’ groups, and the moms often ask: I have congenital nystagmus, and I would like to ask, what are the chances that if I have a child, the child will get this disease? We believe that congenital nystagmus is a disease with genetic predisposition, and the mode of inheritance includes X-linked, autosomal dominant, autosomal recessive and other modes of inheritance. Also certain ocular diseases or X-linked genetic disorders can manifest as congenital nystagmus, such as albinism and color blindness. Patients with disseminated nystagmus can be caused by mutations in the genes and can be passed on to their offspring in an autosomal dominant manner. Experts recommend that patients undergo genetic counseling before giving birth to maximize the likelihood of avoiding the reappearance of nystagmus in the next generation. I would like to give you a generalization, if both mom and dad have dominant nystagmus, the child she gives birth to will have nystagmus, if one of the mom and dad has dominant nystagmus and the other is a carrier, the child born may have 50% nystagmus, and if both of them are carriers, the child born will have 25-30% of normal eyeballs. Therefore, if there are parents with nystagmus in the family, you must be vigilant about the inheritance of nystagmus to your next generation. In addition, I also remind you that when young men and women make friends, if one of the parties has nystagmus, the other party should try to avoid looking for spouses with nystagmus, or else the chances of inheritance of nystagmus in your progeny will be very high. Congenital nystagmus prism treatment principle Congenital nystagmus prism treatment is different from person to person, for different types of nystagmus, prism wearing method is different: 1, the existence of collection of block: if the patient has a congenital nystagmus, collection of block nystagmus when, through the use of the bottom of the outward prism will be made to significantly improve the distance vision. If the patient’s visual acuity improves, prisms and negative spherical lens diopters should be added to the eyeglass prescription. 2. Treatment of Substitute Head Position: Although the predominant treatment for abnormal head position is surgery, optical treatment is also possible. The purpose of prism treatment is to move the position of the middle band with the best quality of vision to the front, so as to correct the head position. Generally, the direction of the tip of the prism is pointing to the direction of the eyeball’s deviation, but at present, the optical prism can only correct the deviation of 7△ degrees, however, with the advancement of science and technology, there is a pressure-applied prism, which makes the scope of the trismus treatment to be further enlarged. Speaking of prisms for nystagmus, I’ll add that some children themselves combined myopia, hyperopia and astigmatism, if the degree of myopia, hyperopia and astigmatism is more than 300 degrees, to be equipped with prisms on a 300-degree basis will be. If the myopia, hyperopia and astigmatism are more than 300 diopters, then a prism will be fitted on top of the 300 diopters. If the child is uncomfortable with the prism, we will fit the child with a press-fit prism, which will be fitted on top of his regular glasses. We will give the child with two pairs of glasses, one pair of prisms, one pair of ordinary glasses, the child goes to school and treatment time to wear ordinary glasses, the child usually play with prisms. Summarize: When it comes to wearing prisms, it is very complicated, and there are very few ophthalmologists who can fit a child with prisms. Therefore, parents with nystagmus should bring their child for an examination, and after the examination, we will fit the child with prisms according to your situation. Why do some people with congenital nystagmus have to wear two pairs of glasses? Not all patients with congenital nystagmus need to wear two pairs of spectacles. There are two main categories of patients who need them: the first category is refractive error combined with convergence block, the first pair of spectacles is used to correct the refractive error and treat amblyopia, while the second pair of spectacles is a pair of double-bottomed outward prisms used to stimulate the convergence and alleviate the nystagmus, and if you use an optical lens, the refractive error + prism degree make the lenses If optical lenses are used, the refractive power + prism power makes the lenses very thick, so they cannot be made in the same pair of spectacles, and if compression prisms are used, they will make the visual acuity decrease to a certain extent, which is not conducive to the treatment of amblyopia, therefore, two pairs of spectacles are worn, and spectacles without prisms are used in the treatment of amblyopia, and prisms to alleviate the nystagmus are worn as much as possible in normal times. In the second category, refractive error combined with head position, the first pair of spectacles is used to correct the refractive error and to treat amblyopia, while the second pair of spectacles is a pair of prisms with a double base turned in the direction of the face to correct the head position. We found a very interesting phenomenon in the clinic, many children wear three pieces of the mother will say that the child’s original look at the phenomenon of head shaking much better, this shaking of the head of the phenomenon of our bed it is called the nodding spasm, I give the child to wear a large number of three prisms in the case of treatment also found that a lot of children wearing glasses after the child’s head shaking significantly reduced. I analyze the reason is due to wear three months later, artificially mobilize and increase the child’s collection and general ability, the child’s collection and convergence ability to enhance the frequency of nystagmus control, so the child’s head shaking phenomenon will be reduced, talking about children’s wear is a very complex topic, ophthalmologists know how to wear the very few. Summarize: For children with nystagmus, we hope that you will come to the hospital, and we will give you a checkup and then wear a suitable pair of prismatic lenses for your child according to your condition.