Cong_Nystagmus 2009.pdf - The Private Eye Clinic

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Why does CN occur? 1 • Poor symmetric acuity @ a critical time of visual development Sometimes there is continuing evidence of the initiating cause – eg bilateral optic n hypoplasia, symmetric terrible refraction, cone dystrophy, cataract OU, macular hypoplasia of albinism, …and sometimes there is no evidence of the initiating cause – macular hemorrhages, terrible refraction that got better, … KOWAL MEACO 2009 4
Why does CN occur? 2 • Genetic reasons – the N waveform itself can be inherited • Abnormal CNS : Peri Ventricular Leukomalacia PVL Many hypotheses / ?Multiple causes • ? abnormal circuit between fixation and ocular stabilisation systems • Abnormal proprioceptors in enthesis* [? cause, ?effect] * where tendon inserts into sclera KOWAL MEACO 2009 5
Page 1 and 2: CONGENITAL NYSTAGMUS WHEN TO RECORD
Page 3: Clinical Features CN 1. L beat on L
Page 7 and 8: Whatever caused it, cNwill then deg
Page 9 and 10: Principles of treatment of CN •1.
Page 11 and 12: 2. Improve 2ary effects such as fac
Page 13 and 14: Effects / Treatment of LMLN • Red
Page 15 and 16: Clinical Features CN 1. L beat in L
Page 17 and 18: CN c.f. LMLN • STRABISMUS : LMLN
Page 19 and 20: ‘I AM WORSE THAN I USED TO BE’
Page 21 and 22: Clinical correlations : Dr Elaine W
Page 23 and 24: Clinical and EMR Correlation KOWAL
Page 25 and 26: Predictive Values of Clinical Featu
Page 27 and 28: Predictive Values of Clinical Featu
Page 29 and 30: Does everyone with N need to be rec
Page 31 and 32: SURGERY IN cN : CN • Eccentric nu
Page 33 and 34: Eccentric null ≤ 20° L face turn
Page 35 and 36: SURGERY IN CN : Convergence null
Page 37 and 38: SURGERY IN cN : PAN • Look for co
Page 39 and 40: THE RECENT PAST AND THE IMMINENT FU

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