Pediatric Nystagmus: Incidence and Types

Journal Highlights

American Journal of Ophthalmology, October 2017

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Estimates of the incidence of pediatric nystagmus, including its subtypes, are limited. Nash et al. addressed this by compiling information from a large epidemiologic database. They found that developmental delays are common among young patients with nystagmus, as are associations with retinal and optic nerve pathology, and that malig­nancy of the central nervous system appears to be rare.

For this study, the authors reviewed medical records for all children younger than 19 years of age in Olmsted County, Minnesota, who were diagnosed as having nystagmus during a 30-year period. Of particular interest were data from the exam in which nystagmus was first observed and from the most recent follow-up evaluation.

The incidence of nystagmus among the study population was 6.72 per 100,000 (N = 71). The median age at diagnosis was 12.7 months (range, 0-18.6 years), and 42 (59.2%) were male. Sixty-two (87.3%) of the 71 chil dren had infantile nystagmus, defined as onset by 6 months of age; this rep­resents a birth prevalence of 1 in 821. Nystagmus occurred bilaterally in 64 cases (90.1%), in only the right eye in 2 cases (2.8%), and in just the left eye in 3 cases (4.2%). The most common type of nystagmus was that associated with retinal/optic nerve disease (n = 23; 32.4%), followed by idiopathic or congenital motor nystagmus (n = 22; 31.0%) and latent forms of nystagmus (n = 17; 24.0%). Less common were associations with Chiari malformation, medication use, or a tumor of the cen­tral nervous system (n = 2.8 each).

Thirty-one children (43.7%) had a developmental delay, 25 (35.2%) had strabismus, and 10 (14.1%) had ambly­opia. Of the 60 patients (84.4%) whose visual acuity was assessed at presenta­tion, 48 (80.0%) had 20/40 vision or better in at least 1 eye.

The original article can be found here.