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Pressure-less orbital lesion removal by endoscopic navigation for orbital apical lesions with poor baseline visual function exerts minimal iatrogenic pressure on the already compromised optic nerve by apical bony decompression and provides route for postoperative hemorrhage.

Lid nystagmus is an unusual rhythmic upward jerking of the upper eyelids that occurs in isolation or relation with the eye movements, secondary to compressive lesion. It is considered a sign of intrinsic midbrain disease. However, this present case developed nystagmus in the setting of III nerve aberrant regeneration. A 31-year-old woman with a III nerve palsy due to grade IV of glioblastoma in the temporal lobe, left cavernous sinus, underwent surgery, followed by radiotherapy and chemotherapy. The patient developed signs of III nerve aberrant regeneration. After three years, left palpebral nystagmus was evident in rest and in all eye positions except when attempt to look up. The cerebral magnetic resonance showed tumor increase. Lid synkinesis etiopathogenesis is unknown. Most hypothesis suggest abnormal disruption of the pretectal inhibitory influence on the levator motoneurons. In this case, probably the tumor growing caused more abnormal regeneration movements in the III nerve branches.

Apraxia of lid opening (ALO) is characterized by the inability to initiate voluntary eyelid opening. Eyelid surgery like orbicularis myectomy is usually required in ALO. This involves excision of the orbicularis muscle fibres, which helps in overcoming levator palpebrae inhibition. In this video, the anatomy of the eyelid and specifically the orbicularis muscle and the surgical technique are highlighted.

This video discusses the disadvantages of conventional full-field electroretinogram (ERG), the advantages of in-office handheld ERG, and conditions in which handheld ERG is particularly useful.

Ocular motor research in the past half-century has produced remarkable advances in our understanding of the underlying mechanisms of the several types of nystagmus seen in infancy and childhood. Research results to better enable the clinician to make accurate diagnoses and provide safe and effective treatment are discussed in this chapter.

The panel discusses the warning signs to look for in end-gaze nystagmus.

Dr. Gill Roper-Hall discusses the characteristics of nystagmus and shares several video examples.

Evaluation of the infant or child with infantile nystagmus syndrome (INS) is very challenging because INS can be an isolated abnormality or appear in association with a wide variety of underlying visual sensory and systemic disorders.

This prospective study found that handheld SD-OCT is highly sensitive and specific in identifying foveal abnormalities in infantile nystagmus.