Interrelations between measures of visual acuity and parameters of eye movement in congenital nystagmus

The authors assessed relationships between visual acuity and the amplitude, frequency, intensity, and duration of foveation periods in a retrospective study of 32 patients. Twenty-four patients had congenital idiopathic nystagmus, and eight patients had nystagmus and albinism. Visual acuity was determined for Landolt ring optotypes and, as the extrapolated high-frequency cutoff of the contrast sensitivity function, for horizontal and vertical gratings. No significant correlation existed between acuity and any measured eye movement parameter; however, optotype acuity was related to the magnitude of astigmatic refractive correction, both in patients with idiopathic nystagmus and in albinos. In a subgroup of patients with idiopathic nystagmus whose astigmatic refractive error was -1.50 D or less, nystagmus intensity (amplitude x frequency) correlated significantly with acuity for optotypes (r = 0.71), but not for gratings. Although resolution for vertical gratings was correlated with astigmatic refractive correction, the ratio of resolution for gratings parallel and orthogonal to the meridian of nystagmus was not. Thus, the belief that poorer acuity in patients with substantial astigmatism is attributable to an optically induced meridional amblyopia is supported only partly by these results. The authors concluded that among patients with congenital nystagmus, the influence of eye motion on visual acuity is not readily predicted either from the parameters of nystagmus that they evaluated or from the comparison of resolution for horizontal and vertical gratings.