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Infantile nystagmus and visual deprivation: foveal instability and refractive development in a low vision register

Hans C Fledelius1, Hanne Jensen

  • 1Copenhagen University Eye Department, Rigshospitalet Copenhagen and Glostrup Hospital - Denmark.

European Journal of Ophthalmology
|December 25, 2013
PubMed

Insights

Children with infantile nystagmus show higher rates of myopia and astigmatism compared to controls. This increased prevalence of refractive errors appears to be of juvenile onset, not directly linked to early visual disturbances.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Developmental Neuroscience

Background:

  • Infantile nystagmus (IN) is an involuntary eye movement condition present from infancy.
  • Early visual development can be impacted by foveal motor instability in IN.
  • The long-term effects of IN on refractive error development are not fully understood.

Purpose of the Study:

  • To investigate refractive error development in children diagnosed with infantile nystagmus.
  • To compare the refractive outcomes in children with IN to those with experimental visual deprivation.
  • To analyze the prevalence of myopia and astigmatism in a childhood series with IN.

Main Methods:

  • Retrospective analysis of 90 children (aged 10-17) with infantile nystagmus from the Danish Register for Blind and Weaksighted Children.
  • Primary outcome: spherical equivalent refraction; secondary outcomes: visual acuity, astigmatism, and age.
  • Subgroup analysis included children with IN as a single diagnosis versus those with co-occurring conditions (Down syndrome, dysmaturity, mental retardation).

Main Results:

  • Median binocular visual acuity was 0.3 across the series.
  • Median refraction was emmetropia, but myopia was over-represented compared to Danish controls, with a juvenile onset.
  • Higher myopia prevalence was observed in the Down syndrome subgroup. 52% of cases had astigmatism exceeding 1 D.

Conclusions:

  • Children with infantile nystagmus exhibit a higher prevalence of myopia and astigmatism than their peers.
  • The observed myopia is primarily juvenile and does not appear to be directly influenced by early infantile nystagmus-related visual disturbances.
  • These findings highlight the significant impact of infantile nystagmus on refractive development, particularly myopia and astigmatism.
Abstract

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