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Incidence and Types of Pediatric Nystagmus
David L Nash1, Nancy N Diehl2, Brian G Mohney1
1Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.
Insights
This 30-year study found pediatric nystagmus incidence at 6.72 per 100,000. Infantile nystagmus was most common, with idiopathic and retinal/optic nerve disease types prevalent. Most children maintained good vision.
Area of Science:
- Ophthalmology
- Pediatric Neurology
- Epidemiology
Background:
- Nystagmus is an involuntary eye movement condition affecting vision.
- Understanding the epidemiology and clinical features of pediatric nystagmus is crucial for early diagnosis and management.
Purpose of the Study:
- To determine the incidence, prevalent subtypes, and clinical characteristics of pediatric nystagmus over a 30-year period.
- To provide population-based data on childhood nystagmus in North America.
Main Methods:
- A retrospective, population-based study was conducted using the Rochester Epidemiology Project.
- Medical records of children (<19 years) diagnosed with nystagmus in Olmsted County, Minnesota, between 1976 and 2005 were reviewed.
Main Results:
- An annual incidence of 6.72 per 100,000 children (<19 years) was observed.
- Infantile nystagmus (onset by 6 months) accounted for 87.3% of cases, with a birth prevalence of 1 in 821.
- Common subtypes included nystagmus associated with retinal/optic nerve disease (32.4%) and idiopathic/congenital motor nystagmus (31.0%).
- Developmental delay (43.6%), strabismus (35.2%), and amblyopia (14.1%) were frequently diagnosed comorbidities.
- Eighty percent of patients presented with 20/40 or better vision in at least one eye.
Conclusions:
- This study offers valuable population-based insights into the incidence and clinical spectrum of childhood nystagmus.
- Idiopathic nystagmus and nystagmus linked to retinal/optic nerve conditions were the most frequent presentations.
- Despite common comorbidities like developmental delay and strabismus, a majority of affected children retained good visual acuity.
Purpose:
To report the incidence, prevalent subtypes, and clinical characteristics of pediatric nystagmus diagnosed over a 30-year period.
Design:
Retrospective, population-based study.
Methods:
Using the Rochester Epidemiology Project, we reviewed the medical records of all children (<19 years) diagnosed as residents in Olmsted County, Minnesota, with any form of nystagmus from January 1, 1976, through December 31, 2005.
Results:
Seventy-one children were diagnosed during the 30-year period, yielding an annual incidence of 6.72 per 100,000 younger than 19 years (95% confidence interval [CI], 5.15-8.28) Infantile nystagmus, onset by 6 months, comprised 62 (87.3%) of the study patients, corresponding to a birth prevalence of 1 in 821. The median age at diagnosis for the cohort was 12.7 months (range, 0 days to 18.6 years) and 42 subjects (59.2%) were male. The main types of nystagmus, in declining order, were nystagmus associated with retinal/optic nerve disease in 23 (32.4%), idiopathic or congenital motor nystagmus in 22 (31.0%), manifest latent nystagmus or latent nystagmus in 17 (24.0%), and 2 (2.8%) each associated with Chiari malformation, medication use, tumor of the central nervous system, and no diagnosis. Developmental delay was diagnosed in 31 (43.6%), strabismus in 25 (35.2%), and amblyopia in 10 (14.1%). Eighty percent had 20/40 (or equivalent) or better vision at presentation in at least 1 eye.
Conclusions:
This study provides population-based data on incidence and clinical characteristics of childhood nystagmus in North America. Idiopathic and nystagmus associated with retinal/optic nerve disease were the most common presentations, with most patients having good vision. Developmental delay, strabismus, and amblyopia were common in this cohort.
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