Use of eye movement auditory biofeedback in the control of nystagmus

Eye movement auditory biofeedback was used in weekly training sessions to control nystagmus in five adult patients. Within the 1st hr of training, all patients were able to reduce nystagmus. Average maximum group reduction of nystagmus amplitude, peak slow-phase velocity, and frequency achieved during training with auditory biofeedback was 82, 86, and 34%, respectively. At periodic intervals during training, audio information was withheld and patients were able to maintain reduced nystagmus for several minutes. In addition, patients were able to reduce nystagmus upon command without audio cues but with conscious effort while engaging in conversation and other tasks with the experimenters. Visual acuity improvement with conscious patient effort to control nystagmus but without auditory biofeedback averaged 10% Snell-Sterling. One of two patients who returned for post-training reevaluation was able to reduce his nystagmus quickly without auditory biofeedback to 50% of the pretraining level, and both patients were able with the aid of auditory cues to reduce their nystagmus rapidly to the level achieved during training. In addition to the improvement in vision, cosmetic and psychological benefits accrued. Eye movement auditory biofeedback should be considered in the treatment of nystagmus, either alone or in conjunction with orthoptic and/or surgical procedures.