[Indications and methods of surgical treatment in congenital nystagmus]

The authors present methods of operation performed in different types of congenital nystagmus in which the amplitude and frequency of nystagmus vary in different positions of gaze. In many cases, a "neutral zone" exists in which the nystagmus is less pronounced or may even be absent. If the "neutral zone" is in the primary position of gaze, then the head position may be normal. If the neutral zone is in another position of gaze, then the patient may assume compensatory head position (CHP) to achieve optimal visual acuity. Methods of surgical treatment in these case are presented. The indications are based on measurement of compensatory head position or on amplitude of convergence in nystagmus blockage syndrome. The elimination of CHP is possible by the Anderson procedure or, in more advanced cases, by the Kestenbaum procedure and/or the artificial divergence procedure of Cüppers. Sometimes Cüppers procedure alone or in combination with recession of the muscles is indicated. Our own material and results of surgical treatment are presented in the next paper.