Management of symptomatic latent nystagmus

Most patients with latent nystagmus are asymptomatic and do not require treatment. We discuss the management by botulinum toxin injection and surgery of five cases of latent nystagmus in which the patients suffered loss of visual acuity on certain manoeuvres as a consequence of an exacerbation of the nystagmus amplitude. The importance of eye movement recordings for accurate diagnosis is stressed and the investigative role of botulinum toxin injection is discussed. Extraocular muscle surgery is helpful in some cases of symptomatic latent nystagmus.