Original ArticleManagement of Strabismus Associated With Infantile Nystagmus Syndrome: A Novel Classification to Assist in Surgical Planning
Section snippets
Methods
This was a retrospective chart review of 147 patients who underwent surgery to correct head positioning associated with INS from 1995 to 2018 at the Vanderbilt Eye Institute. Twenty-eight cases of coexisting horizontal AHP and horizontal strabismus with >2 months of follow-up were reviewed. This study was deemed exempt from review board approval by the Vanderbilt Institutional Review Board, and all data collection was in conformity with county, federal, or state laws and was in adherence to the
General Characteristics
Of 147 patients who underwent surgery for INS, 37 had coexisting strabismus and 32 had ≥2 months of follow-up. Three cases with strabismus were excluded because the head positioning was in the pitch plane (chin up and down) plane, and 1 case was excluded because of a coexisting vertical strabismus. A total of 28 patients with horizontal AHP, horizontal strabismus, and ≥2 months of follow-up were identified and reviewed. The mean age at surgery was 6.8 years, and 15 patients were female. The
Discussion
Surgery to simultaneously correct strabismus coexisting with AHP in patients with infantile nystagmus syndrome can be challenging and is not well described in the literature. In cases of large (≥45°) head position when 60% augmentation is performed on the horizontal rectus muscles to correct AHP, dosages of surgery typically cannot be increased to accommodate for the strabismus because of size limitations of the globe and the concern for limiting motility. This poses a challenge to surgeons who
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Cited by (4)
Analysis of anomalous head posturing in patients with infantile nystagmus syndrome
2021, Journal of AAPOSLong-term Outcomes Following Surgery for Infantile Nystagmus Syndrome With Abnormal Head Positioning
2020, American Journal of OphthalmologyCitation Excerpt :Unlike in horizontal cases, surgical planning for vertical cases represented maximal doses of recession-resection of vertical recti or weakening of both agonist muscles depending on the procedure. When strabismus coexisted with abnormal head posturing, surgery was performed on the fixating eye based on the head position, but decreased in magnitude if the proposed surgery would worsen the strabismus.9 Wilcoxon signed rank tests were used to evaluate for changes in visual acuity over time.
Nystagmus in Children - A Survey
2023, Klinische Monatsblatter fur AugenheilkundeCongenital Nystagmus and Its Congeners
2020, Journal of Binocular Vision and Ocular Motility
Supplemental Material available at AJO.com