The clinical approach to the pediatric patient with nystagmus
The patient with nystagmus presents a difficult diagnostic challenge. The concern is to insure that the nystagmus is not a sign of significant neurologic abnormality which necessitates immediate intervention. The great majority of patients with nystagmus have an ophthalmic etiology which can be elicited with simple examination techniques. There are certain types of nystagmus which do necessitate further intervention, and these are usually readily identifiable. A thorough history and physical examination directed at detecting the more common causes of nystagmus can be easily performed in the office setting. While nystagmus can be confusing at first, a systematic and thorough evaluation will often elicit its etiology, and provide valuable information to the parents about the child's future development and visual prognosis.