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The first 25 slides, exactly as they appear. The full deck has 80 content slides.
Ophthalmology
Nystagmus and Related Oscillations
Built from Khurana — Neuro-Ophthalmology
What’s inside
13 sections · 80 slides
Overview
- What this talk will build up, step by step
What Is Nystagmus?
Definition and the features we grade it by
- Nystagmus in plain terms
- Waveform - pendular or jerk?
- Pendular versus jerk nystagmus waveforms
- Characterising the slow phase
- Direction and conjugacy - how the two eyes relate
- Amplitude - how far the eye travels
- Grading nystagmus amplitude with arrows
- Frequency, intensity and foveation
- Foveation on a nystagmus trace
- Null zone, neutral zone and trajectories
- Recording nystagmus direction and trajectory
- Combined horizontal-vertical trajectories
Why the Eyes Drift
The three systems that normally hold gaze steady
- First, understand steady fixation
- The neural integrator and adaptive tuning
A Modern Classification
From the CEMAS scheme
- How nystagmus is classified today
- The classification at a glance
Physiological Nystagmus
Normal eyes doing normal things
- Three normal forms of nystagmus
Nystagmus Beginning in Infancy
Three forms that start early - and are not truly congenital
- The three infantile forms
- Infantile nystagmus syndrome (INS) - causes
- INS - CEMAS features and clinical clues
- Symbolic recording of infantile nystagmus syndrome
- Fusion maldevelopment (latent) nystagmus - FMNS
- Symbolic recording of fusion maldevelopment nystagmus
- Spasmus nutans syndrome (SNS)
Acquired Nystagmus I
When the visual system itself is at fault
- Why losing vision makes the eyes wander
- Where along the visual pathway the lesion sits
- Chiasm and beyond
- Acquired pendular nystagmus
- Symbolic recording of acquired pendular nystagmus
- Causes of acquired pendular nystagmus
Acquired Nystagmus II
Imbalance in the vestibular pathway
- Peripheral vestibular nystagmus
- Recognising peripheral vestibular nystagmus
- The caloric test - deliberately provoking nystagmus
- Symbolic recording of peripheral vestibular nystagmus
- Central vestibular nystagmus - the overview
- Downbeat nystagmus
- Symbolic recording of downbeat nystagmus
- Upbeat and torsional nystagmus
- Periodic alternating and see-saw nystagmus
- See-saw nystagmus
Acquired Nystagmus III
Failure of the mechanism that holds eccentric gaze
- Gaze-evoked nystagmus - the commonest of all
- Gaze-evoked nystagmus on lateral gaze
- Endpoint versus dissociated (ataxic) nystagmus
- Bruns', convergence-retraction, and rebound nystagmus
- Bruns' nystagmus in cerebellopontine-angle tumour
Examining and Recording Nystagmus
History, the ABCDEF checklist, recordings and imaging
- History and examination
- The ABCDEF checklist for nystagmus
- Measuring head posture with a goniometer
- Recording eye movements - EOG and ENG
- Electro-oculography electrode placement
- Other recording methods and videonystagmography
- Videonystagmography goggles
- What recordings add, and when to image
Treating Nystagmus
Optical, medical and surgical options
- Aims of treatment
- Optical treatment
- Prism correction of anomalous head posture
- Medical treatment
- Surgical treatment
Nystagmus-Like Oscillations
Saccadic intrusions that mimic nystagmus
- Why these are different
- Saccadic intrusions and oscillations
- Myokymia, bobbing, voluntary and roving forms
- Saccadic intrusions and oscillations
Key Takeaways
What to carry away
- Three ideas that organise the whole topic
- Final summary
- References
- Neuro-Ophthalmology