Authors:

Abstract

Aim: To critically evaluate the literature on the visual outcome in patients with infantile idiopathic nystag­mus (IIN) and manifest latent/latent nystagmus (MLN/LN) and appraise the factors that influence the acuity outcome.

Method: A literature review was undertaken to determine visual outcomes and a common prognosis for this population. The implications of the waveform evolution were considered as well as the importance of test parameters. Also the conservative manage­ment options were evaluated.

Results: The best and the worst binocular visual acuity recorded for UN subjects was –0.3 and 1.2, and for MLN/LN was –0.1 and 0.8, respectively. This variation was attributable to factors such as test type, test distance, type of occluder used in monocular assessment and contour interaction. In addition the most effective management options appear to be the use of contact lenses. Although prisms did reduce the oscillations there was little increase in acuity. In terms of amblyopia management a variety of treat­ment options have been suggested, hut no optimum protocol was identified.

Conclusion: This review has highlighted the incon­sistency in outcomes in these patients. In particular, when evaluating the outcome there are a large number of variables in the assessment of visual acuity. Standardisation in visual assessment would allow more effective evaluation and comparison between studies of treatment modalities.

Keywords: Amblyopia, Contour interaction, Foveation period, Infantile idiopathic nystagmus, Manifest latent/latent nystagmus