Nystagmus: effects, solutions and research Flashcards
what are the 2 classifications of nystagmus
- congenital - CN
- acquired - AN
give 3 other names for congenital nystagmus
- congenital idiopathic nystagmus CIN
- infantile idiopathic nystagmus IIN
- early onset nystagmus EON
what is the prevalence of nystagmus
1 in 1000
list 9 effects of nystagmus i.e. what does the person experience
- Poor quality vision
- Stable image (mostly): with congenital nystagmus
- Slow to see: takes longer to see, but can’t be measured as its harder to acquire the target
- Changeable: eye movement changes throughout the day from factors such as, tiredness, stress etc so vision is not constant
- Null, visual field: null point = turn head to opposite direction to view the object, where the eyes stay still, this will affect their visual field
- Movement: can’t see something moving = hard to see
- Clutter/scanning: more clutter = makes it harder to see
- Photophobia: the condition associated with nystagmus has photophobia, so it common in nystagmus px
- Balance/depth perception: is difficult
what is it important to keep in mind with null zones and children with nystagmus
must make sure the child is sitting in the correct position at school
what is visual acuity not a proper measure of
the severity of the nystagmus
can use VA to label somebody with nystagmus, but can’t measure the amount of nystagmus, so is only good for a starting point
list all the 6 things that visual acuity does not take account for in nystagmus and what does this mean
- The null point/visual field impact
- Variability
- Time/scanning
- Movement and oscillopsia
- Clutter
- The physical and emotional impacts
This means VA tests under estimate nystagmus
list the 5 main patient expectations when they visit you about their nystagmus
- Answers to questions
- Cause, effect, solution
Effect = mainly things like driving
Solution = theres no medical solution to nystagmus - Time to talk
- Help and information
- Hope
list 4 main practical issues with having nystagmus
- School: from age 7/8, when theres more visual tasks
- Driving: majority cannot see well enough to drive, is not safe enough even though can see number plate at 20m due to other factors e.g. slow reaction and variance
- Work: slower at work, cannot make eye contact esp when nervous
- Ageing: gets more common as get older, maybe due contribution of other factors e.g. presbyopia
list 5 social and 5 emotional issues with nystagmus
Social:
- Making friends
- Taking part
- Eye contact
- Missing cues: can see subtle changes
- “Ignoring” people: appear to as cannot see them
Emotional
- Feeling different
- Isolation
- Lacking confidence
- Image concerns
- Depression: high correlation with visual impairment, especially with acquired type as lots of life changes
give 2 examples of behaviour that nystagmus/VI can lead to and what conditions do you need to be wary of with nystagmus
- Anger and frustration e.g. with children in school who is too young to explain to teacher
- Misunderstandings
Be wary of diagnoses of autism, ADHD, dyspraxia, etc. with nystagmus
what are the medical options for ophthalmologists to treat nystagmus
The medical options are limited:
- Surgery: moving the null point to pp
- Drugs: no drugs developed for nystagmus, but for other purposes
as well as medical, give 4 other things that ophthalmologists can do to help patients with nystagmus
- Provide an accurate diagnosis: they cant really, but work on the basis of occlusion i.e. rule things out
- Offer a CVI: which makes a difference in things like school
- Explain impact
- Signpost to services
list 5 things optometrists can do for patients with nystagmus
- In some cases: identify / diagnose (especially acquired nystagmus)
- Glasses and CLs (but not for nystagmus)
- LVAs, prisms
- Explain the condition
- Support: education, driving, employment
