The challenges faced by clinicians diagnosing and treating infantile nystagmus Part II: treatment

Abstract

Introduction: Infantile nystagmus syndrome (INS) is the most common nystagmus type in children, and can be idiopathic or associated with ocular, neurologic, and systemic disease. Current treatment options for INS aim to optimize vision by reducing the intensity of nystagmus and correcting anomalous head postures and associated strabismus. A PubMed search of all articles published from January 1980 to July 2021 on the management of INS was performed. Areas covered: This review will address the principles of nystagmus management, including optical, pharmacological and surgical options. Pharmacological treatments, such as gabapentin and memantine, are now being implemented in clinical practice. In patients with obvious torticollis, eye muscle surgery aims to shift the nystagmus null zone into the primary position. Expert opinion: Successful management of INS depends on accurate diagnosis and identification of patient needs and concerns. Recent advances in pediatric retinal imaging and the identification of new genes have refined our understanding of INS subtypes, facilitate early diagnosis, and allow for individualized management. Due to the lack of randomized controlled trials, there is still no consensus on a clinical pathway for INS; however, there are several therapeutic options, which can result in improved vision and amelioration of anomalous head postures.