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Long-term treatment results for nystagmus disappointing
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LONDON — Patients with nystagmus tend to initially respond well to treatment, but “long-term surgical results have little effect” on the patient’s overall condition, said John P. Lee, DO, FRCS, FRCP, FRCOpth, speaking here at the Moorfields Bicentenary scientific meeting. “Surgery tends to reduce the wobble, but inevitably it tends to return to some extent.”
Prof. Lee discussed a study of 18 patients with nystagmus ranging in age from 16 to 51 years. Preoperative visual acuity in the group ranged from 6/9 to 6/60; postoperatively, VA ranged from 6/9 to 6/36. About half the patients reported a gain of one Snellen line postop, he said.
In addition to “very painful” surgery, Prof. Lee said one patient developed scleral perforation, one decompressed to exotropia, one new case of exotropia developed, and one patient developed asthenopic symptoms.
“However, a patient questionnaire indicated eight patients were pleased with their outcomes,” he said. Of the patients, seven of 14 opted for surgery in order to secure a driver’s license. To date, none has done so, he said.
Botulinum toxin has shown some promising results, Prof. Lee added, but the effects tend to wear off in as little as 2 months. “Long-term results are disappointing,” he said.
Patients who also have multiple sclerosis have shown “little to no benefit” from botulinum toxin injections, he said.