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Dr. Andrew Rynne

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Infant Having Difficulty In Holding Eye On One Object, Normal MRI. Suggestion?

hiiiiii my daughter 5 month old. few days before Dr. has diagnosed that she eye twinkling she not hold her eyes on one object. so Dr. told she having low vision power. so neurologist and opthamologist suggested to do MIR scanning, the report of MRI is normal. And opthamologist told her eye don t having problem. she can hear very well. Now neurologist told will see after 2 moths. pls advise
Mon, 11 Jun 2012
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Ophthalmologist,  's  Response
Hi

Did you mean "Nystagmus" ( involuntary fast moving/ dancing eyes) by "eye twinkling?"



If it is so, Nystagmus is a condition in which the eyes move rapidly and involuntarily either horizontally or vertically or rotatory movement. It may be by birth( congenital) or acquired due to ocular pathology /secondary to brain involvement/ medication.



Since your MRI is normal , you are on the safer side. But get her examined by a pediatric ophthalmologist( if possible a low vision specialist) to assess her ocular movements and confirm the diagnosis.



Even though the eyes move rapidly, and has reduced vision,still they have a significant vision to see and only needs some training of how to see and cope up. So get a second opinion and give her the best possible visual stimulus at the earliest.



I am suggesting all this with an assumption that 'eye twinkling' is 'nystagmus'. If I am wrong please let me know the exact appearance of your daughters eye so we could help you better.



Keep us updated and take care :-).
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Ophthalmologist,  Dr. Swapnil Kothari's  Response
hii

there are a few things that do not show up on the MRI but can cause vision loss in this age. chief amogest them being cone rod dystrophy and leber's congenital amaurosis. it would need a ERG to rule out these possibilities. these studies however are not widely available in India and need to go to a higher center.

at this age, she should have steady fixation. needs to be investigated. Where are you based, so that i may suggest some better center for you to visit.

hope this helps
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Infant Having Difficulty In Holding Eye On One Object, Normal MRI. Suggestion?

Hi Did you mean Nystagmus ( involuntary fast moving/ dancing eyes) by eye twinkling? If it is so, Nystagmus is a condition in which the eyes move rapidly and involuntarily either horizontally or vertically or rotatory movement. It may be by birth( congenital) or acquired due to ocular pathology /secondary to brain involvement/ medication. Since your MRI is normal , you are on the safer side. But get her examined by a pediatric ophthalmologist( if possible a low vision specialist) to assess her ocular movements and confirm the diagnosis. Even though the eyes move rapidly, and has reduced vision,still they have a significant vision to see and only needs some training of how to see and cope up. So get a second opinion and give her the best possible visual stimulus at the earliest. I am suggesting all this with an assumption that eye twinkling is nystagmus . If I am wrong please let me know the exact appearance of your daughters eye so we could help you better. Keep us updated and take care :-).