Nystagmus examination

When given a case of nystagmus, make sure you observe the eyes in the primary position noting the characters of the movement ie. fine/coarse, fast/slow, jerk/pendular, direction of the fast phase. In your examination, you want to show the examiner(s) if the nystagmus dampen with convergence, increases with one eye covered and the position of the null point if it were present. Secondly, you want to find out the cause of the nystagmus by performing additional tests. For example: in pendular nystagmus the presence of anterior or posterior segment abnormalities such as iris transillumination (albinism), optic nerve hypoplasia etc. in jerk nystagmus the presence of cerebellar signs by testing the coordination such as finger-nose pointing, disdianochokinesia in see-saw nystagmus the presence of bitemporal hemianopia Common cases   jerk nystagmus downbeat nystagmus congenital / pendular nystagmus see-saw nystagmus

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