Нистагм у детей: что нужно знать педиатру

Abstract

Despite its low prevalence, nystagmus occupies a special position among the variety of ophthalmopathology in children. The disease affects visual functions, causes difficulties in treatment, becomes the cause of the patient’s psychological and social discomfort and professional limitations, and requires rehabilitation measures. The review presents literature data on the nystagmus classification and pathogenesis. However, to date, the neural mechanisms underlying this pathology have not been fully studied. Many hypotheses have been proposed, which come down to disturbances in the oculomotor centers as the direct cause of nystagmus. The role of the oculomotor muscles in the onset of the disease has not received proper study. The article focuses more on the manifestations of infant nystagmus, which is found in the first 3–6 months of a child’s life. Children’s nystagmus may be idiopathic, associated with other eye conditions, albinism, or by a part of neurological syndromes or diseases. The combined pathology requires the participation of not only an ophthalmologist, but also a pediatrician, neurologist, geneticist and doctors of other specialties in the diagnostic examination and treatment. The article describes methods of treating nystagmus aimed at reducing its amplitude and increasing visual acuity. The surgical methods include recession, resection, or tenotomy of the horizontal ocular muscles. The pharmacological methods consist in the use of antiglutaminergic drugs, an agonist of gamma-aminobutyric acid and an inhibitor of carbonic anhydrase, but the mechanism of their effect on nystagmus is not fully understood. The optical methods are represented by the selection of soft contact lenses or glasses for ametropia, as well as prismatic correction. Unfortunately, there are no effective ways to eliminate nystagmus.