Large Rectus Muscle Recessions for the Treatment of Congenital Nystagmus

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To the Editor. —We read the article by von Noorden and Sprunger 1 in the February 1991 issue of theArchiveswith great interest. The authors present an approach to the operative treatment of manifest congenital nystagmus that might, in principle, be applied to many patients with this unfortunate condition. Although not a new condition, this is the first description of the operative intervention in the American literature, for which we are grateful to the authors. Because of its potential profound implications for therapy, we wish to raise questions that the careful clinician may want answered before applying the formidable muscle procedure to patients with congenital nystagmus. How often do the authors see patients with manifest congenital nystagmus of various origins to whom they offer this operative intervention? Since the report describes only three patients, it is important to know what percentage of patients with these diagnoses are candidates, in