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Abstract

We thank Drs Hertle and Dell’Osso for their comments on our review of surgical treatments to improve visual acuity in infantile nystagmus syndrome.1Chang M.Y. Binenbaum G. Heidary G. et al.Surgical treatments to improve visual acuity in infantile nystagmus syndrome: a report by the American Academy of Ophthalmology.Ophthalmology. 2023; 130: 331-344Abstract Full Text Full Text PDF Scopus (0) Google Scholar We are in agreement that in nystagmus, as in many other ocular conditions, visual acuity is only partially representative of the visual function decrements experienced by patients. However, we elected to include visual acuity as the primary focus of our review to facilitate comparison among studies, because it is reported universally as an outcome measure after surgery for infantile nystagmus syndrome. We refer readers to the many publications by Drs Hertle and Dell’Osso for a more comprehensive description of effects of nystagmus surgery on afferent and efferent visual function.2Hertle R.W. Dell'Osso L.F. FitzGibbon E.J. et al.Horizontal rectus tenotomy in patients with congenital nystagmus: results in 10 adults.Ophthalmology. 2003; 110: 2097-2105Abstract Full Text Full Text PDF PubMed Scopus (109) Google Scholar, 3Hertle R.W. Yang D. Tai Z. et al.A systematic approach to eye muscle surgery for infantile nystagmus syndrome: results in 100 patients.Binocul Vis Strabismus Q. 2010; 25: 72-93PubMed Google Scholar, 4Dell'Osso L.F. Jacobs J.B. An expanded nystagmus acuity function: intra- and intersubject prediction of best-corrected visual acuity.Doc Ophthalmol. 2002; 104: 249-276Crossref PubMed Scopus (107) Google Scholar Re: Chang et al.: Surgical treatments to improve visual acuity in infantile nystagmus syndrome: a report by the American Academy of Ophthalmology (Ophthalmology. 2023;130:331–344)OphthalmologyPreviewIn their review of 23 studies, Chang et al concluded that a modest improvement in visual acuity resulted after surgical treatment of infantile nystagmus syndrome (INS).1 The authors’ experience in clinical trials and diligence in researching and writing this meta-analysis have provided an important contribution regarding the relationship between visual acuity and nystagmus surgery. Unfortunately, the choice to focus only on visual acuity is also their greatest weakness. Our critique is based on our combined 70 years of experience working with patients with INS, publication of hundreds of articles, multiple textbooks, chapters and editorials, and numerous national and international presentations. Full-Text PDF