Walsh & Hoyt: Surgical Procedures for Nystagmus

Two surgical procedures may be effective for certain patients with congenital nystagmus. One is the Anderson-Kestenbaum operation. This procedure is designed to move the attachments of the extraocular muscles so that the new central position of the eyes is at the null position. It is performed after first making careful eye movement measurements of nystagmus intensity with the eyes in various positions of gaze and determining the approximate null position. The appropriate extraocular muscles are then weakened or strengthened as necessary to achieve the required shift in the position of the null. The Anderson-Kestenbaum procedure not only shifts and broadens the null region, but also results in decreased nystagmus outside the region. It is of uncertain value in the treatment of acquired forms of nystagmus.