Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, The Johns Hopkins School of Medicine
This is a 45-yo-man with intermittent complaints of horizontal oscillopsia for 1 year. On examination, all classes of eye movements were normal, and neurologic examination was normal. MRI of the brain had been performed previously and was normal. During the exam while viewing any target close to his face, rapid horizontal back-to-back saccades without a clear intersaccadic interval were seen, and these were suggestive of ocular flutter. The oscillations did not occur spontaneously, but only with convergence effort, and miosis was clearly noted as well. In addition to experiencing oscillations during convergence which he reported was involuntary, he could also bring on the episodes on voluntarily, and flutter could only be sustained for several seconds at a time. Therefore, his flutter was functional rather than pathologic.
Spencer S. Eccles Health Sciences Library, University of Utah