Walsh & Hoyt: General Concepts and Clinical Approach

This chapter concerns abnormal eye movements that disrupt steady fixation and thereby degrade vision. We now know a good deal about the normal anatomy, physiology, and pharmacology of ocular motor control. Our approach is to apply this knowledge to nystagmus and other ocular oscillations, since pathophysiology provides a sounder conceptual framework than a system based solely on phenomenology. We first summarize the mechanisms by which gaze is normally held steady to achieve clear and stable vision. We then discuss the pathogenesis and clinical features of each of the disorders that disrupt steady gaze, including the various forms of pathologic nystagmus and saccadic intrusions. Finally, we summarize currently available treatments for these abnormal eye movements and their visual consequences.