Symptomatic Treatment of Infantile Nystagmus: A Systematic Review

Xuanwei Li^1,2Bianca Huurneman^2,3*Jeroen Goossens^1,2

• ¹Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
• ²Donders Institute of Medical Neurosciences, Radboud University Medical Centre, Nijmegen, Gelderland, Netherlands
• ³Royal Dutch Visio, Huizen, Netherlands

Infantile nystagmus (IN) is a neuro-ophthalmic condition characterized by involuntary rhythmic eyemovements that manifest early in childhood. The surge of recent articles focusing on the treatment ofIN demonstrates the need for a new systematic review of the intervention options. The diverse causesof IN complicate its differentiation from symptoms secondary to other conditions, presentingchallenges for clinical decision-making and systematic review. This study provides the firstextensive, focused summary of symptomatic treatment options for IN. We noted that currentapproaches can be broadly categorized into four types of interventions: surgical, pharmacological,optical, and perceptual training methods, each offering distinct benefits and limitations. Most of theincluded studies (28/52) focused on invasive surgical interventions. Alternatively, the nascentperceptual training showed promising improvements in both visual acuity (VA) and quality of life(QoL) and. The heterogeneous reporting of treatment outcomes for IN hindered meta-analysis andprecise comparison of intervention effects, underscoring an urgent need for standardized outcomemeasures in future studies. We further suggest including functional vision measurements and QoLassessments to better address patient well-being, rethinking invasive surgical approaches andexploring non-invasive treatment modalities in clinical practice.