To the Editor.
—The recent discussion in the Archives by Yee1 on the initial evaluation of nystagmus in infants and small children emphasizes the need for neuroradiologic imaging in cases where the nystagmus pattern is atypical. This approach deemphasizes the likelihood of primary sensory abnormalities as a frequent cause of nystagmus in infants.Carr and Siegel2 have provided a useful differential scheme for congenital nystagmus. In many instances, including achromatopsia, congenital stationary night blindness, and Leber's congenital amaurosis, nystagmus due to sensory abnormalities cannot be reliably recognized on funduscopic examination, or by evaluation of the nystagmus pattern. In such circumstances, an electroretinogram (which may easily be obtained without sedation in infants less than 1 year of age) may be a more productive and far less expensive study than computed tomography or magnetic resonance imaging.Reports of the relative frequency of sensory vs motor causes of nystagmus depend so
Brodie SE. Choice of Initial Tests for Nystagmus in Infants. Arch Ophthalmol. 1991;109(4):464. doi:10.1001/archopht.1991.01080040024005