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JAMA Ophthalmology Clinical Challenge
November 2015

Nystagmus in an Emaciated Infant

Author Affiliations
  • 1Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
  • 2Department of Pediatric Hematology-Oncology, Mayo Clinic, Rochester, Minnesota
  • 3Department of Neurology, Mayo Clinic, Rochester, Minnesota
JAMA Ophthalmol. 2015;133(11):1349-1350. doi:10.1001/jamaophthalmol.2015.1940

A 7-month-old boy was referred for monocular nystagmus and failure to thrive. He was born at full term weighing 3.63 kg after a normal pregnancy, labor, and delivery. He grew appropriately until 3 months of age, after which his weight dropped from the 50th percentile to the fifth percentile in 2 months despite maintenance of a fairly adequate caloric intake. The patient had multiple episodes of emesis. Results of his gastrointestinal evaluation were normal. At 6 months of age, he developed a constant rapid nystagmus of the right eye.