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Supranuclear eye movements and nystagmus in children: a review of the literature and guide to clinical examination, interpretation of findings and age appropriate norms

Supranuclear eye movements and nystagmus in children: a review of the literature and guide to clinical examination, interpretation of findings and age appropriate norms
Supranuclear eye movements and nystagmus in children: a review of the literature and guide to clinical examination, interpretation of findings and age appropriate norms
Abnormal eye movements in children present a significant challenge to Ophthalmologists and other healthcare professionals. Similarly, examination of supra-nuclear eye movements in children and interpretation of any resulting clinical signs can seem very complex. A structured assessment is often lacking although in many cases, simple clinical observations, combined with a basic understanding of the underlying neurology, can hold the key to clinical diagnosis. As the range of underlying diagnoses for children with abnormal eye movements is broad, recognising clinical patterns and understanding their neurological basis is also imperative for ongoing management. Here we present a review and best practice guide for a structured, methodical clinical examination of supranuclear eye movements in children, a guide to clinical interpretation and age-appropriate norms. We also detail the more common specific clinical findings and how they should be interpreted and used to guide further management. In summary, this review will encourage clinicians to combine a structured assessment and a logical interpretation of the resulting clinical signs, in order to recognise patterns of presentation and avoid unnecessary investigations and protracted delays in diagnosis and clinical care.
Nystagmus, eye movements
0950-222X
261-273
Osborne, D.
ec301605-203d-498b-9d5f-9ab4c198c09a
Theodorou, M.
dbc0a10f-e5fb-4057-b416-7048023b5d67
Lee, H.
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Ranger, M.
ec142d15-ec0b-4eb9-89c2-a71f36f02d39
Hedley-Lewis, M.
61afc617-ef7b-4e03-bf4f-41d0536a7445
Shawkat, F.
580315b7-94dd-4606-a311-5f58b1988cda
Harris, C.M.
babe5d95-0ea9-4a60-923c-2379b71b7b74
Self, J.E.
0f6efc58-ae24-4667-b8d6-6fafa849e389
Osborne, D.
ec301605-203d-498b-9d5f-9ab4c198c09a
Theodorou, M.
dbc0a10f-e5fb-4057-b416-7048023b5d67
Lee, H.
5d36fd1e-9334-4db5-b201-034d147133fb
Ranger, M.
ec142d15-ec0b-4eb9-89c2-a71f36f02d39
Hedley-Lewis, M.
61afc617-ef7b-4e03-bf4f-41d0536a7445
Shawkat, F.
580315b7-94dd-4606-a311-5f58b1988cda
Harris, C.M.
babe5d95-0ea9-4a60-923c-2379b71b7b74
Self, J.E.
0f6efc58-ae24-4667-b8d6-6fafa849e389

Osborne, D., Theodorou, M., Lee, H., Ranger, M., Hedley-Lewis, M., Shawkat, F., Harris, C.M. and Self, J.E. (2019) Supranuclear eye movements and nystagmus in children: a review of the literature and guide to clinical examination, interpretation of findings and age appropriate norms. Eye, 33 (2), 261-273. (doi:10.1038/s41433-018-0216-y).

Record type: Article

Abstract

Abnormal eye movements in children present a significant challenge to Ophthalmologists and other healthcare professionals. Similarly, examination of supra-nuclear eye movements in children and interpretation of any resulting clinical signs can seem very complex. A structured assessment is often lacking although in many cases, simple clinical observations, combined with a basic understanding of the underlying neurology, can hold the key to clinical diagnosis. As the range of underlying diagnoses for children with abnormal eye movements is broad, recognising clinical patterns and understanding their neurological basis is also imperative for ongoing management. Here we present a review and best practice guide for a structured, methodical clinical examination of supranuclear eye movements in children, a guide to clinical interpretation and age-appropriate norms. We also detail the more common specific clinical findings and how they should be interpreted and used to guide further management. In summary, this review will encourage clinicians to combine a structured assessment and a logical interpretation of the resulting clinical signs, in order to recognise patterns of presentation and avoid unnecessary investigations and protracted delays in diagnosis and clinical care.

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Final accepted manuscript August 2018 - Accepted Manuscript
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s41433-018-0216-y - Version of Record
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More information

Accepted/In Press date: 30 August 2018
e-pub ahead of print date: 23 October 2018
Published date: February 2019
Keywords: Nystagmus, eye movements

Identifiers

Local EPrints ID: 428493
URI: http://eprints.soton.ac.uk/id/eprint/428493
ISSN: 0950-222X
PURE UUID: 51131f30-bc1e-4189-97d2-1bf7da7e2ea7
ORCID for H. Lee: ORCID iD orcid.org/0000-0002-2573-9536
ORCID for J.E. Self: ORCID iD orcid.org/0000-0002-1030-9963

Catalogue record

Date deposited: 28 Feb 2019 17:30
Last modified: 18 Feb 2021 17:25

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Contributors

Author: D. Osborne
Author: M. Theodorou
Author: H. Lee ORCID iD
Author: M. Ranger
Author: M. Hedley-Lewis
Author: F. Shawkat
Author: C.M. Harris
Author: J.E. Self ORCID iD

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