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Effects of retinal image stabilization in acquired nystagmus due to neurologic disease

Departments of Neurology (Drs. Leigh, Thurston, and Hertle) and Optometry (Dr. Yaniglos), University Hospitals and Cleveland VA Medical Center, Case Western University, Cleveland, OH, and the Medical Research Council Neurological Prostheses Unit (Dr. Rushton), Institute of Psychiatry, London, UK.

We studied the effects of variable amounts of artificial retinal image stabilization (RIS) upon oscillopsia and visual acuity in eight patients with acquired nystagmus due to neurologic disease. We measured horizontal and vertical eye movements with the magnetic search coil technique and used these electronic signals to control the position of a visual stimulus on a screen in front of the patient. We also used an optical device to stabilize images of the real world upon the retina. During electronic stabilization, RIS was progressively increased until oscillopsia was abolished; this was achieved in all eight patients and corresponded to retinal image drift of 5 degrees/sec or less. In five patients with downbeat nystagmus, further increases in RIS caused the oscillopsia to reappear, but in the opposite direction. Electronic stabilization also improved visual acuity in four of five patients; the limitation of improvement could be related to coexistent visual system defects. Using electronic feedback, we could measure the range of RIS that any individual required to abolish oscillopsia; from this measurement, the components of the optical device that were best suited to provide a stable field of vision could be calculated.

Address correspondence and reprint requests to Dr. Leigh, Department of Neurology, University Hospitals of Cleveland, 2074 Abington Road, Cleveland, Ohio 44106.

Supported by US PHS grant EY06717 (to Dr. Leigh), the Evenor Armington Fund, Veterans Administration, and (to Dr. Rushton) Medical Research Council of the UK.

Received February 23, 1987. Accepted for publication in final form March 26, 1987.

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