A Novel Surgical Treatment for Nystagmus

Eight days after eye surgery, eight-year-old Thomas Walkup spends some time with his favorite baseball player, Mike Trout. (MLB.com Video)

Nystagmus General Information - Click to Download: Augmented Sinskey Extirpation Procedure for Nystagmus

Nystagmus (ni’-stag-mus) refers to a condition of involuntary eye movements. The eye muscles that control eye movement receive a pulsating stimulus to contract, instead of a quiet steady tone. Patients with this affliction will adopt an unusual head, or eye position to minimize their unwanted appearance, or wear dark glasses. It can be present at birth or acquired anytime throughout life due to neurologic or ocular disease. When it has its onset in adulthood, the world appears in constant motion. When it has its onset in childhood, there is often a significant impact on education and social development. It affects approximately 1 in 5,000 people.

The clinical appearance is variable. The uncontrollable eye shaking can be horizontal, vertical, rotational, or any in combination of those directions. It can consist of a slow, to and fro slow oscillation of the eyes (“pendular”), or have both a slow drifting phase and a rapid repositioning (“jerk”) phase.

Congenital nystagmus, that occurring at or shortly after birth, has traditionally been thought of as untreatable. Research in treatment has been primarily directed toward trials of medications that quiet the nervous system, for example, those used for seizure control, and therefore their use has many potential unwanted side effects. Surgical approaches to change the effects of muscle contractions on the eye have had limited success in eliminating the unwanted, uncontrollable eye movement.

In 2002, Dr. Robert Siskey and colleagues, reported on an aggressive surgical approach to quiet the unwanted eye movements by removing the offending muscles. Not only was the eye shaking controlled but the eyes could still move sufficiently to accomplish normal tasks of daily living. After evaluating one of these patients, 10 years after that surgical approach, Dr. Robert Lingua and colleagues at the Gavin Herbert Eye Institute, have re-opened the case for eye muscle removal (“sub-total anterior extirpation”) to treat nystagmus. Preliminary results can be found in a 9 minute video on YouTube:


Dr. Lingua now regularly performs this surgery even if the patients who were treated with other types of unsuccessful surgery in the past, and has achieved a near surgical cure of the nystagmus, as documented by objective, sophisticated, infra-red video eye movement recordings (infra-red videonystagmography). Dr. Lingua was the first surgeon to apply this technique to children with nystagmus, operating as young as 1 year of age, with the goal of optimizing vision development in childhood, and improving personal self image, in the child’s school and formative years.

Nystagmus General Information - Click to Download: Augmented Sinskey Extirpation Procedure for Nystagmus



UC Irvine Health eye surgeon describes new treatment that restored girl's vision

August 15, 2014


IN THE NEWS: Dr. Robert Lingua and Grace Nassar talk with Dr. Bruce Hensel of NBC4 about the procedure that restored the seven-year old's vision. Dr. Lingua, a pediatric ophthalmologist at the UC Irvine Health Gavin Herbert Eye Institute, is perfecting a surgery to treat nystagmus, a condition marked by uncontrollable eye movements.

Grace was three months old when her parents were told she had nystagmus. Worse, an underlying condition would eventually make her functionally blind.

By age six, Grace was studying Braille, walking with a white cane and facing an uncertain future. An acquaintance told her parents about Dr. Lingua and the eye institute. Last summer, Grace underwent a revolutionary operation to eliminate her eye movements and improve her vision.

See more about Grace and the gift of vision ›



Anand Bhatt, M.D.
Marjan Farid, M.D.
Sumit (Sam) Garg, M.D.
Sanjay Kedhar, M.D.
Sameh Mosaed, M.D.
Matthew Wade, M.D.

Kavita K. Rao, M.D.

Marjan Farid, M.D.
Sumit (Sam) Garg, M.D.
Sanjay Kedhar
Matthew Wade, M.D.

Anand Bhatt, M.D.
Sameh Mosaed, M.D.

Marjan Farid, M.D.
Sumit (Sam) Garg, M.D.
Robert Lingua, M.D.
Matthew Wade, M.D.

Chantal Boisvert, M.D.
R. Wade Crow, M.D.

Donald S. Minckler M.D.


Jeremiah Tao, M.D.

Kathleen Dang, O.D.
Scott Liegler, O.D.
Kailey Marshall, O.D.

Chantal Boisvert, M.D.
Robert Lingua, M.D.
Jennifer Simpson, M.D.

Lbachir BenMohamed, Ph.D.
James Jester, Ph.D.
Tibor Juhasz, Ph.D.

M. Cristina Kenney, M.D., Ph.D.
Henry Klassen, M.D., Ph.D.
Anthony Nesburn, M.D.
Eric Pearlman, Ph.D.
Jing Yang M.D.

Andrew Browne, M.D., Ph.D.
Baruch Kuppermann, M.D., Ph.D.

Stephanie Lu, M.D.
Mitul Mehta M.D.

Sanjay Kedhar, M.D.

For ophthalmology
appointments, please call:

Gavin Herbert Eye Institute

Laser Refractive Surgery

UC Irvine Medical Center

Optical Shop
949-824-7690 Phone
949-824-8850 Fax





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