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Task-induced Changes in Idiopathic Infantile Nystagmus Vary with Gaze

Salehi Fadardi, Marzieh*; Bathke, Arne C.; Harrar, Solomon W.; Abel, Larry Allen

Optometry and Vision Science: May 2017 - Volume 94 - Issue 5 - p 606–615
doi: 10.1097/OPX.0000000000001060

Purpose Investigations of infantile nystagmus syndrome (INS) at center or at the null position have reported that INS worsens when visual demand is combined with internal states, e.g. stress. Visual function and INS parameters such as foveation time, frequency, amplitude, and intensity can also be influenced by gaze position. We hypothesized that increases from baseline in visual demand and mental load would affect INS parameters at the null position differently than at other gaze positions.

Methods Eleven participants with idiopathic INS were asked to determine the direction of Tumbling-E targets, whose visual demand was varied through changes in size and contrast, using a staircase procedure. Targets appeared between ±25° in 5° steps. The task was repeated with both mental arithmetic and time restriction to impose higher mental load, confirmed through subjective ratings and concurrent physiological measurements.

Results Within-subject comparisons were limited to the null and 15° away from it. No significant main effects of task on any INS parameters were found. At both locations, high mental load worsened task performance metrics, i.e. lowest contrast (P = .001) and smallest optotype size reached (P = .012). There was a significant interaction between mental load and gaze position for foveation time (P = .02) and for the smallest optotype reached (P = .028). The increase in threshold optotype size from the low to high mental load was greater at the null than away from it. During high visual demand, foveation time significantly decreased from baseline at the null as compared to away from it (mean difference ± SE: 14.19 ± 0.7 msec; P = .010).

Conclusions Under high visual demand, the effects of increased mental load on foveation time and visual task performance differed at the null as compared to 15° away from it. Assessment of these effects could be valuable when evaluating INS clinically and when considering its impact on patients’ daily activities.



Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia (MSF, LAA); Department of Statistics, University of Kentucky, Lexington, Kentucky (ACB, SWH); and Department of Mathematics, Salzburg University, Salzburg, Austria (ACB).

Marzieh Salehi Fadardi, Department of Optometry and Vision Sciences, Level 4, Alice Hoy Building, The University of Melbourne, Melbourne VIC 3010, Australia, e-mail:

© 2017 American Academy of Optometry