Straight Flush in the surgical management of nystagmus

Purpose: Since the fifties, eye muscle surgery for the treatment of nystagmus has been well documented in the ophthalmic literature. Bilateral parallel shifting of the eyes according to Kestenbaum and Anderson is the most popular surgical maneuver to correct for an abnormal head posture (AHP). However, dose recommendations differ considerably.

Material and Methods: Here we present a three-year-old girl with infantile nystagmus syndrome and compensatory AHP who underwent Kestenbaum surgery with classic Parks dosage.

Results: The moderate head turn was successfully corrected by Kestenbaum surgery according to Parks also in the longterm over a 7-year period.

Conclusion: In Kestenbaum surgery the compensatory AHP is corrected by symmetrically shifting the causing eccentric null points of both eyes to the primary gaze. A unilateral medial rectus recession of 5 mm with a lateral rectus resection of 8 mm in combination with a medial resection of 6 mm and a lateral recession of 7 mm in the other eye (classic Parks dosage) may be applied in moderate head turn.