The Heimann‐Bielscholwsky phenomenon: Dissociated vertical nystagmus

Davey, Keith; Kowal, Lionel; Friling, Ronit; Georgievski, Zoran; Sandbach, Jen

doi:10.1111/j.1442-9071.1998.tb01318.x

Cited by 19 publications

(11 citation statements)

References 8 publications

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“…4,5 Second, the Heimann-Bielschowsky movements have been described as nystagmoid with pendular vertical oscillations about the horizontal meridian. [9][10][11] In contrast, the eye movements in our cases were not truly rhythmic or nystagmoid, but were more sporadic and therefore similar to that of the more common hypertropic DVD. 7,8,12 Case 2 is the first case, to our knowledge, that presents eye movement recordings of the hypotropic drifts in a case of dissociated hypotropia.…”

Section: Discussioncontrasting

confidence: 65%

“…The visual acuity levels in these eyes were usually worse than 6/60, but the condition has been described in eyes with visual acuities better than 6/60. 11 The onsets of the vision deficits have ranged from infancy to 50 years of age. 9,10 In common with our cases, the velocity of the movements are reported to be slow, up to 5 cycles per second, and the amplitudes are variable, ranging from 5 to 50 degrees.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11] This enigmatic eye movement condition has been termed the Heimann-Bielschowsky phenomenon. 1,[9][10][11] All of the reported cases have affected only one eye. The visual acuity levels in these eyes were usually worse than 6/60, but the condition has been described in eyes with visual acuities better than 6/60.…”

Section: Discussionmentioning

confidence: 99%

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Dissociated Hypotropia: Clinical Features and Surgical Management of Two Cases

Kraft

Long

Irving

2006

Journal of American Association for Pediatric Ophthalmology and

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

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Dissociated Hypotropia: Clinical Features and Surgical Management of Two Cases

Kraft

Long

Irving

2006

Journal of American Association for Pediatric Ophthalmology and

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“…Thus, both Heimann and Bielschowsky pointed at the role of absent fusion (either nonacquired or disrupted) in HBP. Davey et al have suggested that HBP could be due to central fusion disruption (CFD) [12]. If CFD may well explain the loss of stability of the disabled eye in HBP, it does not explain the characteristic oscillations of this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

The Heimann-Bielschowsky Phenomenon: A Retrospective Case Series and Literature Review

Nguyen

Borruat

2019

Klin Monatsbl Augenheilkd

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Background The Heimann-Bielschowsky phenomenon (HBP) is an unusual form of monocular vertical pendular nystagmus and is usually asymptomatic. It always occurs in an eye with longstanding, profound visual loss. Reports of HBP are few and HBP is probably underdiagnosed. Recognition of HBP could prevent unnecessary and potentially harmful investigations. The purpose of this study was to report a series of patients with HBP and to summarise the international literature on the subject in order to better define the clinical presentation of HBP. Patients and Methods The study was approved by the local ethics committee. Medical records of patients diagnosed with HBP and examined by one of us (F. X. B.) were retrieved. Eye movements were quantified, either from video or eye tracking recordings, in all patients. The international literature on HBP was reviewed using the keywords “Heimann-Bielschowsky” or “monocular nystagmus”. Results From 2007 to 2017, we retrieved seven patients with HBP. In the literature, we found only 8 publications, accounting for 66 cases. In both our cases and those from the literature, VA was worse in the eye with HBP and was usually ≤ 20/200. Visual loss was either congenital or acquired and resulted from a variety of aetiologies. The eye movement was strictly monocular, pendular, mostly vertical, but sometimes oblique. Characteristically, its frequency was irregular but low (0.2 to 2.6 Hz in our cases, 0.05 to 5 Hz in the literature) and its amplitude very variable (1 to 9° and 1.5 to 50°, respectively). Extraocular movements were always preserved. Conclusions HBP is a benign monocular eye movement disorder that is always secondary to severe visual loss. Being asymptomatic, HBP is still under-recognised and easily overlooked. Furthermore, both amplitude and frequency of HBP may be small and irregular. Recognition of HBP is mandatory in order to prevent costly, unnecessary, and potentially hazardous investigations, and caution is advised, as cataract surgery might be responsible for postoperative oscillopsia.

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“…Smith et al reported cases of improvement of oscillations following strabismus surgery, whereas Davey et al did not observe any reduction in oscillation after strabismus surgery. 4,5 Our patient underwent rectus muscle resection, which could have had a similar effect to tenotomy. Therefore, this case suggests that surgery performed on horizontal extraocular muscles could be an effective treatment for HeimannBielschowsky phenomenon.…”

Section: Commentmentioning

confidence: 99%

The Effect of Horizontal Extraocular Muscle Surgery on the Heimann-Bielschowsky Phenomenon

Choi

Baek

Kim

2013

Neuro-Ophthalmology

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We report the effect of horizontal extraocular muscle surgery of Heimann-Bielshowsky phenomenon. A 52-year-old woman complained of binocular diplopia for a few months. In 2000, she underwent extracapsular cataract extraction with intraocular lens implantation in the right eye. After surgery, the diplopia persisted and developed further. She showed an esodeviation of 60 prism dioptres at near fixation and distance fixation. Cortical opacity and nucleus sclerosis were observed in the left lens, and phacoemulsification with intraocular lens implantation was performed in the left eye in October 2011. After cataract surgery, the patient suffered from oscillopsia and diplopia. Examination revealed unilateral coarse, slow, pendular vertical oscillations in the right eye and an esodeviation of 45 prism dioptres and a right hypodeviation of 8 prism dioptres, which were observed before the surgery. We performed a medial rectus muscle 6 mm recession and lateral rectus muscle 7 mm resection surgery on the right eye. After the operation, the oscillations disappeared and diplopia greatly improved. Moreover, the patient no longer complained of oscillopsia. We conclude that surgery performed on horizontal extraocular muscles could be an effective treatment for Heimann-Bielschowsky phenomenon also.

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The Heimann‐Bielscholwsky phenomenon: Dissociated vertical nystagmus

Abstract: We believe that the HBP may be a reasonably common condition, although very under diagnosed. This condition may be similar to Central Fusion Disruption. Patients with HBP appear to have lost the potential for fusion.

Cited by 19 publications

References 8 publications

Dissociated Hypotropia: Clinical Features and Surgical Management of Two Cases

Dissociated Hypotropia: Clinical Features and Surgical Management of Two Cases

The Heimann-Bielschowsky Phenomenon: A Retrospective Case Series and Literature Review

The Effect of Horizontal Extraocular Muscle Surgery on the Heimann-Bielschowsky Phenomenon

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