This video shows an eye suffering from superior oblique myokymia. This occurs when the superior oblique muscle rhythmically fires, causing a twitching intorsion of the eye. This is a difficult finding to pick up by simple external examination alone, as the twitching is subtle. Under the microscope, however, you can see the eye intorting. The key is to examine the conjunctival vessels as they move rhythmically.
These patients present with a lot of discomfort from oscillopsia and treatment is challenging in my experience. Typically involves medical therapy as surgery isn’t terribly helpful and can cause significant diplopia afterwards.
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Comment by dr saeed — September 24, 2007 @ 1:20 pm
how we can differentiate from rotary nystagmus?
Rotary nystagmus, though torsional, should still behave like any other type of nystagma: the key finding being a rhythmic to-and-fro movement.
This isn’t the greatest video, but if you watch those conjunctival vessels you can see that the movement doesn’t have rhythm (try clapping your hand or tapping a table with the movement). This looks more like the fasicular movements you see with lid twitching, but in this case it’s the superior oblique muscle that is randomly firing.
I have SOB and have had video taken by doctors at RPH in Perth. No I have had glasses made to suit it is quite good. I have movement when I am straining to see or driving e.g. on a country road (which I don’t often) or at night also don’t often unles I’m in the city where there are plenty of lights. Lately the superior olique muscle is jumping externally. It feels like it’s pushing out of my head. It can be seen jumping up and down quite clearly but it feels like it’s jumping out of my head. It is quite forceful and quite alarming. It is happening about 6 - 8 times a day and each time it does it, it lasts longer. I have counted it jumping up to 9 tmes straight. It is a strong movement like it’s being pinched and pulled out. I’m a bit concerned so will make an appointment to my specialist asap just in case other things are going on as lately I go to sleep on the Pc and driving and am very tired and dizzy.
If anyone has experienced this I would like to know.
Regards Margaret
Comment by Margaret Rowe — February 13, 2010 @ 9:41 am
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