title: Extended slow phase in latent/manifest latent nystagmus.
abstract: OBJECTIVE
  To investigate the slow phase in latent/manifest latent nystagmus (LMLN) by producing long eye-drift intervals devoid of fast phases (extended slow phases [ESPs]) and to relate ESP metrics to clinical findings.
  
  
  METHODS
  Ten patients with LMLN had eye movements recorded while attending to paired visual and auditory cues presented to their left or right. Patients compared location of the visual target with that of the subsequently heard tone. The auditory cue and the comparison task directed attention away from vision and delayed the fast-phase onset to obtain ESPs. ESP metrics were analyzed with regard to patients' clinical characteristics. Five patients' data were further explored by isolating slow-phase components.
  
  
  RESULTS
  All patients exhibited ESPs that resembled the usual slow phase but lasted two to three times longer. Five patients maintained alignment, whereas the other five made vergence movements. Greater eye velocity, excursion, and convergence during an ESP were associated with poor vision and large uncorrected esotropia. These metrics decreased when the viewing eye was in adduction, compared with primary position or abduction. Slow-phase components found in five patients consisted of a dominant decreasing-velocity or linear drift and a low-amplitude periodic oscillation.
  
  
  CONCLUSIONS
  Shifting attention away from vision reliably delays the fast phase, revealing long intervals of slow phase, which can facilitate nystagmus investigation. ESP analysis in five patients with LMLN demonstrated two slow-phase components. ESP characteristics suggest that better ocular alignment is associated with improved stability in LMLN and provide metrics of eye drift that correlate with vision.
authors.affiliation: Laboratory of Sensorimotor Research, National Eye Institute, National Institutes of Health, Bethesda, Maryland 20892-1863, USA. libe@nei.nih.gov
authors.forename: Libe
authors.initials: L
authors.lastname: Gradstein
authors.forename: Herschel P
authors.initials: HP
authors.lastname: Goldstein
authors.forename: Sheryl S
authors.initials: SS
authors.lastname: Wizov
authors.forename: Robert D
authors.initials: RD
authors.lastname: Reinecke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004584:Electronystagmography; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000503:physiopathology*; D009799:Ocular Physiological Phenomena; D014792:Visual Acuity / Q000502:physiology