Large rectus muscle recessions for the treatment of congenital nystagmus.

Retroequatorial recessions of the horizontal rectus muscles 10 to 12 mm behind their insertions reduced the amplitude of manifest congenital nystagmus in three patients. Modest improvement of visual acuity occurred in two patients. In a third patient with periodic alternating nystagmus, a compensatory head turn was eliminated by shifting the neutral zone of the nystagmus to the primary position of gaze. In spite of large recessions of the muscle insertions, none of the patients had a functionally significant postoperative limitation of ocular motility.