Congenital ocular motor apraxia without head thrusts.

Congenital ocular motor apraxia is a distinctive disorder that may present initially as apparent cortical blindness, because of the patient's inability to make saccadic eye movements to fixate targets moving in the horizontal plane. Affected children develop a characteristic compensatory head thrust that allows them to fixate and allows the physician to make the diagnosis. Two patients, initially thought to be blind because of a lack of fix or following responses in the horizontal plane, are reported. Although head thrusts were not present because of inadequate head control, the diagnosis of congenital ocular motor apraxia was made because of other diagnostic features. The cases emphasize the need to consider congenital ocular motor apraxia in any child thought to be cortically blind.