Microsaccadic opsoclonus: an idiopathic cause of oscillopsia and episodic blurred vision.

Purpose: To describe the clinical presentation and results of three-dimensional video-oculography of a patient with idiopathic microsaccadic opsoclonus.
Design: Observational case report.
Methods: Neuro-ophthalmologic examination and video-oculographic recording of horizontal, vertical, and torsional eye movements.
Results: A 67-year-old man with intermittent blurred vision and oscillopsia, which persisted with monocular occlusion, over a five year period was found to have high frequency, small amplitude back-to-back multivectorial saccadic movements which were visible with slit lamp biomicroscopy and direct ophthalmoscopy. Video-oculography showed a 20 Hz, 0.2 to 1 degree pattern of horizontal, vertical, and torsional microsaccades. This microsaccadic disorder has persisted for five years with no etiology.
Conclusions: Microsaccadic opsoclonus is an idiopathic disorder that presents with oscillopsia and intermittent blurred vision. The diagnosis can be confirmed with three-dimensional eye movement recordings.