Tenometry - A New Type of Surgery For Eyes

Tenotomy is designed to correct nystagmus by removing selected eye muscles and re-attaching them to the eyeball at exactly the same spot. A surgery typically used on ankle tendons knee joints or bicep muscles is now being applied to eyes. The director of Clinical Neuro-Ophthalmology at University Hospitals of Cleveland Dr. Robert Tomsak recently performed an innovative surgical procedure to improve the vision of patients with nystagmus an involuntary movement of the eyes that can impair vision and cause balance and equilibrium problems.

This very rare condition may be congenital or acquired perhaps as the result of a neurological condition such as multiple sclerosis. Experts estimate that congenital nystagmus affects about one in 3000 people. Acquired nystagmus is an even rarer condition. Medications have been used to treat acquired nystagmus but have not always worked effectively.

In order to transmit a clear signal to the brain your eye has to stay on target and focus on a specific object. If your eye is constantly moving though the brain cannot ’take a picture’ quickly enough to make a sharp image. The surgery’s goal is to slow the involuntary eye movements so your eye can take a better more detailed picture.

This surgery called tenotomy is designed to correct nystagmus by removing selected eye muscles and re-attaching them to the eyeball at exactly the same spot. Tenotomy presumably interrupts electrical signals between the brain and the eye muscles – as a result these involuntary and debilitating eye movements are dampened or lessened.

In October 2003 Dr. Tomsak became the first physician to perform tenotomy on a patient with acquired nystagmus (this patient has multiple scerlosis). The surgery was successful in reducing the nystagmus by 50 per cent according to Dr. Tomsak. The patient’s vision has improved slightly since the operation and it is hoped that he will continue to improve as time goes on.

Both congenital and acquired nystagmus doctors say are directly caused by instability of the motor system controlling the eyes. Dr. Tomsak a neuro-ophthalmologist and collaborators Dr. Dell’Osso R. John Leigh MD and Janet Rucker MD presented these results of their research at the North American Neuro-Ophthalmological Society meeting in March 2004.