Abordaje optométrico de un lactante con fotofobia y nistagmus en Bucaramanga, 2025-2026

Abstract

Early visual disorders, such as photophobia and nystagmus, require timely detection for interdisciplinary management. Objective: To describe the clinical and interdisciplinary approach for an infant with photophobia, nystagmus, and suspected cone dystrophy in Bucaramanga (2025–2026). Methodology: Case report (Universidad Santo Tomás). Assessment included anamnesis, behavioral visual function, cycloplegic refraction, motor evaluation, and chromatic filters. ERG and genetic testing were referred. Case Description: Preterm infant with nystagmus since 8 months old. At 11 months, the patient presented head tilting, photophobia, and high hyperopia (optically corrected). At 18 months, a null position was identified, showing functional improvement with a 527 nm filter. ERG suggested cone dystrophy, and suspected autism spectrum disorder remained. A behavioral assessment further explored sensory organization. Conclusions: Clinical management requires age-appropriate evaluation, including motor analysis and null position identification. Prisms and chromatic filters reduce sensory overload, while ERG and genetic testing are essential for differential diagnosis of retinal dystrophies. Observing gait and environmental exploration provides data on sensory integration, guiding caregivers in therapeutic strategies. Coordination between optometry, pediatric ophthalmology, genetics, psychiatry, and occupational therapy is fundamental for an intervention plan consistent with the child's visual and sensory needs.