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2025 ICD-10-CM code H55.01

Congenital nystagmus.

Medical necessity for the diagnosis and management of congenital nystagmus stems from the potential impact on vision and quality of life. Nystagmus can reduce visual acuity and make it difficult to perform daily activities. Treatment may include eyeglasses, contact lenses, medications, or surgery to improve vision and reduce the severity of nystagmus.

In simple words: Congenital nystagmus is a condition where the eyes make repetitive, uncontrolled movements. These movements can be from side to side, up and down, or in a circular pattern. It is present from birth or shortly after.

Nystagmus present at birth or caused by lesions sustained in utero or at the time of birth. It is usually pendular and is associated with albinism and conditions characterized by early loss of central vision. Inheritance patterns may be X-linked, autosomal dominant, or recessive.

Example 1: A newborn infant is observed to have constant, involuntary, back-and-forth eye movements shortly after birth. After a thorough ophthalmological examination, the infant is diagnosed with congenital nystagmus., A 2-month-old infant is brought to the pediatrician because the parents have noticed that the baby's eyes seem to shake. The pediatrician diagnoses congenital nystagmus and refers the infant to a pediatric ophthalmologist., A child with albinism also exhibits nystagmus, which was present from birth. This supports the association between albinism and congenital nystagmus.

Documentation should include a detailed description of the nystagmus, including the direction of the eye movements (horizontal, vertical, rotary, or mixed), the frequency and amplitude of the movements, any associated symptoms like oscillopsia (the illusion of objects moving in the visual field), and any relevant family history. Any underlying conditions, such as albinism or other ocular abnormalities, should also be documented.

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