Heimann-Bielschowsky phenomenon

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Teaching Video NeuroImages: Heimann-Bielschowsky phenomenon
A harmless monocular nystagmus

Heimann-Bielschowsky phenomenon (HBP) is a rare form of dissociated nystagmus.1 A 38-year-old man complained of poor vision in his right eye for 6 years. Right visual acuity was 20/200 due to traumatic aphakia (cataract extraction without intraocular lens) and 20/20 in the left eye. An asymptomatic coarse, low frequency, pendular, vertical nystagmus was manifest in the right eye only (video, http://links.lww.com/WNL/A177). HBP is an asymptomatic monocular slow, pendular, mostly vertical nystagmus, which can develop years after uniocular severe visual loss.1 The pathogenesis of HBP is debated, but vertical fusion disruption due to monocular visual loss is hypothesized.2 Recognizing HBP should prevent unnecessary investigations or treatments.

Teaching slides: http://links.lww.com/WNL/A178

Video: http://links.lww.com/WNL/A177

February 20, 2018; 90 (8)


  1. Yee RD, Jelks GW, Baloh RW, Honrubia V. Uniocular nystagmus in monocular visual loss. Ophthalmology 1979;86:511–522.
  2. Leigh RJ, Thurston SE, Tomsak RL, Grossman GE, Lanska DJ. Effect of monocular visual loss upon stability of gaze. Invest Ophthalmol Vis Sci 1989;30:288–292.