Rotary/torsional nystagmus?

[TDBC]

I am a 46-year old women with congenital amblyopia in my left eye.  I had a muscle surgery on my left eye on age 4, though it still turns inward when I am tried or not wearing my glasses.  My corrected vision is fine, though I don't have the best depth perception and my stereovison is abnormal (can't ever see those dang magic pictures!!) .  I moved recently and went to see a new optometrist about a week ago, just to get new contacts, and he told me I had a very mild torsional (rotary) nystagmus -- he referred me to an ophthalmologist and said I will likely need an MRI to check for brain lesions.  This, of course, freaked me out!  I have zero symptoms and feel perfectly fine!

I called my old optometrist (who I'd seen for 10+ years before moving out of state) and he told me that he thinks I've always had this (he remembered noticing it but never said anything because 1) it was so mild, and 2) he assumed it was due to the abnormal visual development/impaired stereo vision from my amblyopia.  I know for a fact that I noticed it myself several years ago (when I started having to get closer to the mirror to do my make-up!!).  I just assumed it was the normal movement of my eyes focusing.  

I'm going to keep the appointment with the ophthalmologist, but was hoping for some reassurance while I wait.  Can a slight degree of visible torsional movement just be a normal part of  amblyopia and impaired stereo vision ?  I have no other symptoms!  

[JohnHaganMD]

With that history that both you and your previous optom have noted the  small rotary nystagmus and if you have no other neurological symptoms such as headache, speech or balance problem. a strong case can be made to just document to your new optom and ophthalmologist that both you and your old optom noted this several to many years ago without it getting worse or new symptoms appearing and foregoing the expensive MRI and neurological work-up. That might be called 'watchful waiting" and you would not have to have the extensive/expensive work up unless new problems develop or the nystagmus gets worse.