Neuropediatric action protocol.
- Transfontanelar ultrasound (in children under 6 months with ultrasound window).
- Fundus of the eye (fundamental).
- PEV flash (optional).
- Neurological and dysmorphological examination, with special attention to dyschromia.
- Referral to early care regardless of neurodevelopment (neurodevelopmental risk).
Based on the previous findings, assess the indication for neuroimaging testing.
- MRI with sedation.
- Genetic.
| Red flag signs |
| • Later onset nystagmus (in the absence of signs in keeping with an ocular disorder). |
| • Constant oscillopsia in older children. |
| • Dysconjugate/gaze evoked/seesaw/convergence-retraction nystagmus. |
| • Horizontal nystagmus becoming vertical in vertical gaze. |
| • Vertical or torsional nystagmus (in the absence of retinal pathology (e.g. achromatopsia). |
| • Any associated neurological signs and/or a systemically unwell child. |
