If we see nystagmus, what type of astigmatism should we expect?

• A. WTR
• B. ATR
• C. Oblique
• D. No astigmatism

Answer: (A)

Nystagmus in early development is often accompanied by refractive errors, including astigmatism. In infants and young children, the most common astigmatism pattern is with-the-rule, where the vertical meridian is steeper. This orientation tends to be the typical astigmatic pattern seen alongside congenital nystagmus, reflecting how the eye’s refractive surfaces develop in early life. Therefore, you would expect with-the-rule astigmatism. The other patterns—against-the-rule or oblique—are less commonly associated in this context, and having no astigmatism would not account for the presence of nystagmus with a refractive error.