Abstract: Objective To conduct a retrospective analysis of the characteristics of visual swaying, types of abnormal eye movements, and relevant etiological factors and treatment outcomes in patients presenting with oscillopsia. Design Retrospective case series. Participants 29 patients with visual swaying initially presenting at the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, from January 2019 to January 2023. Methods Clinical data, including features of visual swaying, characteristics of video-nystagmography (VNG), brain MRI findings, etiological diagnosis, treatment, and outcomes, were retrospectively reviewed. Main Outcome Measures Clinical manifestations, VNG, brain MRI, and treatment outcomes. Results All 29 patients exhibited oscillopsia and visual related dizziness, with 27 cases (93.1%) presenting with binocular symptoms, 18 cases with vertical oscillopsia, 8 cases with horizontal oscillopsia, and 1 case with seesaw (vertical and torsional mixed type) oscillopsia. Two cases (6.9%) presented with monocular symptoms, including torsional or horizontal oscillopsia. 27 cases (93.1%) had persistent symptoms, while 2 cases (6.9%) had episodic symptoms. VNG revealed that the direction of visual swaying was consistent with abnormal eye movement, 23 cases (79.3%) showed nystagmus, including 17 cases with downbeat nystagmus, 3 cases with periodic alternating nystagmus, 2 cases with acquired pendular nystagmus, and 1 case with pendular seesaw nystagmus. Three cases (10.3%) exhibited saccadic intrusion, 2 cases (6.9%) had bilateral vestibular dysfunction, and 1 case (3.4%) had superior oblique myokymia. All patients underwent at least one MRI examination, with 21 cases (87.5%) showing positive abnormal changes in cerebellar tonsils or optic nerves. Fourteen cases (48.3%) demonstrated improvement with different targeted treatments, such as surgical decompression or gabapentin, baclofen, or clonazepam. Conclusion Patients with oscillopsia commonly present with vertical and horizontal binocular visual swaying phenomena. Among etiology is varied, its characteristics are related to the type of abnormal eye movement, acquired nystagmus is predominant. Early recognition and understanding of visual symptoms and signs contribute to the prompt diagnosis and treatment. (Ophthalmol CHN, 2024, 33: 9-14)

Key words: visual swaying, oscillopsia, nystagmus, nystagmus-like abnormal eye movements