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WHAT IS OCULAR MOTOR APRAXIA


Ocular Motor Apraxia is a rare neurological condition affecting controlled eye movement. People with this condition have difficulty moving their eyes horizontally and therefore saccades (the  normal, quick, simultaneous movement of both eyes in the same direction) are abnormal. Because of this, most patients  with OMA have to turn their head in order to follow objects in side gaze. When this difficulty is present, people with OMA develop side-to-side head thrusts to compensate. Typically, vertical eye movements are unaffected. There are degrees in this condition, ranging from people presenting significant head thrusts, to people who are barely affected presenting only occasional  abnormal eye movement. 


HOW IS OMA IDENTIFIED?

It's easier to identify this abnormality in the person, when they are tracking objects moving horizontally or when turning their heads side-to-side and you can see a "delay" in the eye movements in relation to the head. Given that the source of OMA is in the brain, neuroimaging with magnetic resonance imaging (MRI) is commonly performed when evaluating OMA. Findings may be normal or may reveal poor development of regions of the brain, in particular the corpus callosum and cerebellum. A neurologist or an ophthalmologist will be able to diagnose it just by observation, however, MRI and genetic testing are sometimes performed to find the cause or the severity of it.


WHAT CAUSES OMA?


The genetics of OMA is not well understood and may be multifactorial.  Isolated OMA is generally considered non-hereditary and would not be associated with an increased risk of siblings or other family members developing this condition.  However, a number of genetic mutations have been identified which cause OMA in addition to other clinical features.  Siblings would be at increased risk of developing the condition in these cases, but the inheritance patterns can be variable. 


WHAT OTHER CONDITIONS MAY BE ASSOCIATED WITH OMA?


A person with OMA may be slow when performing tasks that involve scanning or switching their attention between locations and do best when they can focus on one thing at a time. They often seem clumsy, bump into things, and blink more than most people do. They also may avoid eye contact, watch you out of the corner of their eye, roll their eyes or shake their head while speaking with you. Commonly, OMA is accompanied by developmental delays, speech difficulties, low muscle tone, and/or difficulty with balance and coordination. Also, some behavioral issues, such as Autism, ADHD, and sensory processing disorder have been identified in some individuals.


To find out more about this OMA-related issues, and find resources to help you overcome these "side effects" please check out our helpful resources section.

WHAT ARE THE CLINICAL DIAGNOSIS THAT ACCOMPANY OMA?


There is a wide range of clinical entities that have  been reported in children with OMA. Please refer to the links on the top left to find out more about some of them. Not many individuals fall into any of those categories, and when not actual cause nor medical condition can be diagnosed, it's often referred as Idiopathic OMA.  


WHAT IS THE TREATMENT FOR OMA?


While symptoms tend to decrease over time and some people find therapy helpful, OMA is a disorder that cannot be cured or completely grown out of, however the related developmental delays can be treated and improved significantly with therapies and exercises.  The head thrusts associated with OMA typically diminish over time, but tend not to completely disappear. This may represent a true improvement in the disorder or be an adaptive compensatory mechanism to mask the head thrust.


Most challenges are presented in the first few years of life. The lives of people with OMA, particularly those with Cogan's OMA and Idiopathic OMA, tend to improve significantly on their second decade of life. Adults with OMA are able to go to go to school, have a job, have a family and live their lives like any non-OMA person. 


To find ways to connect with other people living with OMA, please check our  Community section.


For more information, please click on MEDICAL LINKS on the left.