Evaluation of transdermal scopolamine as treatment for acquired nystagmus

We conducted an unmasked evaluation of transdermal scopolamine in seven pat ients with acquired nystagmus for whom other treatments had been unsatisfac tory. We measured eye speed and visual acuity before and several hours afte r starting treatment. Median eye speed decreased slightly in three patients but increased in two; no change in visual acuity occurred in any patient. One patient was unable to tolerate the side effects of scopolamine after tw o hours, but the others continued the scopolamine treatment for 48 hours; o nly one reported minor improvement. We conclude that transdermal scopolamin e is not likely to be an effective treatment of acquired nystagmus. Patient s should be monitored during the first few hours of treatment to determine whether vision is improved or made worse and whether side effects occur.