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Saccadic Intrusions and Dysmetria

Saccadic dysmetria, intrusions, and oscillations are often encountered in association with certain cerebellar and neurodegenerative diseases. When severe, they can give rise to visual symptoms, such as difficulty with reading and oscillopsia. In this chapter, we begin by reviewing the clinical features of saccadic dysmetria, in which the saccadic amplitude is inappropriately calibrated. We next review the clinical features of saccadic intrusions and oscillations, which include square-wave jerks, macrosaccadic oscillations, ocular flutter, and opsoclonus. We review the common causes of these entities and discuss the diagnostic workup. Lastly, we discuss potential medical treatments to reduce the magnitude and frequency of saccadic intrusions and oscillations.