To describe the clinical presentation and results of three-dimensional video-oculography of a patient with idiopathic microsaccadic opsoclonus. Observational case report. Neuro-ophthalmologic examination and video-oculographic recording of horizontal, vertical, and torsional eye movements. A 67-year-old man with intermittent blurred vision and oscillopsia, which persisted with monocular occlusion, over a five year period was found to have high frequency, small amplitude back-to-back multivectorial saccadic movements which were visible with slit lamp biomicroscopy and direct ophthalmoscopy. Video-oculography showed a 20 Hz, 0.2 to 1 degree pattern of horizontal, vertical, and torsional microsaccades. This microsaccadic disorder has persisted for five years with no etiology. Microsaccadic opsoclonus is an idiopathic disorder that presents with oscillopsia and intermittent blurred vision. The diagnosis can be confirmed with three-dimensional eye movement recordings.
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