Arnold Chiari Malformation (ACM) and Syringomyelia (SM) are being diagnosed more frequently with the use of Magnetic Resonance Imaging. Clinicians must consider ACM or SM in any patient that presents with unexplained sensory deficits, vertigo, headaches, nystagmus, oscillopsia, diplopia, motor reflex changes, transient vision loss and/or blurred vision. Studies involving the neurological and ophthalmological signs and symptoms of ACM and SM were reviewed. A survey was conducted among 38 patients with either ACM, SM or both to determine what signs and symptoms are most frequently reported. Optometric management requires recognizing when a patient presents with these symptoms, particularly downbeat nystagmus to refer them to for a neurological assessment with a recommendation for an MRI. In addition, management requires alleviating the patient's symptoms and frequent monitoring of the patient's extra-ocular muscles and evaluation of their optic nerve heads and visual fields.
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