The neutral point is the direction of gaze where nystagmus changes direction.

• A. End-point nystagmus
• B. Neutral point
• C. Null point
• D. Gaze-evoked nystagmus

Answer: (B)

The key idea is that nystagmus has a specific gaze direction where its velocity is zero and the direction of the eye drift reverses. At this neutral point, the slow phase of nystagmus effectively stops, so the quick corrective movements switch direction. That’s why this direction is described as the point where nystagmus changes direction.

Clinically, this concept helps explain why people with congenital or gaze-evoked nystagmus often have a preferred eccentric gaze—the null or neutral point—where the nystagmus is minimized or its direction flips. While some texts use “null point” to describe a similar phenomenon, the description given in the question aligns with the neutral point: the direction of gaze at which the nystagmus reverses.

End-point nystagmus refers to nystagmus that appears at extreme gaze due to mechanical limitation, and gaze-evoked nystagmus arises when nystagmus is provoked by sustaining a non-primary gaze; these describe different patterns and aren’t about the point where velocity crosses zero and reverses.