What is Nystagmus?

Nystagmus is an unintentional jittery movement of the eyes.  Nystagmus usually involves both eyes and is often exaggerated by looking in a particular direction.

What Causes Nystagmus?

Many conditions are associated with nystagmus.  Sometimes, the brain’s control of eye movements is poor, resulting in an inability to look steadily at an object.  Some forms of nystagmus are associated with reduced vision such as occurs in albinos, extreme near or farsighted people, or in those with scars in the retina or optic nerve.  Rarely, nystagmus can occur as a result of brain tumors or in serious neurologic disorders.  Nystagmus can be found in families as an isolated problem, not associated with other conditions. 

What should be done about Nystagmus?

A thorough evaluation by an ophthalmologist and perhaps other medical specialists is important.  The cause can usually be determined.  Important clues relate to age of onset, family history, general health of the patient, or the use of certain medications.  Your ophthalmologist may examine the pattern of the nystagmus, its speed and direction and look for other eye problems such as a droopy lid, cataract, or an abnormality of the retina or optic nerves.  Blood tests or special x-rays may be useful in determining the cause.

Can Nystagmus Be cured?

Sometimes, removal of the cause may cure nystagmus.  Often, however nystagmus is permanent.  The reduced vision may be improved with glasses and low vision aids.  If the eyes are more stable while looking in a certain direction glasses with prisms or eye muscle surgery may improve the head position and allow better vision.  Medication, biofeedback and eye exercises have rarely helped control nystagmus.

What are the most common forms of nystagmus?

Motor nystagmus tends to begin between six weeks and three months of age.  Other family members may have similar unusual eye movements.   The motion is usually horizontal.  Often focusing up sloe or looking in an odd direction reduces the nystagmus intensity and improves the vision.  Fortunately, patients DO NOT see the world moving as their eyes move.  Vision may be reduced at distance but is almost normal up close.   There are usually no limits to the educational potential of one who has motor nystagmus.

Sensory nystagmus is associated with reduced vision of any cause.  Sensory nystagmus usually begins at 6 to 8 weeks of age.  The eyes appear to rove, sometimes slowly and sometimes quickly.  Very often the eyes will also rotate upward and the eyelids may flicker as well.  As a baby becomes older, he may poke at his eyes or wave his hands in front of them.  Sometimes the cause is treatable as in babies who are born with cataracts.  Other conditions which can lead to sensory nystagmus may not be treatable.   Nevertheless, understanding the underlying cause is of great importance to predicting how the baby will so in the future.

What are other causes of nystagmus?

Medications or drugs can cause nystagmus.  Rarely, this nystagmus can be associated with double vision and is often worse looking to the side.   Causes include excessive drinking of alcohol, or use of medications such as those given for seizure control.  Often the nystagmus will improve if the medication is stopped.

Voluntary nystagmus can be created by some people much in the same way as ear wiggling.  Fine rapid, horizontal movements can be produced and sustained for a short period of time.  Often this is done to gain attention.

Disease-induced nystagmus is less common.  It is often associated with neurologic signs and symptoms which indicate the seriousness of the problem.

Summary

If nystagmus is present, a full eye examination by an ophthalmologist is needed.  Underlying causes which determine the effect on the patient’s life and vision vary greatly.