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Nystagmus

Pronounced: ni-STAG-mus

Definition

Nystagmus is a type of involuntary movement of the eyes. The movement usually alternates between slow and fast and involves both eyes.

Different types of nystagmus are:

  • Horizontal—side-to-side
  • Vertical—up and down
  • Rotatory—circular
  • Infantile—tends to develop between ages 6 weeks and 3 months and is the most common type
  • Acquired—occurs later in life

Causes    TOP

The direct cause of nystagmus is instability in the motor system that controls the eyes. Sometimes it can be the result of poor vision and is called sensory nystagmus. In some cases, the cause of nystagmus is unknown.

Risk Factors    TOP

Factors that may increase your chance of nystagmus include:

  • Genetic tendency
  • A family member with nystagmus
  • Poor development of eye control that may be caused by an eye disease or visual problem during infancy, such as bilateral optic nerve hypoplasia or congenital cataracts
  • Lack of pigmentation resulting in reduced vision—albinism
  • Eye disorders, such as optic nerve degeneration or severe astigmatism or severe nearsightedness
  • Health conditions, such as Menieres disease which involves balance problems, multiple sclerosis, spasmus nutans, or stroke
  • Injury to the head or involving the body’s motor system
  • Use of certain medications, such as lithium or antiseizure medications
  • Alcohol use disorder or drug abuse
  • Inner ear problems, such as infections, irritation, or benign paroxysmal positional vertigo
  • Thiamine or vitamin B12 deficiency
  • Conditions that affect the brain, such a tumor

Symptoms    TOP

Nystagmus may cause:

  • Sensitivity to light
  • Difficulty seeing in darkness
  • Vision problems
  • Head held in a turned position
  • Oscillopsia—feeling that the world is shaking or moving
  • Vertigo

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done. If nystagmus seems to be present, you may need:

  • A full exam with an eye specialist called an ophthalmologist
  • An ear exam, including a hearing test
  • Exam with a neurologist or other medical specialist

Tests may include the following:

  • Visual exam of the inside of the eye with an ophthalmoscope
  • Vision testing
  • Eye movement recordings

Imaging tests may include:

MRI Scan

MRI of the Brain
Copyright © Nucleus Medical Media, Inc.

The ophthalmologist will also look for other eye problems that may be related to the nystagmus, such as strabismus, cataracts, or abnormality of the optic nerves or retina.

The ear specialist will look for signs of ear infection, and for worsening of the nystagmus with head positions.

Treatment    TOP

Talk with your doctor about the best treatment plan for you. Removal of the cause of nystagmus can sometimes eliminate the problem, such as discontinuing a medication or stopping alcohol or drug use. However, nystagmus often is a permanent condition that can only be reduced and not eliminated. Treatment options to reduce nystagmus and improve vision include the following:

  • Prisms, tints, eyeglasses, or contact lenses
  • Adopting a particular angle of vision where the nystagmus is reduced, such as holding the head in a certain position
  • Vibratory stimulation of the face and neck
  • Certain medications for certain types of nystagmus, including botox injections to relax the eye muscles, muscle relaxants, and certain antiseizure medications
  • Surgery on the eye muscles

Low-vision aids can often help improve vision. They may include large print or high contrast materials, good lighting, and magnifying devices.

Prevention    TOP

There are no current guidelines to prevent nystagmus.

RESOURCES:

American Optometric Association
http://www.aoa.org
Eye Smart—American Academy of Ophthalmology
http://www.eyesmart.org

CANADIAN RESOURCES:

Canadian Ophthalmological Society
http://www.cos-sco.ca

References:

Eye facts about nystagmus. American Nystagmus Network website. Available at:
...(Click grey area to select URL)
Accessed November 5, 2015.
General information about nystagmus. American Nystagmus Network website. Available at:
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Accessed November 5, 2015.
Hertle RW. Understanding and treatment of infantile nystagmus syndrome. Presentation at the 4th Biennial Conference of the American Nystagmus Network, Los Angeles, CA. July 8-10, 2005. American Nystagmus Network website. Available at:
...(Click grey area to select URL)
Accessed November 5, 2015.
Nystagmus. American Academy of Ophthalmology Eye Smart website. Available at:
...(Click grey area to select URL)
Accessed November 5, 2015.
Maybodi M. Understanding nystagmus: diagnosis, related disorders, treatment, and research. Presentation at the 3rd Biennial Conference of the American Nystagmus Network, Baltimore, MD. July 11-13, 2003. Available at:
...(Click grey area to select URL)
Accessed November 5, 2015.
Last reviewed November 2015 by Michael Woods, MD
Last Updated: 12/20/2014

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