Everything You Need To Know About Nystagmus | Ophthalmology

Nystagmus

What is nystagmus?

Nystagmus is a condition that causes rapid, involuntary movement of one or both eyes. It often occurs with vision problems, including blurred vision. This condition is sometimes called “dancing eyes.”

What are the symptoms of nystagmus?

The symptoms include fast, uncontrollable eye movements. The direction of movement determines the types:

  • Horizontal nystagmus involves side-to-side eye movements.
  • Vertical nystagmus involves up-and-down eye movements.
  • Rotary, or torsional, nystagmus involves circular movements.

These movements may occur in one or both eyes depending on the cause.

Types of nystagmus

This can occur when the part of the brain or inner ear that regulates eye movement and positioning doesn’t function correctly.

The labyrinth is the outer wall of the inner ear that helps you sense movement and position. It also helps control eye movements. The condition can be either genetic or acquired.

Infantile nystagmus syndrome

Congenital nystagmus is called infantile nystagmus syndrome (INS). It can be an inherited genetic condition. INS usually appears in the first six to three months of a child’s life.

This type is usually mild and is not usually caused by an underlying health problem. In rare cases, congenital eye disease can cause INS. Albinism is a genetic condition associated with INS.

Most people with INS do not need treatment and have no future problems. In fact, most people with INS don’t even notice the movements of their eyes. However, vision problems are common.

Vision problems range from mild to severe and most people need corrective lenses or decide to have corrective surgery.

Acquired nystagmus

Acquired, or acute, nystagmus can develop at any stage of life. It often occurs due to injury or disease. This can typically occur due to events that affect the labyrinth in the inner ear.

What are the causes of acquired nystagmus?

  • Stroke
  • Some medications, including narcotics and antiseptics, such as phenytoin (Dilantin)
  • Excessive alcohol drinking
  • Head injury or trauma
  • Eye diseases
  • Inner ear diseases
  • B-12 or thiamine deficiencies
  • Brain tumours
  • Central nervous system diseases, including multiple sclerosis.

When to seek treatment for nystagmus

See your doctor if you begin to notice symptoms. It always occurs due to an underlying health condition. You’ll want to determine what that condition is and how best to treat it.

Diagnosis

If you have this type of disease, the condition worsens, or you are concerned about your vision, you should see an ophthalmologist.

Your ophthalmologist can diagnose through an eye exam. They will ask about your medical history to find out if any underlying health problems, medications, or environmental conditions are contributing to your vision problems. They can also be:

  • Perform a refraction test to determine the optimal power of the lens you need to replace for your vision problems.
  • Test your eyesight, movement, and how they work together to see problems that affect control of your eye movements or make it difficult to use both eyes at the same time.

Treatment

Treatment depends on whether the condition is congenital or acquired. It does not require treatment, but the following can help improve your vision:

  • Eyeglasses
  • Contact lenses

Sometimes this subsides in childhood without treatment. If your child has a very bad case, your doctor may prescribe a surgery called a tenotomy to change the position of the muscle that controls eye movement.

These surgeries may not cure, but they can reduce the level at which your child turns his head to improve vision.

Some common treatments are:

  • Changing medications
  • Correct vitamin deficiencies with supplements and diet adjustments.
  • Eye drops for eye infections
  • Antibiotics for inner ear infections.
  • Special eyeglass lenses called prisms

Outlook for people who have nystagmus

This can improve over time with or without treatment. However, it usually never goes away completely.

The symptoms can make daily tasks more challenging. For instance, those with severe nystagmus may not be able to get a driver’s license, which can limit their mobility and require them to make transportation arrangements regularly.

Another challenge of acute nystagmus is finding the help of a caregiver. If you have very poor eyesight, you may need help with daily activities. Limited eyesight may increase the chances of injury.

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