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Nystagmus: What Medical Experts Say About the Condition

In this guide, we’ll dive into what medical experts say about nystagmus, a vision condition that can cause rhythmic side-to-side, up-and-down, or circular eye movements.

We’ll walk through the different types of nystagmus, causes, symptoms, treatment options, and some helpful tips for living with this condition.

What Is Nystagmus?

Simply put, nystagmus is a condition that causes the eyes to move rapidly and uncontrollably. There’s a lot of variation within this condition.

For some people, the movement is rapid, and for others, it’s slow. There are also people for whom it happens in only one eye, and for others, it affects both eyes, which is more common.

Looking in a certain direction or holding your head in one position can usually make it worse. In some cases, nystagmus lasts only for a few seconds, but in the most severe cases, it can be permanent.

If you know someone with nystagmus, you may notice that they tilt or turn their head to see more clearly and slow down their eye movements. Usually, nystagmus is a symptom of another eye condition or medical issue (we’ll do a deep dive into all the various causes of nystagmus later in this article).

There are names for the different directions and patterns your eyes may move in if you have nystagmus. These categories include:

  • Horizontal nystagmus: Eyes move side to side
  • Vertical nystagmus: Eyes move up and down
  • Rotary or torsional nystagmus: Eyes move in a circle
  • Jerk nystagmus: Eyes drift one way and then jerk in the opposite direction
  • Pendular nystagmus: Eyes sway back and forth like they’re following a pendulum

What Are the Symptoms of Nystagmus?

When someone has nystagmus, they don’t necessarily see the world “shaking” as might be assumed. Rather, they have blurred vision, and it can get worse if they look in directions that worsen their nystagmus. It’s only in more severe cases of nystagmus that someone might experience oscillopsia, the illusory sensation that the world is moving when it’s not.

Along with rapid, uncontrolled eye movement and visual impairment, some other symptoms of nystagmus that may occur include:

  • Light sensitivity
  • Difficulty seeing at night or in the dark
  • Other types of vision problems
  • Dizziness and difficulty with balance

Generally speaking, dizziness and difficulty with balance occur when nystagmus is caused or related to a problem with the vestibular system. These problems can involve either the inner ear or the brain. People with nystagmus tend to report that their symptoms worsen when they’re tired or stressed.

What Are the Different Types of Nystagmus?

Like many vision problems, there are several different types of nystagmus. This section will describe the three different types of nystagmus.

Infantile

Infants with nystagmus generally develop this condition when they’re a couple of months of age, and it’s also referred to as congenital nystagmus. In cases of infantile nystagmus, the baby’s eyes tend to move in horizontal, pendular motion.

Infants with nystagmus also tend to have other conditions, such as albinism. Albinism has been linked to nystagmus because it results in the absence of the iris, which can lead to congenital cataracts and underdeveloped optic nerves.

Acquired

Spasmus nutans is a type of acquired nystagmus that tends to develop between six months and three years of age, and, thankfully, it usually resolves on its own anywhere between two and eight years of age.

Spasmus nutans is a variety of acquired nystagmus that can cause kids to tilt and nod their heads. This type of nystagmus is distinct from infantile or congenital nystagmus because there’s no specific direction or movement that characterizes this type of nystagmus.

Other types of acquired nystagmus occur later in childhood or adulthood. Unlike infantile and spasmus nutans, there are several known causes of acquired nystagmus. Serious medical conditions, drug and alcohol use, and metabolic disorders are some of the most common causes of this type of nystagmus.

Adults with this condition do tend to describe seeing the world around them as shaky, a symptom that’s not usually seen in children with this condition.

What Causes Nystagmus?

Unfortunately, there’s not one, clear cause of nystagmus in all cases. This condition can be caused by a variety of things and can arise at any point in life.

That being said, some basic biology can explain nystagmus as a whole. The brain entirely controls eye movement through structures in your ear called the vestibular system.

Although it happens unconsciously, your eyes move constantly to accommodate the movements of your head. This allows you to see clear, sharp images. For people with nystagmus, the part of the brain that controls all of these important, often tiny, movements doesn’t work properly.

For this reason, nystagmus can indicate a problem with the eyes, neurological disorders, or issues with your inner ear.

There are a few reasons that the functioning of this part of the brain may be impaired. As previously mentioned, albinism, cataracts, metabolic disorders, and substance use are all potential causes of nystagmus.

Other cases include inner ear problems like Meniere’s disease (issues such as these usually lead to jerk nystagmus), multiple sclerosis (which usually results in pendular nystagmus), stroke, head injury, use of certain medication, and a family history of nystagmus.

Stroke is usually a cause of acquired nystagmus in older people, and head injury is a common cause of nystagmus in younger people and kids.

It’s thought that 6 to 24 people out of every 10,000 experience some form of nystagmus.

How Is Nystagmus Diagnosed?

To have nystagmus diagnosed, you need to see an ophthalmologist or a professional in neuro-ophthalmology.

During your visit, they will examine the inside of your eyes, perform an eye exam, and look for evidence of some of the other conditions often associated with nystagmus, like strabismus (misaligned eyes) or a problem with the optic nerve.

There are lots of different kinds of tests that may be used to diagnose nystagmus. One basic test involves spinning someone around for 30 seconds and then asking them to stare at an object. If their eyes move slowly one way and then rapidly in the opposite direction, they likely have nystagmus.

How Is Nystagmus Treated?

In the same way that nystagmus has many different causes, there are also many different treatment options. There’s no way to cure nystagmus, but people who are born with it may find that glasses or contact lenses help improve their vision. For kids struggling to put contact lenses in, glasses are usually the better option.

By clearing their vision with glasses or contact lenses, people with nystagmus may find their rapid eye movements slow down. For the same reason, other tools to help improve vision — like large print books, increased lighting, and magnifying devices can also be helpful.

In very rare cases, people undergo surgery to change the position of the muscles that are responsible for eye movement. Although this is not a cure, it may minimize how much someone has to change their head position to achieve clear vision.

It’s also important to keep in mind that nystagmus may naturally resolve and go away on its own. This is especially true if the underlying cause or behavior is treated.

Is There Any Way To Prevent Nystagmus?

Given that some types of nystagmus can be hereditary, there’s no way to prevent congenital forms of nystagmus.

However, abstaining from drug and alcohol use may help prevent acquired nystagmus. It’s also important to keep in mind that regular checkups and vision tests can help you stay on top of your health and deal with issues that may potentially lead to nystagmus if left untreated.

What Are Some Tips for Living With Nystagmus?

If you are an adult with nystagmus, you can make your life easier by enlarging the print on all of your devices and seeking out large-print books. Also, filling your home with lots of light will make it easier for you to see.

For parents of kids with nystagmus, it’s important to encourage them to use their eyes. Playing with big, brightly colored toys is a great way to encourage this. Toys with distinct textures and sounds can also be helpful because they give your child clues about the toy when they are having trouble seeing.

Wrapping Up

Nystagmus is an eye condition that affects the movement of the eyes and leads to abnormal visual activity. People with nystagmus will experience involuntary eye movements that cause either blurry vision or, in more severe cases, shaky vision.

To have nystagmus diagnosed, you’ll need to see an ophthalmologist and with them come up with a comprehensive eye care plan to help improve your vision. This may include using corrective tools like glasses (find a pair you love at Pair Eyewear) and making lifestyle changes so that it’s easier and more comfortable for you to see.

Sources:

Nystagmus Types - StatPearls | NCBI Bookshelf

Spasmus Nutans | EyeWiki

Meniere's disease - Symptoms and causes | Mayo Clinic

Gaze‐evoked nystagmus induced by alcohol intoxication | NIH