Nystagmus: Causes, Symptoms, Types, and Treatment

What is Nystagmus?

Nystagmus is a vision condition characterised by uncontrolled, rapid eye movements. These movements can happen in different patterns: side-to-side (horizontal), up-and-down (vertical), or in a circular motion (rotary). As a result, people with nystagmus may have vision-related challenges such as trouble seeing clearly, judging distances, and keeping their balance or coordinating movements.

What Are the Types of Nystagmus?

There are two main nystagmus types based on the age of onset:

• Congenital or Infantile Nystagmus: Babies with nystagmus usually start showing symptoms between 6 weeks and 3 months old. The exact cause is unclear, but it can be inherited from parents. Children with congenital nystagmus may often have it in both eyes, with the eyes typically moving side to side. The main symptom is blurry vision.
• Acquired Nystagmus: Acquired nystagmus develops later in life and is common in adults. It can be a symptom of a medical condition affecting the brain, eyes, or ears, but sometimes it isn’t linked to any specific condition. Acquired nystagmus can also result from an alcohol and drug use. Adults suffering from an acquired nystagmus often describe their symptoms as shaky vision.
• Spasmus Nutans: A specific type of acquired nystagmus called Spasmus Nutans affects children, usually diagnosed between 6 months and 3 years old. This type usually improves without treatment between ages 2 and 8.

In addition to the age of onset, nystagmus can also be classified based on the type of eye movement:

• Jerk Nystagmus: Characterised by a slow drift in one direction followed by a fast corrective movement in the opposite direction
• Pendular Nystagmus: The eye movements are smooth and equal in both directions, resembling a pendulum
• Rotary or Torsional Nystagmus: The eyes move in a circular or rotational pattern

Understanding nystagmus types and causes is important to determine the appropriate treatment and management strategies.

How Common is Nystagmus?

While the exact number of people with nystagmus isn’t fully known, it’s estimated that about 6 to 24 out of every 10,000 people may have some form of nystagmus.

Is Nystagmus a Serious Condition?

While nystagmus itself may not pose severe risks, it could signal other serious health conditions affecting the brain such as stroke, brain tumour, toxicity, and head trauma.

What are the Symptoms of Nystagmus?

One of the most noticeable nystagmus symptoms is uncontrollable eye movements. Some other signs may include a sensation of moving surroundings (oscillopsia), blurry vision, balance problems, light sensitivity, and dizziness or vertigo.

What Causes Nystagmus?

Nystagmus is characterised by involuntary eye movements and can be caused by various factors.

• Common nystagmus causes include congenital conditions, where individuals are born with the disorder, often presenting symptoms in infancy.
• Genetic factors may play a role, but the exact cause is often unclear.
• Acquired nystagmus develops later in life and can result from several underlying health issues. Neurological disorders, such as multiple sclerosis or stroke, are some of significant nystagmus causes, affecting the brain regions that control the eye movements.
• Additionally, inner ear problems, like Meniere's disease and vestibular disorders, can cause nystagmus because they affect balance and how we understand our position in space.
• Substance use is another factor; excessive alcohol intake and certain medications, such as anticonvulsants or sedatives, can also lead to nystagmus.
• Nutritional deficiencies, particularly thiamine or vitamin B12 deficiencies, may also contribute to the condition.

Understanding these nystagmus causes is essential for effective diagnosis and treatment.

How is Nystagmus Diagnosed?

An ophthalmologist diagnoses nystagmus. They perform several tests, including a detailed examination of the eyes and vision testing. Other diagnostic methods may involve eye-movement recordings, ear examinations, neurological evaluations and imaging tests such as CT scans and MRIs.

What are the Tests to Diagnose Nystagmus?

Diagnosing nystagmus typically involves a comprehensive eye exam and specialised tests to determine the type and underlying cause.

The most common tests include:

• Eye Movement Recordings: Devices such as an electronystagmography (ENG) or a videonystagmography (VNG) are used to record eye movements. This helps confirm the type of nystagmus and analyze its specific characteristics.
• Caloric Reflex Test: In this test, one ear canal is stimulated with warm or cold water or air. This activates the horizontal semicircular canal, which can provoke nystagmus.
• Optokinetic Testing: Rapid moving images are presented to observe how the eyes track them, as nystagmic eye movements are a natural reaction to the stimuli.
• Positional Testing: The patient's head is turned in different positions to check for positional nystagmus. This can help identify inner ear disorders, such as benign paroxysmal positional vertigo (BPPV).

These tests, along with thorough medical history and physical examination, help diagnose nystagmus and identify any underlying neurological or vestibular conditions.

Can Nystagmus Be Corrected?

While people born with nystagmus cannot be completely cured, they can benefit from glasses or contact lenses that may help slow down eye movements. In some rare cases, surgery might be needed to reposition certain eye muscles.

However, surgery doesn't cure nystagmus; it merely allows individuals to maintain their head in a more comfortable position. In some cases, acquired nystagmus can resolve if the underlying condition is treated.

What Are the Treatments For Nystagmus?

Nystagmus treatment strategies depend on the root cause.

They may include:

Glasses or Contact Lenses

For individuals with nystagmus, wearing glasses or contact lenses can help improve vision. Special prism lenses may be prescribed to reduce the amount eye movement needed to see clearly. These optical aids can enhance visual acuity and minimising the impact of nystagmus on daily activities.

Medications

Several medications can be effective manage nystagmus symptoms. Muscle relaxants or medications such as anticonvulsants have shown promise in reducing certain nystagmus types and can also alleviate symptoms for some patients. The medication choice is based on the reason for the nystagmus and how well each person responds.

Eye Muscle Surgery

In cases where nystagmus significantly affects vision, eye muscle surgery may be an option. This surgery involves repositioning the eye muscles to improve alignment and reduce abnormal eye movements. While surgery doesn’t cure nystagmus, it can help enhance vision and reduce the need to tilt the head, making it easier for people to see clearly.

Vision Correction Surgery

Laser vision correction surgeries, such as LASIK, may benefit patients with nystagmus who are nearsighted. Although these procedures do not cure nystagmus, but they can improve overall vision clarity, potentially reducing the symptoms associated with the condition.

How can I Prevent Nystagmus?

Nystagmus can't always be prevented, especially if it's congenital. However, managing the underlying conditions that cause acquired nystagmus can help lessen its effects.

What can I Expect if I Have Nystagmus?

If you have nystagmus, you may experience involuntary eye movements that can cause blurred vision, dizziness, and depth perception issues. Symptoms can vary based on the type and cause.

Treatment options include glasses, contact lenses, prism lenses, medications, and in some rare cases surgery to adjust eye muscles. With the right management, many people with nystagmus can reduce its effects on their daily life.

When to see a Doctor?

Getting a timely diagnosis and treatment is essential for managing nystagmus. If you experience any of the symptoms, it’s important to see a healthcare provider as soon as possible.

Conclusion

Understanding and managing nystagmus is important for those who have it. Remember, you’re not alone; medical professionals are there to support and guide you throughout every step of the way.

For any pathology-related concerns or testing services, Metropolis Healthcare can be your trusted partner. Their advanced labs, at-home sample collection facilities, and reliable test results empower patients with accurate information, enabling them to make an informed decisions about their health.

Whether it's understanding your health better or scheduling a home visit for testing, remember that it’s your health, and you have the power to prioritise it!