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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:
- Vertical—up and down
- Infantile—tends to develop between 6 weeks and 3 months of age and is the most common type.
- Acquired—occurs later in life
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.
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 Meniere’s 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
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
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:
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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.
Talk with your doctor about the best treatment plan for you. Removal of the cause of nystagmus can sometimes eliminate the problem, for example 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 anti-seizure 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.
American Optometric Association
Eye Smart—American Academpy of Ophthalmology
Canadian Ophthalmological Society
Eye facts about nystagmus. American Nystagmus Network website. Available at: http://www.nystagmus.org/aao.html. Accessed November 5, 2015.
General information about nystagmus. American Nystagmus Network website. Available at: http://www.nystagmus.org/aboutn.html. 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: http://www.nystagmus.org/doc/conf2005/hertle%5FANN.pdf. Accessed November 5, 2015.
Nystagmus. American Academy of Ophthalmology Eye Smart website. Available at: http://www.geteyesmart.org/eyesmart/diseases/nystagmus.cfm. 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: http://www.nystagmus.org/doc/conf2003/KEYNOTE.pdf. Accessed November 5, 2015.
- Reviewer: Michael Woods, MD
- Review Date: 11/2015
- Update Date: 12/20/2014