Abnormal Eye Movements (Nystagmus)

What is nystagmus?

Nystagmus is abnormal eye movements that a person cannot control. The eyes may move from side-to-side, up and down, in a circle, or one eye may go up and the other down.

There are 2 main kinds of nystagmus: congenital nystagmus, and acquired nystagmus.

What is the cause?

Congenital nystagmus is present soon after birth. It may be caused by

• problems in the brain
• conditions that can cause problems with vision early in life, such as
  • cataract (cloudiness of the lens of your eye)
  • problems with the retina (the tissue lining the back of the eye that turns light into visual images) or optic nerve (the nerve located behind the eye that sends visual images to the brain)
  • glaucoma (damage to the optic nerve usually caused by high pressure inside the eye)

Acquired nystagmus develops later in life. Common causes include:

• drugs and medicines (such as antiseizure medicines or alcohol)
• multiple sclerosis
• brain tumors
• stroke
• injury

Sometimes, no cause can be found. This type of nystagmus is called idiopathic.

What are the symptoms?

The symptoms depend on when the problem happens. If you have nystagmus from an early age, your vision will usually be decreased, but the eye movements may not bother you.

Nystagmus that develops later in life may lead to blurry vision, dizziness, problems with walking, or a sense that your vision is shaking. Some people with nystagmus turn or tilt their head to lessen the symptoms.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, examine your eyes, and do tests. Tests you may have are:

• an exam using drops to dilate your pupil and special lenses to look in the back of your eye
• a detailed examination of your eye movements
• an MRI to examine your brain and check for swelling, stroke, or tumors

Children with nystagmus may need an exam under anesthesia to allow the eye care provider to examine their eyes closely to look for causes of nystagmus.

You may be referred to a doctor who specializes in the way the eye and brain interact, a doctor who specializes in the brain and nervous system, or to a brain surgeon.

How is it treated?

The treatment of nystagmus depends on its cause. If your healthcare provider thinks that it is related to medicine you are using, you may be switched to a different medicine. Tumors may be treated with steroids, radiation or surgery. Your provider will treat eye problems such as a cataract or glaucoma, or prescribe glasses to correct vision problems.

Your healthcare provider may recommend eye muscle surgery. This surgery can decrease the symptoms of nystagmus. Other treatment options include muscle relaxants, anticonvulsants, and BOTOX.

How can I take care of myself?

• Follow your treatment plan.
• Keep all appointments for provider visits or tests.

How long will the effects last?

Some causes of nystagmus (such as drugs or operable tumors) are able to be corrected. Others are not. People with poor vision that can cause congenital nystagmus may have decreased vision ranging from mild to severe.

How can I prevent nystagmus?

In most cases, nystagmus cannot be prevented. If your child has abnormal eye movements, be sure to have your child examined by a healthcare provider as soon as possible.