Nystagmus
Overview
What is nystagmus?
Nystagmus (ni-stag-muhs) is a condition in which your eyes make rapid, repetitive, uncontrolled movements — such as up and down (vertical nystagmus), side to side (horizontal nystagmus) or in a circle (rotary nystagmus). These eye movements can cause problems with your vision, depth perception, balance and coordination.
Who does nystagmus affect?
Nystagmus can affect both children and adults. There are two types: congenital and acquired.
Congenital nystagmus
Babies with this condition start to show symptoms between six weeks and three months of age. This type of nystagmus is congenital, meaning people are born with it. In some cases, it’s passed down to children from their parents, but the exact cause isn’t always clear. Children with congenital nystagmus usually have it in both eyes. The main symptom is blurry vision.
Acquired nystagmus
Unlike congenital nystagmus, acquired nystagmus develops later in life. The condition is usually caused by an underlying health condition or drugs. Adults with acquired nystagmus describe their vision as “shaky.”
How common is nystagmus?
Approximately 1 in 1,000 people have some form of nystagmus.
Is nystagmus a serious condition?
Nystagmus itself isn’t considered dangerous. But it may be associated with serious health conditions, especially those affecting the brain, such as stroke, brain tumor, toxicity, head trauma and inflammatory diseases.
Symptoms and Causes
What are the symptoms of nystagmus?
Nystagmus symptoms can affect one or both eyes. Some of the most common warning signs include:
- Uncontrollable eye movement.
- Shaky or blurry vision.
- Balance problems.
- Dizziness.
- Light sensitivity.
- Nighttime vision problems.
If you have nystagmus, you might hold your head in a tilted or turned position. This improves focus and helps things look clearer when you can’t hold a steady gaze.
How do you get nystagmus?
Your brain controls your eye movement. When you move your head, your eyes move automatically to adjust. This stabilizes the image and helps you see clearly. In individuals with nystagmus, the areas of the brain that control eye movements don’t work properly.
Nystagmus could indicate another eye problem, or it could be associated with another medical condition. Nystagmus causes and risk factors include:
- Retina or optic nerve disorders.
- Underdeveloped control over eye movements.
- Inner ear conditions, such as Meniere’s disease.
- Stroke.
- Head trauma.
- Diseases of the central nervous system.
- Albinism (lack of pigmentation in the skin).
- Multiple sclerosis (MS).
- Certain medications, such as antiseizure drugs.
- Eye problems in babies, including strabismus (crossed eyes), cataracts and focusing problems.
- Alcohol or drug use.
Diagnosis and Tests
How is nystagmus diagnosed?
Generally, nystagmus is diagnosed by an ophthalmologist. They’ll test your vision, examine the inside of your eyes and ask about your symptoms. They’ll also check for other eye problems that might be related to nystagmus, including strabismus, cataracts or issues with the retina or optic nerve.
What tests will be done to diagnose nystagmus?
Your ophthalmologist may run a number of other nystagmus tests, including:
- A neurological examination.
- Eye-movement recordings.
- An ear exam.
- Imaging tests, such as CT scans or MRI, to capture pictures of your brain.
Another common nystagmus test involves spinning around for 30 seconds, then stopping. Your healthcare provider will then ask you to stare at an object. If you have nystagmus, your eyes will move slowly in one direction, then quickly in the other.
Management and Treatment
Can nystagmus be corrected?
Acquired nystagmus can sometimes be corrected once the underlying condition is addressed. For example, if nystagmus is caused by an inner ear condition, symptoms may go away once it’s treated. People with congenital nystagmus cannot be cured completely, but symptoms can be managed with proper treatment.
What nystagmus treatments are used?
There are a few different nystagmus treatments available. The approach that’s best for you depends on the cause of your condition, your health history and your personal preferences.
Glasses or contact lenses
Clearer vision can help slow the rapid eye movements associated with nystagmus. As a result, symptoms can be successfully managed with eyeglasses or contact lenses.
Medications
Some medications can reduce nystagmus symptoms in adults, such as gabapentin (antiseizure), baclofen (muscle relaxant) and onabotulinumtoxina (Botox®). These medications aren't used in children with nystagmus.
Eye muscle surgery
In rare instances, eye muscle surgery may be recommended. During this procedure, your surgeon repositions the muscles that move the eyes. This type of surgery doesn’t cure nystagmus, but it allows you to keep your head in a more comfortable position, thereby limiting eye movement.
Vision correction surgery
If you have nystagmus and are nearsighted, laser vision correction surgery — such as LASIK — may be beneficial. While laser eye surgery doesn’t cure nystagmus, it improves your vision. As a result, nystagmus symptoms may be reduced.
Prevention
How can I prevent nystagmus?
Currently, there is no way to prevent nystagmus. But you can reduce troublesome symptoms by treating the underlying cause.
Outlook / Prognosis
What can I expect if I have nystagmus?
Nystagmus can make everyday tasks more challenging. In some cases, it may even limit the types of jobs and hobbies you can have. Nystagmus rarely goes away completely, but it can improve over time. Your healthcare provider can help you find a treatment that works for you.
Living With
When should I see my healthcare provider?
If you notice any changes in your vision or other related symptoms, call your healthcare provider right away. Keep in mind that nystagmus can be linked to serious health issues, so prompt diagnosis and treatment is imperative. If you’ve already been diagnosed with nystagmus, let your provider know if your symptoms worsen.
A note from Cleveland Clinic
Nystagmus can have a significant negative impact on your vision. While the condition can’t be cured completely, there are treatments that can help. Ask your healthcare provider for resources. Learning everything you can about nystagmus can help you make an informed decision about your health.
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