Nystagmus is a condition that causes involuntary, rapid movement of one or
both eyes. Nystagmus often occurs with vision problems, including blurriness.
This condition is sometimes called “dancing eyes.”
Symptoms of nystagmus
The symptoms include fast, uncontrollable eye movements. The direction of
movement determines the type of nystagmus:
- Horizontal nystagmus involves side-to-side eye
- Vertical nystagmus involves up-and-down eye
- Rotary, or torsional, nystagmus involves
These movements may occur in one or both eyes depending on
Nystagmus occurs when the part of the brain or inner ear that regulates eye
movement and positioning doesn’t function correctly. The labyrinth is the outer
wall of the inner ear that helps you sense movement and position. It also helps
control eye movements. The condition can be either genetic or acquired.
Congenital nystagmus is called infantile nystagmus syndrome (INS). It may be
an inherited genetic condition. INS typically appears within the first six
weeks to three months of a child’s life. This type of nystagmus is usually mild
and isn’t typically caused by an underlying health problem. In rare cases, a
congenital eye disease could cause INS.
Most people with INS will not need treatment and don’t have complications
later in life. In fact, many people with INS don’t even notice their eye
movements. However, vision challenges are common. Vision problems can range
from mild to severe, and many people require corrective lenses or decide to
have corrective surgery.
Acquired, or acute, nystagmus can develop at any stage of life. It often
occurs due to injury or disease. Acquired nystagmus typically occurs due to
events that affect the labyrinth in the inner ear.
Possible causes of acquired nystagmus
Possible causes of acquired nystagmus include:
- certain medications, including sedatives and antiseizure
medications like phenytoin (Dilantin)
- excessive alcohol consumption
- head injury or trauma
- disease of the eye
- diseases of the inner ear
- B-12 or thiamine deficiencies
- brain tumors
- diseases of the central nervous system, including
to seek treatment for nystagmus
See your doctor if you begin to notice the symptoms of nystagmus. Acquired
nystagmus always occurs due to an underlying health condition. You’ll want to
determine what that condition is and how best to treat it.
If you have congenital nystagmus, you’ll need to see
an eye doctor called an ophthalmologist if the condition worsens or if you’re
concerned about your vision.
Your ophthalmologist can diagnose nystagmus by performing an
eye exam. They’ll ask you about your medical history to determine if any
underlying health problems, medications or environmental conditions may be
contributing to your vision problems. They may also:
- measure your vision to determine the type of
vision problems you have
- conduct a refraction test to determine the
correct lens power you’ll need to compensate for your vision problems
- test how your eyes focus, move, and function
together to look for problems that affect control of your eye movements or make
it hard to use both eyes together
If your ophthalmologist diagnoses you with nystagmus, they
may recommend that you see your primary care physician to address any
underlying health conditions. They may also give you some tips for what to do
at home to help you cope with nystagmus.
Your primary care physician can help determine what’s
causing your nystagmus. They’ll first ask about your medical history and then
perform a physical exam.
If your doctor cannot determine the cause of your nystagmus
after taking your history and performing a physical exam, they’ll run various
tests. Blood tests can help your doctor rule out any vitamin deficiencies.
Imaging tests, such as X-rays, CT scans, and MRIs can help your doctor
determine if any structural abnormalities in your brain or head are causing
Treatment for nystagmus depends on whether the condition is congenital or
acquired. Congenital nystagmus doesn’t require treatment, although the
following may help improve your vision:
- contact lenses
- increased lighting around the house
- magnifying devices
Sometimes, congenital nystagmus lessens over the course of childhood without
treatment. If your child has a very severe case, their doctor may suggest a surgery
called a “tenotomy” to change the position of the muscles that control eye
movement. Such surgery cannot cure nystagmus, but it can reduce the degree to
which your child needs to turn their head to improve their vision.
If you have acquired nystagmus, treatment will focus on the underlying
cause. Some common treatments for acquired nystagmus include:
- changing medications
- correcting vitamin deficiencies with supplements
and dietary adjustments
- brain surgery for central nervous system
disorders or brain diseases
- medicated eye drops for eye infections
- antibiotics for infections of the inner ear
- botulinum toxin to treat severe disturbances in
vision caused by eye movement
- special glasses lenses called prisms
Outlook for people who have nystagmus
Nystagmus may improve over time with or without treatment.
However, nystagmus usually never goes away completely.
The symptoms of nystagmus can make daily tasks more
challenging. For instance, those with severe nystagmus may not be able to get a
driver’s license, which can limit their mobility and require them to make
transportation arrangements on a regular basis.
Sharp eyesight is also important if you’re handling or
operating potentially dangerous equipment or equipment requiring precision. Nystagmus
can limit the types of occupations and hobbies you have.
Another challenge of severe nystagmus is finding caregiver
help. If you have very poor eyesight, you may need help carrying out daily
activities. If you need assistance, it’s important to ask for it. Limited
eyesight may increase your chances of injury. The American Nystagmus Network has a
list of helpful resources. You should also ask your doctor about the resources they