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by Scholten A

Definition

Nystagmus is an uncontrolled movement of the eyes. The movement can be slow and fast. It involves both eyes and may be:

  • Side-to-side
  • Up and down
  • Circular

There are several types of nystagmus:

  • Infantile, the most common type—tends to start between ages 6 weeks and 3 months
  • Acquired—happens later

Causes

Infantile nystagmus is usually due to problems in the part of the brain that controls the eyes.

Acquired nystagmus is usually due to problems with vision or the nervous system.

Sometimes the cause is unknown.

Risk Factors

Things that may raise the risk of this problem are:

  • Genetics or family history
  • Albinism
  • Certain eye problems such as:
  • Health conditions, such as:
  • Conditions that affect the brain—such as injury, tumor, or infections
  • Alcohol or drug abuse
  • Use of certain medicines—such as lithium or antiseizure medicines
  • Thiamine or vitamin B12 deficiency

Symptoms

Nystagmus may cause:

  • Sensitivity to light
  • Vision problems
  • Head held in a turned or tilted position
  • Feelings of shaking, moving, or spinning

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam may be done. You may be sent to doctors who treat eye, ear, and nervous system problems.

Tests may include:

  • Eye exam and vision tests—to look for other eye problems
  • Eye movement recordings
  • Ear exam and hearing tests—to look for ear problems and infections
  • Imaging tests such as CT scan and MRI scan—to look at the brain and nervous system
MRI Scan
MRI of the Brain
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Treatment

The goal is to treat underlying causes, ease symptoms, and improve vision. Sometimes nystagmus can be cured by removing the cause. This may mean stopping certain medicines, drugs, or alcohol. Many times, however, this condition is permanent. It may be reduced but not cured.

Treatment options may be:

  • Prisms, tints, eyeglasses, or contact lenses—to improve vision
  • Holding the head in a certain position—to reduce symptoms
  • Certain medicines to relax eye muscles such as— Botox injections, muscle relaxers, and certain antiseizure medicines
  • Surgery on the eye muscles

Low-vision aids may help improve vision. They may include:

  • Large print or high contrast materials
  • Good lighting
  • Magnifying devices

Prevention

There are no current guidelines to prevent nystagmus.

RESOURCES

American Optometric Association  http://www.aoa.org 

Eye Smart—American Academy of Ophthalmology  http://www.eyesmart.org 

CANADIAN RESOURCES

Canadian Ophthalmological Society  http://www.cos-sco.ca 

Health Canada  https://www.canada.ca 

References

Bou Ghannam AS, Yassine S. Pediatric nystagmus. Int Ophthalmol Clin. 2018;58(4):23-65.

Eye facts about nystagmus. American Nystagmus Network website. Available at: http://www.nystagmus.org/aao.html. Accessed February 22, 2021.

General information about nystagmus. American Nystagmus Network website. Available at: http://www.nystagmus.org/aboutn.html. Accessed February 22, 2021.

Nystagmus - approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/nystagmus-approach-to-the-patient. Accessed February 22, 2021.

Nystagmus. Eye Smart—American Academy of Ophthalmology website. Available at: http://www.geteyesmart.org/eyesmart/diseases/nystagmus.cfm. Accessed February 22, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Mary Beth Seymour, RN
  • Review Date: 01/2021
  • Update Date: 02/22/2021