• What is Nystagmus? - Symptoms, Causes Treatment

What is Nystagmus? — Symptoms, Causes Treatment

Nys­tag­mus is a vision prob­lem in which the eyes make unco­or­di­nat­ed and uncon­trolled move­ments. In addi­tion to com­pro­mis­ing vision and depth per­cep­tion, it also caus­es prob­lems with bal­ance and coor­di­na­tion.

Most peo­ple with nys­tag­mus seem to be look­ing quick­ly from side to side or rapid­ly look­ing up and down. They often tilt their heads at an angle to bal­ance their visu­al field. The con­di­tion can be seri­ous enough for some patients to be con­sid­ered legal­ly blind.

Almost all peo­ple with severe nys­tag­mus are born with the con­di­tion (con­gen­i­tal) or devel­op it as infants. So, what’s behind this lit­er­al­ly unset­tling con­di­tion?

Nystagmus Causes Are Often Neurological

There do not seem to be direct nys­tag­mus caus­es but most cas­es are thought to be neu­ro­log­i­cal and stem from prob­lems with the inner ear (vestibu­lar) or eye mus­cles (opto­ki­net­ic).

In peo­ple with vestibu­lar nys­tag­mus, the eyes drift and jerk back into place. Not sur­pris­ing­ly, ver­ti­go (dizzi­ness), and nau­sea are com­mon prob­lems. It can also be trig­gered when the water set­tles inside the ear. Thank­ful­ly, this form is tem­po­rary for many patients.

Peo­ple with opto­ki­net­ic nys­tag­mus often have crossed eyes (med­ical name: stra­bis­mus), in which the eyes are not prop­er­ly aligned, or cataracts, par­tic­u­lar­ly con­gen­i­tal cataracts. We real­ly don’t under­stand what caus­es stra­bis­mus, but it has been seen in infants as soon as they open their eyes. In part, this is because their eye­sight is still devel­op­ing. If it con­tin­ues, there could be a prob­lem with the part of the ner­vous sys­tem that con­trols eye move­ment.


Cataracts, which are cloudy areas on the eye lens­es, are asso­ci­at­ed with opto­ki­net­ic nys­tag­mus. They are fair­ly com­mon in old­er peo­ple. Con­gen­i­tal cataracts can be inher­it­ed or caused by dis­ease in the moth­er includ­ing measles, rubel­la, chick­en­pox, flu, sex­u­al­ly trans­mit­ted dis­ease, or dia­betes.

Some chil­dren com­pen­sate by using one eye for vision, lead­ing to “lazy” or “wan­der­ing” eye in the oth­er. And some peo­ple devel­op this lat­er in life, trig­ger­ing dou­ble vision.

Oth­er neu­ro­log­ic caus­es for nys­tag­mus come from head injury, stroke, and dis­ease. Lazy eye can be an ear­ly sign for stroke. Mul­ti­ple scle­ro­sis, Meniere’s dis­ease (a con­di­tion in which flu­ids build up in the inner ear and cause imbal­ances), and albinism (lack of pig­men­ta­tion) are all thought to be under­ly­ing caus­es as well.

Final­ly, med­ica­tions and sub­stance abuse can cause nys­tag­mus in adults and devel­op­ing fetus­es. Also, stress, which is often height­ened in peo­ple liv­ing with dif­fi­cult neu­ro­log­i­cal con­di­tions, can aggra­vate nys­tag­mus.

Nystagmus Treatment Includes Surgery and Corrective Lenses

Treat­ing the under­ly­ing nys­tag­mus caus­es is one way to ease or cure the con­di­tion. For exam­ple, the med­ica­tion that caus­es it can be halt­ed. Nys­tag­mus in peo­ple with sub­stance abuse prob­lems will ease with suc­cess­ful treat­ment.

Eye­glass­es and con­tact lens­es, includ­ing bifo­cal con­tact lens­es, often improves the con­di­tion but won’t cure it. Cataracts can only be cured with surgery. It’s one of the most com­mon surg­eries today and is very low risk. In infants, how­ev­er, the treat­ment is not so straight­for­ward. Surgery is riski­er for them for a num­ber of rea­sons, and par­ents should seek out more than one opin­ion.

In adults and old­er chil­dren, surgery on eye mus­cles can bring relief from the head tilt­ing posi­tion. Botox injec­tions will tem­porar­i­ly reduce the eye move­ment for adults (this is not rec­om­mend­ed in chil­dren). Some adult patients ben­e­fit from anti-seizure med­ica­tions and mus­cle relax­ers. Oth­er patients have ben­e­fit­ted biofeed­back treat­ment.

Nys­tag­mus is often a symp­tom for oth­er con­di­tions. Don’t ignore it in your­self, fam­i­ly mem­bers, and espe­cial­ly chil­dren and infants. Con­tact a med­ical pro­fes­sion­al for an eval­u­a­tion.

December 30th, 2018|Comments Off on What is Nystagmus? — Symptoms, Causes Treatment

About the Author:

Born in Connecticut and raised in Upstate New York , Dr. Stetson graduated Cum Laude from Colgate University in New York, and then earned an MD degree with honors at the University of Vermont College of Medicine. He distinguished himself again in residency at the Albany Medical Center, where he obtained the highest percentile in the Ophthalmology Knowledge Assessment Examinations. Dr. Stetson has performed more than 50,000 refractive surgeries and has been on staff at Diamond Vision since 2004, before becoming Medical Director in 2006.


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