Nystagmus

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at August 4, 2016
StartDiseasesNystagmus

Nystagmus, also known as dancing eyes involves painless but uncontrolled eye movement. It can stem from various causes and often appears in children who do not yet have a fully developed visual system. It can also appear in adults and is often a symptom of a more serious underlying condition and should be evaluated by a doctor.

Contents

Definition & Facts

Nystagmus causes an individual's eye to move repetitively and involuntarily. This condition is painless, but it can cause vision loss, loss of coordination, difficulties with balance, and impaired depth perception. It can be both inherited and acquired for a variety of reasons. It is best to see a doctor as soon as possible if one suspects they have this condition because in adults, it can be a symptom of a number of underlying conditions.

Symptoms & Complaints

Symptoms of this condition are usually quite noticeable both to patients and the people around them. Their symptoms are such that reading, driving a car, operating machinery and other activities that rely on sight become much more difficult. For this reason, having this condition is often considered a physical disability. Generally speaking, symptoms of nystagmus include: 

Causes

This condition is usually caused by some kind of neurological disorder and can appear at birth or much later in life. It occurs when the patient’s motor system becomes unstable, resulting in erratic eye movements. In children, it often appears between the ages of two months and eight years.

Most of the causes relate to previous injuries, neurological issues, birth defects, and vision problems, but medication can sometimes cause this issue as well. Having nystagmus can also be indicative of a brain tumor, which is why getting this condition evaluated is so important. Even with all of these possible risk factors, sometimes the cause of the disorder remains unknown (i.e. that the disorder is idiopathic). Nevertheless, some prominent risk factors for nystagmus include: 

Diagnosis & Tests

Nystagmus is traditionally diagnosed by either an eye doctor or a neurologist. The most obvious symptom is the signature erratic eye movement, but the doctor will also inquire about the age of onset and factor that into his or her diagnosis.

An eye doctor can perform several tests to determine whether or not a patient has the condition. First, a patient will undergo a handful of basic tests, like a vision test, a hearing test, eye movement recordings or a visual exam with an ophthalmoscope. If it is determined that a patient does have nystagmus, the eye doctor will likely order a computed tomography (CT) scan or magnetic resonance imaging (MRI) to determine if there are any underlying problems.

Depending on the results, the patient will either continue treatment with the eye doctor or be referred to a neurologist. The eye doctor will also look for additional causes of the condition, including any undiscovered cataracts, internal eye abnormalities or strabismus. Strabismus means that the patient is cross-eyed. Once the underlying condition is treated, the nystagmus should be lessened.

Treatment & Therapy

A doctor can choose to treat this condition in a number of ways depending on its cause. A doctor may elect to perform surgery in the case of children, in order to correct certain muscles that control eye movement. In the case of an adult patient, they will want to find and treat the root cause because it should also lessen the nystagmus.

In the meantime, specialized glasses, contact lenses or prisms may be prescribed for both adults and children if the condition interferes with the patient’s eyesight. Each patient also has a unique head angle they can adopt to help them see more clearly, and a doctor will encourage the patient to find that angle.

Medications to treat the condition are also an option, including gabapentin, 4-aminopyridine, baclofen, acetazolamide, and memantine. Most of these medications aim to relax the eye muscle. These medications may have side effects like dizziness, drowsiness, lethargy, and dry mouth.

Some proposed treatments for this condition that are currently being researched include acupuncture, botulism injections, cutaneous stimulation, and biofeedback. As scientific research continues into this condition, more treatments may come to light.

Prevention & Prophylaxis

In most cases, nystagmus cannot be prevented. Early diagnosis and treatment are the best methods for approaching the condition.

Because the condition can affect everyone differently, each individual needs to find his or her own approach for preventing or reducing the worst symptoms of nystagmus. For some, the impact of the condition can be lessened by avoiding psychological stress and overtiring oneself.

That all said, to the extent that nystagmus can be caused by the alcoholism, one should consume alcohol in moderation or seek treatment if one believes one has alcoholism. Treatment can take the form of counseling, psychotherapy, and group therapy.