Nystagmus is the medical term to describe involuntary eye movements. The eyes may move vertically, horizontally, in circles, or erratically in different directions.
Nystagmus affects about 1 in every 1,000 people. The speed of the uncontrollable eye movements can vary, but they tend to happen in both eyes.
This article looks at nystagmus and the types of eye movements and symptoms a person may experience. It also explores the causes, diagnosis, and treatment of the condition and provides tips for living with it.
Nystagmus is a condition in which the eyes move uncontrollably, often rhythmically and rapidly.
This condition can be either congenital or acquired. The most common form is congenital nystagmus, which accounts for about 80% of cases. When nystagmus is congenital, it usually presents at the age of 6–12 weeks. However, someone who has acquired nystagmus can develop the condition at any age.
Nystagmus can cause the eyes to make different motions. There are two main types of nystagmus: pendular and jerk. Doctors may define either type by the direction of movement.
- Pendular, or horizontal, nystagmus: The eyes shift back and forth like a pendulum.
- Jerk nystagmus: The eyes drift in one direction and then quickly move or jerk in the other.
- Vertical nystagmus: The eyes move up and down.
- Rotary nystagmus: The eyes move uncontrollably in circles.
Moving the head can sometimes trigger
In addition to rapid and uncontrollable eye movements, other common symptoms that a person may experience include:
- light sensitivity
- feeling dizzy
- difficulty seeing in the dark
- problems with vision
- tilting the head to try to slow down the eye movements
Children with nystagmus do not
According to the American Academy of Ophthalmology, the main causes of nystagmus include:
- a family history of nystagmus
- inner ear problems
- multiple sclerosis
- stroke in older adults
- head injuries in younger people
- cataracts or strabismus in infants
- some medications, such as lithium
- alcohol or drug use
- lack of pigment, or having albinism
- reduced vision
Other causes
Nystagmus can also be a symptom of a condition called benign paroxysmal positional vertigo (BPPV). A person with BPPV experiences brief, intense bouts of vertigo. During these episodes, they may have abnormal eye movements.
In some people, the exact cause of BPPV is unknown. Experts believe that abnormalities affecting the inner ear cause most cases of BPPV. Crystals in the inner ear that become dislodged and disturb the balance nerve may also lead to BPPV.
A doctor may diagnose nystagmus using the following steps:
- performing a comprehensive eye exam
- taking a complete medical history
- checking visual acuity by assessing the ability to see shapes
- conducting measurements to see what lenses a person needs to correct their nearsightedness or farsightedness
- analyzing how well a person’s eyes move, focus, and work together
- referring a person for an ear or neurological exam
- ordering an MRI scan of the brain
There is currently no cure for nystagmus, but doctors can treat certain underlying conditions, such as childhood cataracts and strabismus.
Glasses or contact lenses are frequently the best treatment for a person with congenital nystagmus. These products cannot get rid of nystagmus, but they can aid vision. Additionally, some forms of congenital nystagmus show signs of improvement as the child matures.
In cases where medications cause nystagmus, it tends to go away after discontinuation of the medication. Addressing treatable causes — such as underlying medical conditions or alcohol or drug use — can also help resolve nystagmus in some people.
Botulinum toxin injections (Botox) have been somewhat effective for people with acquired nystagmus but not for those with congenital nystagmus. Research has also shown that drugs such as gabapentin, baclofen, and memantine can reduce the effects of acquired nystagmus.
Surgery on the eye muscles is available to help a person hold their head more naturally and still see more clearly. This procedure can also moderate the nystagmus and reduce the appearance of crossed eyes.
How nystagmus affects vision and quality of life will vary among individuals. However, it does not lead to a total loss of sight.
Practicing self-care may help a person lessen the impact of nystagmus on their vision. Despite the lack of scientific data to confirm that these practices work, anecdotal evidence suggests that they can lead to improved vision. People with nystagmus may, therefore, wish to try:
- yoga
- tai chi
- pilates
- relaxation
- meditation
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