Understanding Nystagmus: Causes, Symptoms, and Treatment Options

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on October 4th, 2023.

Key Takeaways

  • This neurological condition affects 1 in 1,000 people and causes involuntary eye movements in horizontal, vertical, or rotary patterns that can occur 100+ times per minute.

  • Congenital forms appear within the first 6 weeks of life due to genetic mutations, while acquired cases often result from stroke, multiple sclerosis, brain tumors, or medications like lithium and anti-seizure drugs.

  • The characteristic head positioning (turning or tilting) develops as patients find their "null point"—the head position where eye movements are minimized and vision is clearest.

  • Surgical intervention can reduce oscillations by 30-70% through procedures that reposition eye muscles, while gabapentin at 900-2400mg daily helps some patients with acquired forms.

  • Visual acuity typically ranges from 20/30 to 20/200, with many patients achieving functional vision through high-contrast materials, task lighting at 1000+ lux, and prismatic lenses.

Nystagmus, also known as "dancing eyes," is a condition where you experience uncontrollable eye movements. These movements can be up and down, side to side, or in a circular motion. If you or your child have been diagnosed with nystagmus, it's essential to understand the causes, symptoms, and available treatment options.

Causes of Nystagmus

Nystagmus can be present from birth or develop later in life. Some common causes include:

  • Genetic factors passed down from parents

  • Other eye issues, such as cataracts or strabismus

  • Diseases like stroke, multiple sclerosis, or Meniere's disease

  • Head injuries

  • Albinism (lack of skin pigment)

  • Inner ear problems

  • Certain medications, like lithium or drugs for seizures

  • Alcohol or drug use

In some cases, the exact cause of nystagmus may be unknown.

Symptoms of Nystagmus

The primary symptom of nystagmus is uncontrollable eye movements. These movements can be fast, slow, or a combination of both, and usually affect both eyes. Other symptoms may include:

  • Nodding or tilting the head to focus better

  • Blurred vision (more common in children)

  • Appearance of a shaky world (more common in adults)

  • Difficulty seeing in the dark

  • Sensitivity to bright light

  • Problems with balance and dizziness, especially when tired or stressed

Understanding Nystagmus: Causes, Symptoms, and Treatment Options

Diagnosing Nystagmus

If you suspect that you or your child may have nystagmus, consult an eye doctor. They will examine the eyes, test vision, and look for other eye problems. Additional tests may include:

  • Ear exam

  • Neurological exam

  • Brain MRI or CT scan

  • Recording of eye movements

Your doctor may also perform a spinning test, where you'll be asked to spin in a chair for about 30 seconds, stop, and then try to stare at an object. If you have nystagmus, your eyes will move slowly in one direction and then quickly in the other.

Treatment Options for Nystagmus

Treatment for nystagmus depends on the underlying cause and the age at which it developed. For adults who developed nystagmus later in life, simple lifestyle changes like stopping certain medications or quitting alcohol or drug use may help lessen the effects.

Other treatment options include:

  • Wearing the correct contacts or glasses to improve vision

  • Eye muscle surgery to help with head tilting and potentially improve vision

  • Medications like gabapentin, baclofen, or Botox to ease symptoms in adults (not recommended for children)

  • LASIK or Visian ICL for people with severe nearsightedness

Living with Nystagmus

If you or your child have nystagmus, there are several ways to make daily life easier:

  • Use large-print books and increase the font size on digital devices

  • Ensure adequate lighting to improve vision

  • Encourage children to use their eyes with brightly colored, noise-making, and textured toys

  • Allow children to hold books close to their eyes and tilt their head as needed

  • Use hats or tinted glasses to reduce glare, even indoors

  • Communicate with your child's teacher to make accommodations at school, such as choosing a seat with a clear view of the board and teacher

For more information on nystagmus, consult the following resources:

If you or your child have been diagnosed with nystagmus, remember that you are not alone. Work closely with your eye doctor and other healthcare professionals to find the best treatment options and strategies to manage this condition and maintain the best possible quality of life.

The Bottom Line

While there's no cure, combining optical aids, medications, and environmental modifications can significantly improve daily functioning for most patients. Early intervention is crucial for children to prevent developmental delays in motor skills and depth perception. If you're experiencing involuntary eye movements or related vision problems, Doctronic can help you understand your symptoms and next steps.

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