Nystagmus is a type of involuntary movement of the eyes. It is usually side-to-side (horizontal nystagmus)
, but sometimes is up and down (vertical nystagmus)
or in a circular fashion (rotatory nystagmus). The movement varies between slow and fast and usually involves both eyes. In infancy, it tends to develop between six weeks and three months of age and is called infantile nystagmus. It can also be acquired later in life and is called acquired nystagmus.
The direct cause of nystagmus is instability in the motor system that controls the eyes. In some cases, the cause of nystagmus is unknown.
There are a number of factors or conditions that increase the risk of this instability, including: GeneticsA family member with nystagmusPoor development of eye control that may be caused by an eye disease or visual problem during infancy, such as bilateral optic nerve hypoplasia or congenital cataractsAlbinism—lack of skin pigmentation
Eye disorders, such as optic nerve degeneration or severe
Diseases of the body, such as
which involves balance problems,
multiple sclerosis, spasmus nutans, or
strokeInjury to the head or involving the body’s motor systemUse of certain medications, such as lithium or antiseizure medicationsAlcohol
drug useInner ear problems, such as infections, irritation, benign paroxysmal positional vertigo, some brain tumorsThiamine or vitamin B12 deficiency
Any disease that can also affect the brain
Other symptoms besides the eye movements may include: Sensitivity to lightDifficulty seeing in darknessVision problemsHead held in a turned positionOscillopsia—feeling that the world is shaking or movingVertigo
Your doctor will ask about your symptoms and medical history. A physical exam will be done. If nystagmus seems to be present, you may need: A full exam with an eye specialist called an ophthalmologistAn ear exam, including a hearing testExam with a neurologist or other medical specialist
Tests may include the following:
You may need tests of your eyes. This can be done with:
Visual exam of the inside of the eye with an ophthalmoscopeVision testingEye movement recordings
Images may need to be taken of your brain. This can be done with:
Computerized tomography (CT)Magnetic resonance imaging (MRI)
Magnetic Resonance Imaging
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The ophthalmologist will also look for other eye problems that may be related to the nystagmus, such as strabismus,
, or abnormality of the optic nerves or retina.
The ear specialist will look for signs of ear infection, and for worsening of the nystagmus with head positions.
Talk with your doctor about the best treatment plan for you. Removal of the cause of nystagmus can sometimes eliminate the problem, for example discontinuing a medication or stopping alcohol or drug use. However, nystagmus often is a permanent condition that can only be reduced and not eliminated. Treatment options to reduce nystagmus and improve vision include the following: Prisms, tints, eyeglasses, or contact lensesAdopting a particular angle of vision where the nystagmus is reduced, such as holding the head in a certain positionVibratory stimulation of the face and neckCertain medications for certain types of nystagmus, including
botox (botulinum toxin) injections
to relax the eye muscles, muscle relaxants, and certain anti-seizure medicationsSurgery on the eye muscles
Low-vision aids can often help improve vision. They may include large print or high contrast materials, good lighting, and magnifying devices.
There is no known way to prevent nystagmus.
Hertle RW. Understanding and treatment of infantile nystagmus syndrome. Presentation at the 4th Biennial Conference of the American Nystagmus Network, Los Angeles, CA. July 8-10, 2005. American Nystagmus Network website. Available at:
. Accessed February 18, 2013.
Maybodi M. Understanding nystagmus: diagnosis, related disorders, treatment, and research. Presentation at the 3rd Biennial Conference of the American Nystagmus Network, Baltimore, MD. July 11-13, 2003. Available at:
. Accessed February 18, 2013.
Last reviewed March 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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