Nystagmus is a rare neurological condition that affects about 1 in 1,000 people. It causes rapid, uncontrollable eye movements. This can make it hard to see clearly, affect depth perception, and make the world seem to move.
It’s important to know about the causes, symptoms, and treatments for nystagmus. This knowledge helps manage this vision disorder effectively.
Key Takeaways
- Nystagmus is a neurological condition that causes rapid, uncontrollable eye movements.
- It can lead to vision problems, dizziness, and a feeling of the world shaking.
- Nystagmus can be present from birth (congenital) or develop later in life (acquired).
- Underlying conditions such as multiple sclerosis, stroke, or brain injury can cause acquired nystagmus.
- Treatment options include corrective lenses, surgical interventions, and medication to manage symptoms.
What is Nystagmus?
Definition and Types of Nystagmus
Nystagmus is a condition where your eyes move on their own, quickly and in a zigzag pattern. It can be divided into two main types. The first is infantile or congenital nystagmus, which shows up early in life. The second is acquired nystagmus, which starts later.
Congenital nystagmus is linked to eye problems or brain issues. On the other hand, acquired nystagmus might signal a neurological problem. This could be a stroke, multiple sclerosis, or a brain tumour.
| Type of Nystagmus | Description |
|---|---|
| Congenital Nystagmus | Appears in the first few months of life, often associated with other eye conditions or brain control issues |
| Acquired Nystagmus | Develops later in life, can be a sign of neurological disorders like stroke, multiple sclerosis, or brain tumour |
Causes of Infantile or Congenital Nystagmus
Infantile or congenital nystagmus is often spotted in very young kids, usually in the first few months. It can be linked to other eye conditions like congenital cataracts or ocular albinism. These issues can mess with how the visual system develops early on.
Children with learning disabilities or neurological conditions might also have nystagmus. This includes kids with Down’s syndrome or cerebral palsy. Sometimes, the reason for congenital nystagmus is unknown, and it’s called idiopathic infantile nystagmus.
A study in the Journal of American Ophthalmology in 2017 found 31 cases of pediatric nystagmus out of 34,000 patients. A Danish study in Acta Ophthalmologica in 2020 reported 5.9 cases per 10,000 people in a large population.
| Eye Conditions Associated with Nystagmus | Neurological Conditions Associated with Nystagmus |
|---|---|
| Congenital cataracts | Down’s syndrome |
| Ocular albinism | Cerebral palsy |
| Retinal dystrophies | Learning disabilities |
| Optic nerve problems | – |
Research at the University of Washington found that CASK mutations often cause X-linked nystagmus in males. A study in the Annals of Neurology in 2007 showed that memantine/gabapentin can help treat congenital nystagmus.
In short, infantile or congenital nystagmus is connected to many eye and neurological issues. These problems affect the visual system’s development in young children. Knowing the causes helps in managing and supporting those with this condition.
Causes of Acquired Nystagmus
While congenital nystagmus is present from birth, acquired nystagmus develops later in life. It often signals an underlying neurological condition. This eye tremor is usually caused by brain damage.
Some common causes of acquired nystagmus include:
- Stroke
- Multiple sclerosis
- Brain tumours
- Head injuries
- Side effects of certain medications or recreational drugs
Unlike congenital nystagmus, acquired nystagmus is a new condition. The brain has not adapted to it. This can cause the world to seem to move around them, known as oscillopsia.
Nystagmus can also be linked to other neurological disorders. These include Down’s syndrome, cerebral palsy, and various degenerative conditions. Finding the underlying cause is key to managing acquired nystagmus.
“Anything that damages the parts of the brain that regulate eye movements can result in the development of acquired nystagmus.”
Regular visits to a neurologist or neuro-ophthalmologist are important. They help find the cause of acquired nystagmus. This information guides the best treatment. Understanding the causes of acquired nystagmus, its connection to neurological disorders, and brain function is crucial for effective management.
Effects of Eye Tremor (Nystagmus) on Vision
Infantile Nystagmus and Vision
Nystagmus, or the shaking of the eyes, can really affect how we see things. People with infantile nystagmus, which starts early in life, might see the world differently. Some can read easily, while others struggle a lot with their vision.
Those with nystagmus often find it hard to see things clearly or judge distances. Their vision can change based on how they’re feeling or where they are. The constant eye movement makes it tough to focus and understand what they see.
Sarvanathan et al found that about 24 people out of 10,000 have nystagmus. This number is higher in people of European descent. Infantile nystagmus affects 17 people out of 10,000. These numbers show how important it is to understand how nystagmus affects vision and how it impacts seeing things clearly.
Even though nystagmus and depth perception can be tough, many people with it find ways to see the world effectively. They often don’t feel like their vision is moving, even though it is.
Acquired Nystagmus and Oscillopsia
People who get acquired nystagmus later in life often feel like the world is moving. This is called oscillopsia. It happens because their brain is still getting used to the eye movements from nystagmus. This condition can make it hard to see and can cause dizziness and balance problems.
For some, oscillopsia and the visual issues from acquired nystagmus might get better as their brain adjusts. But for others, it can last a long time, really affecting their life. Downbeat nystagmus is the most common type, and upbeat nystagmus can be caused by certain brain issues.
Torsional (rotary) nystagmus points to a problem in the central vestibular system. It shows different signs depending on the cause. Pendular nystagmus can be present at birth or develop later, often due to brain stem or cerebellar problems.
The symptoms of acquired nystagmus include oscillopsia, blurred vision, and trouble with balance and focus. These issues can get worse with tiredness, hunger, or different lighting. Stress, excitement, and eye movements can also affect it.
“Acquired nystagmus can be extremely disabling, making it very difficult to see clearly and often leading to feelings of dizziness and imbalance.”
Some people with acquired nystagmus find ways to cope, like adjusting colours and contrasts. They might also use head positioning or mobility training. Those with nystagmus might struggle socially, needing bright lights and tech help for better communication.
At work, people with acquired nystagmus have legal protection. They might get help like visual aids, equipment, and travel support through schemes like ‘access to work’.
Management and Treatment Options
There is no cure for nystagmus yet, but many treatments can help. Glasses or contact lenses can improve vision by fixing any vision problems. Low vision assessments and assistive devices like magnifiers or tinted glasses also help use what vision you have.
Some people find a head position that reduces eye movement, called the “null zone.” This can improve their vision. But these methods don’t cure nystagmus. They help people live better with it.
Glasses, Contact Lenses, and Low Vision Aids
People with nystagmus might find glasses or contact lenses helpful. They can fix vision problems and make seeing clearer. Low vision aids, like magnifiers or tinted glasses, can also boost what you can see.
- Glasses and contact lenses can correct refractive errors and improve visual acuity.
- Low vision aids, like magnifiers or tinted glasses, can enhance residual vision and visual function.
- Finding a “null zone” head position that minimises eye movements can also help improve vision in some cases.
These strategies don’t cure nystagmus. They help people adapt and live better with it.
Surgical Interventions
In some cases, surgery might be an option for treating nystagmus. Surgery can’t fix the nystagmus itself. But it can help by adjusting the eye muscles to find a better head position. This is especially helpful for kids with infantile nystagmus, helping them keep a natural head position.
But, surgery isn’t right for everyone. Its success depends on the person.
There are different surgeries for nystagmus, like the Anderson-Kestenbaum procedure and vertical recti surgeries. These aim to improve how the head is held and vision in people with nystagmus.
| Surgical Intervention | Description |
|---|---|
| Anderson-Kestenbaum procedure | A procedure that involves the repositioning of the eye muscles to help the individual find a more comfortable head position. |
| Vertical recti surgeries | Surgeries that target the vertical eye muscles to improve head position and reduce nystagmus. |
| Maximal retro-equatorial recession of the horizontal recti muscles | A surgical technique that involves moving the horizontal eye muscles further back in the eye socket to reduce nystagmus. |
| Artificial divergence surgery | A procedure that aims to create a divergent eye position to improve head posture and reduce nystagmus. |
| Tenotomy-resuture | A technique that involves cutting and reattaching the eye muscles to alter their position and reduce nystagmus. |
| Myectomy | A surgical procedure that removes a portion of the eye muscle to reduce its influence on nystagmus. |
Research on nystagmus surgery is still in its early stages. A study in India looked at two surgeries on 10 people. It found some benefits but more research is needed. The study didn’t report all side effects and didn’t compare surgery to not treating nystagmus.
More studies are needed to fully understand how safe and effective these surgeries are.
Medication and Botulinum Toxin Injections
In some cases of acquired nystagmus, like when it’s caused by multiple sclerosis, medicine can help. It aims to control eye movements and reduce symptoms like oscillopsia. Yet, drugs have limited use due to their side effects often being worse than the benefits.
Botulinum toxin (Botox) injections into eye muscles are sometimes used. They can slow down eye movements and help with nystagmus in people with neurological conditions. However, Botox can weaken all eye movements, not just those with nystagmus. This can cause its own issues and limit its effectiveness.
- Botox typically lasts for three to four months before wearing off.
- Repeated injections are often needed for patients to continue experiencing the effects of Botox.
- Only Botox and Xeomin are currently used by ophthalmologists for botulinum toxin injections.
- Complications from Botox injections are rare and temporary.
- The most common side effect of Botox injections is an unwanted droopy eyelid, occurring in a fraction of people with epiphora.
- Botox therapy is not recommended for individuals who are pregnant or breastfeeding, have myasthenia gravis, or are taking aminoglycoside antibiotics.
- Botox injections for FDA-approved medical uses are likely to be covered by insurance, whereas off-label uses such as refractory filamentary keratitis and excessive tearing may require out-of-pocket payments.
“Botox typically lasts for three to four months before wearing off, and repeated injections are often needed for patients to continue experiencing the effects.”
While medication and Botox injections can offer some relief for acquired nystagmus, their impact is limited. The potential side effects must be weighed carefully. Ongoing research and new treatments are crucial in managing this condition.
Support and Accommodations
Living with nystagmus, especially for children, can be tough. The right support and accommodations can really help. Working with a qualified teacher of the visually impaired (QTVI) is key. They offer guidance on learning and development.
Registering as sight impaired or severely sight impaired opens doors to special services. It also brings financial help. Low vision assessments and assistive devices improve life quality.
Children with impaired vision struggle in school and sports. They face job hurdles too. Accommodations and support can ease these challenges.
Education and Resources for Nystagmus
Classroom adjustments are crucial. This includes the right seating and lighting. It also means less distraction.
Increasing font size helps with visual stress. Organising materials well is important. Visual breaks during focused tasks are also key.
- Nystagmus affects at least 1 in 1,000 people in the UK.
- It’s the most common visual impairment in school kids.
- Many children with nystagmus have colour vision problems.
- Most have poor distance vision.
- Schools celebrate Nystagmus Awareness Day on 20 June.
- Children with nystagmus get extra time in exams.
- They may need help with hand-eye coordination and seeing around them.
- Assessment for an Education and Health Care Plan is available.
Ongoing Research
Researchers are working hard to find new ways to understand and manage nystagmus. They have made progress in diagnosing infantile nystagmus syndrome. This includes studying the genetics behind it.
Studies have also looked at how to treat chronic dizziness and acute vertigo. These studies involved many patients. This research helps us understand how to help people with these conditions better.
Experts have come together to discuss cerebellar syndrome. They looked at how it affects people. This work helps us understand more about nystagmus and its symptoms.
The Research Unit for Nystagmus (RUN) has been leading the way since 2000. They work with volunteers who have nystagmus. Their research has been published in top journals like Investigative Ophthalmology and Visual Science (IOVS).
Now, RUN is studying how people with infantile nystagmus see motion. They have funding from groups like Fight for Sight and Nystagmus Network UK. They are looking for more people to join their research.
As we learn more about nystagmus, we hope to find better treatments. This will help improve life for those with this condition.
“Research conducted at RUN aims to address major challenges affecting society, the economy, and the environment.”
Living with Nystagmus
Many people with nystagmus lead full and independent lives. They use support, accommodations, and technology to cope with nystagmus effectively. This includes managing vision changes, finding comfortable head positions, and using low vision aids.
Nystagmus can be a lifelong condition, but with the right help, people can adapt and thrive. It’s important to find ways to manage vision changes, especially when tired or stressed. This helps in coping with nystagmus.
- Nystagmus is the most common type of vision impairment in school-aged children.
- Children with infantile nystagmus syndrome are often diagnosed at a very young age.
- People with nystagmus can have very different experiences, depending on how much their functional vision is affected.
“Congenital nystagmus, known as infantile nystagmus syndrome (INS), typically appears within the first six weeks to three months of a child’s life.”
In rare cases, a congenital eye disease could cause INS, with albinism being one genetic condition associated with it. Most people with INS do not need treatment, and many do not even notice their eye movements, although vision challenges are common.
Acquired nystagmus can develop at any stage of life due to injury or disease affecting the labyrinth in the inner ear. Possible causes include stroke, certain medications, head injury or trauma, brain tumours, and diseases of the central nervous system like multiple sclerosis.
Those with severe nystagmus may not qualify for a driver’s licence, limiting their mobility and necessitating alternative transportation arrangements. Severe nystagmus can also impact job choices and hobbies due to limitations in sharp eyesight required for certain tasks.
While nystagmus can present significant challenges, with the right support and a positive outlook, individuals affected can often find ways to adapt and thrive in their daily lives. By developing effective coping strategies and making use of available accommodations, many people with nystagmus are able to lead full and independent lives.
Conclusion
Nystagmus is a complex vision disorder that causes involuntary, rapid eye movements. It can affect how well you see, your depth perception, and your overall life quality. It’s important to understand the summary of nystagmus, including its types, causes, and treatment options.
There’s no cure for nystagmus yet. But, many strategies can help. These include corrective lenses, low vision aids, surgery, and making life easier for those with nystagmus. As key takeaways on understanding and managing nystagmus, new research and treatments are always being found. This gives hope to those dealing with this condition.
There’s not enough research on how eye and body movements are linked in essential tremor (ET). More studies are needed to understand this connection better. This research could lead to better ways to manage nystagmus and related conditions.
FAQ
What is nystagmus?
Nystagmus is a condition where your eyes move quickly and uncontrollably. These movements can go up and down, side to side, or in circles. It can start at birth or appear later in life.
What are the main types of nystagmus?
There are two main types. Infantile or congenital nystagmus starts in the first few months. Acquired nystagmus develops later in life.
What causes congenital nystagmus?
Congenital nystagmus is linked to eye problems or brain issues. This includes conditions like cataracts, albinism, and optic nerve problems.
What causes acquired nystagmus?
Acquired nystagmus is a sign of a brain issue. This can be due to stroke, multiple sclerosis, tumours, injuries, or drug side effects.
How does nystagmus affect vision?
Nystagmus can make seeing things clearly hard. It can also mess with depth perception and make the world seem to move.
What are the treatment options for nystagmus?
Treatments include glasses, low vision aids, and finding a comfortable head position. Surgery or medication might also be used to control eye movements.
How can individuals with nystagmus be supported?
People with nystagmus can work with a teacher for the visually impaired. They should also register as sight impaired and use assistive devices.
What is the current state of research on nystagmus?
Researchers are looking into new treatments like acupuncture and biofeedback. They’re also studying genetics to find ways to help congenital nystagmus.
