Nystagmus: Symptoms, Causes, Diagnosis & Treatments

If a person is suffering from Nystagmus, there will be involuntary eye movement. The condition will be present in either one or both eyes. The person may suffer from blurred vision or other kinds of eye problems. The condition is also called ‘dancing eyes’. There will be quick and uncontrollable eye movement. Based on the direction of movement, the type of Nystagmus will be determined.

Nystagmus can be inherited from parents. Some patients will suffer from Nystagmus due to cataracts or strabismus. Head injuries and diseases like stroke, multiple sclerosis and Meniere’s disease will have an impact on your health. The lack of skin pigmentation, inner ear issues, drugs for seizures and alcohol use will also lead to Nystagmus.

Symptoms of Nystagmus

  • There will be different kinds of symptoms in people suffering from Nystagmus.
  • If a person suffers from horizontal Nystagmus, you can find a side to side eye movements.
  • In the case of vertical Nystagmus, there will be up and down eye movements.
  • With rotary or torsional Nystagmus, you can find circular eye movements.
  • Depending on the case, the eye movement will be present in one or both eyes.
  • The eye movements will be recorded by performing various kinds of tests.
  • Some of the tests performed by doctors to identify the issue include ear exam, brain MRI, brain CT scan and neurological examination.
  • The eye movement will be recorded in a systematic way and the root cause will be identified by the doctor.

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Causes of Nystagmus

  • A person suffers from Nystagmus if there is brain or inner ear problem. In some people, a part or inner ear will not function properly and if affects the regulation of eye movement. The sense movement and position will be noticed through the labyrinth (the outer wall of the inner ear). It will also control the eye movements.
  • There are genetic reasons as well as acquired reasons that lead to Nystagmus. The symptoms in some people will worsen by looking up.
  • The conditions which will affect Nystagmus include Labyrinthitis, Vestibular neuronitis, Cholesteatoma, Ménière's disease, and BPPV.

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Infantile Nystagmus

It is an inherited genetic condition which is also called as congenital Nystagmus or Infantile Nystagmus Syndrome (INS). INS can be noticed in between the first 6 weeks to 3 months of a child’s life. It can be stated as a mild state of Nystagmus. There will not be any underlying health condition which leads to Nystagmus.

It is a very rare condition that a congenital eye disease will lead to infantile Nystagmus. Most of the people suffering from Nystagmus will not want treatment. There will not be any complications in life.

There are many people who will not notice the eye movements (which are abnormal). However, some people will suffer from vision issues. There will be mild to severe vision issues. By undergoing surgery or using corrective lenses, the vision-related issues can be overcome.

Acquired Nystagmus

It can develop at any stage in life. In most of the cases, the acquired Nystagmus will take place through the disease or injury of the ear. There are various events that affect the labyrinth of the ear.

The causes of acquired Nystagmus are listed below:

  • Stroke
  • Medications
  • Sedatives
  • Antiseizure medications
  • Alcohol consumption (excessive)
  • Head injury
  • Eye disease
  • Inner ear disease
  • Brain tumour
  • Vitamin B-12 deficiency
  • Failure of the central nervous system

How Nystagmus is Diagnosed?

  • If you are suffering from congenital Nystagmus, you should consult an ophthalmologist. If there is deterioration in your vision, you should consult the ophthalmologist immediately.
  • An eye exam will be performed by the ophthalmologist to figure out the Nystagmus. The doctors will asses the impact of environmental conditions, medications, and underlying health conditions to understand their impact on your vision issues.
  • If a patient has vertigo, the doctor will examine the ears. The issues related to the inner ear will be probed by the doctor. The cause of dizziness will be found by the doctor.
  • The patient will be subjected to the lying position from the sitting position at a rapid phase to figure out the Nystagmus.
  • Electronystagmography (ENG) – The test will record Nystagmus electronically. The patient will wear a headset which comprises electrodes around the headset. The eye movements will be measured by the device.
  • Videonystagmography (VNG) is a new technology with which video recording will be done to figure out the Nystagmus. Special glasses will be worn by the patient. The glasses comprise video cameras with which horizontal, vertical and torsional eye movements will be detected by the camera in a very efficient way. The data will be collected by the computer and it will be processed to analyze the results.
  • Head impulse test – The head impulse test will be conducted at the doctor’s office. The patient should gaze at the tip of the doctor’s nose while will be moved very quickly. If the patient fails to keep eyes on the nose of the doctor, it will lead to a negative result. As the inner ear problem is ruled out, the doctor will perform other kinds of tests to figure out the root cause of Nystagmus. Some patients will suffer from Nystagmus due to the blood clot in the brain or due to some issues in the central nervous system.
  • Romberg's test – The person will be asked to close his/her eyes while the feet are together and arms are at the sides. They will want to close their eyes suddenly. If the person is unsteady, it is a sign of inner ear problem. If they fall on the left side, it indicates the issue of the left ear.

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The ophthalmologist will measure your eye vision

  • The refraction test will be conducted by the ophthalmologist to suggest the most appropriate glasses to overcome the vision issues
  • The focus of your eyes will be tested by the ophthalmologist
  • The problem associated with using both eyes will be found
  • The ophthalmologist may refer you to your physician if there is a need to address underlying health issues
  • The tips shared by an ophthalmologist will help patients in overcoming the condition very easily.
  • The physician will go through your medical history and further tests are conducted to figure out an issue.
  • Blood test – It is conducted to figure out the vitamin deficiency.
  • Imaging test – X-rays, CT scan and MRI will be conducted to figure out the abnormality in the structure of the brain or head.

Prevention of Nystagmus

  • You can avoid caffeine, alcohol, chocolate and tobacco to reduce the build-up in the inner lobe.
  • If you are suffering from vertigo or dizziness, you should not drive or use a ladder.
  • Your home should be adapted as per your needs so that you can prevent falls
  • You should get up slowly so that you can overcome the issue in a systematic way
  • If you are looking upward, you should not make sudden changes in the head.
  • If a person is suffering from vertigo, a number of exercises can be performed to witness a great improvement in the condition. The manoeuvres and exercises should do done as per the type of condition.
  • By performing various kinds of exercises, there will be a great improvement on a day-to-day basis.
  • By making lifestyle changes, it is possible to witness improvement in symptoms. There are certain movements which will make you feel the symptoms. However, you can overcome them by doing those movements in a gradual manner.

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Treatment of Nystagmus

  • If you find the symptoms of Nystagmus, you should consult the doctor. The doctor will figure out the root cause of Nystagmus after the physical check-up and diagnosis.
  • If there is an underlying health condition, a person may suffer from acquired Nystagmus. It is very much important that the doctor should figure out the type of condition. The best treatment will be suggested by the doctor to deliver the best results.
  • If a person is suffering from congenital Nystagmus, no treatment is required. However, there will be a great improvement in vision by wearing eyeglasses, contact lenses and improving the daylight conditions at home. Magnifying devices can be used to overcome vision-related issues.
  • The congenital Nystagmus will subside in children without treatment. However, a child can undergo ‘tenotomy’ if there is severe suffering from congenital Nystagmus. The position of eye muscles will be changed by a surgery called ‘tenotomy’.
  • Even though ‘tenotomy’ cannot cure Nystagmus, there will be a great improvement in turning the head. The child will not want to turn the head vigorously to see the objects clearly.

  • The following treatment options are available to deal with acquired Nystagmus:

  • Central nervous system disorders will be corrected through the brain surgery
  • Changing medications will have a positive impact on the health
  • Supplements and dietary adjustments are done to change the vitamin deficiency
  • Eye infections are treated with eye drops
  • The infection in the inner ear will be treated with antibiotics
  • Botulinum toxin will be used to treat severe disturbance in eye movements
  • Prisms to enhance the vision
  • The dizziness associated with the Meniere’s disease will be overcome by using prescription drugs such as meclizine, lorazepam and glycopyrrolate.
  • The intake of salt can be reduced so that the build-up of the inner ear can be avoided. The diuretic therapy will reduce the fluid that may build up in the ear.
  • The pressure pulse treatment will be offered to deliver right air pressure pulses in the middle ear and it will reduce vertigo in a very efficient manner.

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Complications of Nystagmus

  • Severe Nystagmus may impact your driving license – If you are suffering from severe Nystagmus, you may not get a driving license from the concerned authorities. It will limit your mobility. Hence, you should take corrective action to get eligibility for the driving license.
  • Impact on your employability – In performing certain kinds of jobs, there is a great requirement of sharp vision. The vision will help you in operating dangerous equipment or controlling precision-equipment.
  • Impact in pursuing your favourite hobbies – Nystagmus may not allow you in pursuing your favourite hobbies such as racing, shooting and other kinds of adventure sports.
  • Poor eyesight – If you are suffering from poor eyesight you will want help from other family members or friends in performing various kinds of day-to-day activities. If your eyesight is limited the risk of accidents will increase.
  • Nystagmus and vertigo – Nystagmus can take place in a person suffering from vertigo. It can take place due to dysfunction of the brain or the inner ear.
  • Inner surgery – Some patients should undergo the inner surgery to overcome the Nystagmus. The inner surgery will be conducted to overcome the intractable Benign Paroxysmal Positional Vertigo (BPPV). A bone plug will be inserted into the inner ear to avoid the factor that triggers vertigo. The plug will ensure that the inner part of the ear will not respond to the head movements which can lead to vertigo.
  • The vestibular nerve will be cut to overcome the issue. It will be performed in severe cases when all other options are exhausted.

Myths Related to Nystagmus

Myth #1:  No improvement in spite of medication

Nystagmus in children will be overcome very easily without medication. If you are suffering from acquired Nystagmus, the doctor will identify the underlying cause and the best medication will be offered to overcome the condition.

Myth #2: Herbal treatment to overcome Nystagmus

Some people will approach alternate methods of treatment such as acupuncture and herbal treatment. However, it was not proven scientifically. If you would like to undergo alternate treatment, you should consult your doctor.

Conclusion

There are two types of Nystagmus. If you are suffering from an inherited type of Nystagmus, it will be corrected automatically in time. The vision-related issues in children will be overcome very easily without treatment. The acquired Nystagmus can be treated after a proper diagnosis. The ophthalmologist and your physician will help you overcome the issue in the best possible way. However, it is not possible to get rid of Nystagmus completely. You can manage the condition in a very efficient manner so that there will not be any difficulty in your day-to-day life.

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Last updated on : 24-12-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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