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Health and Disease

Nystagmus: Types, Causes, and Treatments

Nystagmus is an involuntary shaking of the eye, or both eyes, similar to a twitch. They can move in different directions: vertical, horizontal, and in circular motions. Typically, nystagmus is a sign of another underlying eye or neurological condition. If someone has nystagmus, it can be picked up using special equipment and tests, one being the caloric reflex.

Nystagmus is an involuntary shaking of the eye, or both eyes, similar to a twitch. They can move in different directions: vertical, horizontal, and in circular motions. Typically, nystagmus is a sign of another underlying eye or neurological condition. If someone has nystagmus, it can be picked up using special equipment and tests, one being the caloric reflex. The caloric reflex test is when a doctor, or nurse, gently runs either hot or cold water, or air, down one ear canal. If the patient has nystagmus, this test will stimulate it because of the temperature gradient.

One cause of nystagmus is an inner ear infection. Infections, such as labyrinthitis and vestibular neuritis, are known to cause nystagmus due to the eye attempting to compensate for the lack of balance. This is a similar effect as travel sickness; if the fluid in the ear is unstable due to an infection, you will feel as if you are constantly in motion, and the eyes and ears will be receiving different sensory messages. The eyes then overwork to attempt to regain equilibrium and balance, causing nystagmus. This particular type of nystagmus should resolve itself once the inner ear infection has been fought off. To diagnose this nystagmus, an ophthalmologist may get you to follow their finger up and down and side to side to check which direction triggers the shuddering of the eye.

Another type of nystagmus can be brought on by conditions such as albinism and develop in infants aged 2-3 months. This nystagmus, due to ocular albinism, is more common in male babies and early signs of it may include them tilting or “bobbing” their head to get a clearer vision. Other symptoms of albinism, which are likely to coincide with the nystagmus, are a lack of pigmentation in the iris and abnormal connection between the nerves on the retina and the brain. Treatment for ocular albinism includes glasses, which can improve vision greatly, as well as sun shields and rimmed headgear to reduce the effects of light sensitivity related to albinism.

One of the most common causes of nystagmus is a neurological condition, usually present since birth. Some conditions which can cause nystagmus include multiple sclerosis, Meniere’s disease, and strokes. Nystagmus due to multiple sclerosis is most often a result of the disease-causing damage to the cerebellum and affecting muscles, vision, and balance. In addition, certain medications for epilepsy can cause nystagmus due to how they interact with the brain. To diagnose what the root cause of the nystagmus is, a neurologist or ophthalmologist may suggest for you to get a CT scan or MRI of the brain to rule out any more sinister causes.

Being diagnosed with nystagmus can impact individuals’ lives. Not only could nystagmus be the first indicator of a more invasive disease, but it can also cause a decline in eyesight and make it uncomfortable to do normal things. Many people that suffer from nystagmus say that it is an unpleasant feeling and twitching can strain the muscles in the eye. Getting a thorough consultation with an ophthalmologist is the first step in improving your nystagmus related symptoms; they can consider whether you need glasses or other methods to control the symptoms.

A lot of sufferers, especially teenagers, may feel quite self-conscious about their nystagmus due to it being visible to other people. Stress and fatigue can also exacerbate nystagmus so sufferers must try to stay away from tense environments and keep good sleep hygiene. Anyone with nystagmus must remember that it is not anything to be embarrassed about or hide, it is involuntary and nothing to be ashamed of. Sufferers need to speak to their medical team to get more support with their condition and to ensure it is monitored for any signs of regression or progress.

References

“Labyrinthitis and Vestibular Neuritis.” NHS , NHS, 11 Feb. 2020, http://www.nhs.uk/conditions/labyrinthitis/.

“Nystagmus.” American Optometric Association, American Optometric Association, http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/nystagmus#:~:text=and%20drug%20toxicity.-,What%20causes%20nystagmus%3F,stroke%2C%20multiple%20sclerosis%20or%20trauma.

“Nystagmus.” American Optometric Association, http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/nystagmus#:~:text=Nystagmus%20is%20a%20vision%20condition,or%20in%20a%20circular%20pattern.

Wachler, Brian S. Boxer. “Nystagmus: Symptoms, Causes, Diagnosis, Treatment.” WebMD, WebMD, 7 Nov. 2019, http://www.webmd.com/eye-health/nystagmus.

By Sophie Farr

I am a student from the UK and my ambition is to become a doctor.

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