Nystagmus
Nystagmus is a condition where the eyes move rapidly and uncontrollably. They can move:
• side to side (horizontal nystagmus)
• up and down (vertical nystagmus)
• in a circle (rotary nystagmus)
The movement can vary between slow and fast and usually happens in both eyes. The eyes may shake more when looking in certain directions. People with nystagmus may tilt or turn their head to see more clearly. This helps to slow down the eye movements. Approximately 1 in 1,000 people have some form of nystagmus
Types –
• Infantile.
Most often develops by 2 to 3 months of age. The eyes tend to move in a horizontal swinging fashion. It is often associated with other conditions, such as albinism, congenital absence of the iris (the colored part of the eye), underdeveloped optic nerves and congenital cataract.
• Spasmus nutans.
It usually occurs between 6 months and 3 years of age and improves on its own between 2 and 8 years of age. Children with this form of nystagmus often nod and tilt their heads. Their eyes may move in any direction. This type of nystagmus usually does not require treatment.
• Acquired.
Develops later in childhood or adulthood. The cause is often unknown, but it may be due to the central nervous system and metabolic disorders or alcohol and drug toxicity.
Symptoms –
The main symptom of nystagmus is rapid eye movement that cannot be controlled. Usually the movement is side to side.
In addition to rapid eye movement, nystagmus symptoms include –
• Sensitivity to light
• Dizziness
• Difficulty seeing in the dark
• Vision problems
• Holding the head in a turned or tilted position
• The feeling that the world is shaking
Causes –
Nystagmus is caused by many different things, including:
• Being passed down from your parents
• Other eye issues, like 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
Diagnosis –
It can be diagnosed through a comprehensive eye exam. Testing for nystagmus, with special emphasis on how the eyes move.
Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems, medications taken, or environmental factors that may be contributing to the symptoms.
One way to see nystagmus is to spin a person around for about 30 seconds, stop and then have them try to stare at an object. If they have nystagmus, their eyes will first move slowly in one direction, then move rapidly in the opposite direction.
Other tests that may be used to diagnose are:
• Eye-movement recordings (to confirm the type of nystagmus and see details of the eye movements)
• An ear exam
• A neurological exam
• Tests to get images of the brain, including computerized tomography (CT) and magnetic resonance imaging (MRI)
Treatment –
There are a few different treatments available for this problem. The approach that’s best for you depends on the cause of your condition, your health history and your personal preferences.
• Glasses or contact lenses
Clearer vision can help slow the rapid eye movements associated with nystagmus. As a result, symptoms can be successfully managed with eyeglasses or contact lenses.
• Medications
Some medications can reduce it’s symptoms in adults, such as gabapentin (antiseizure), baclofen (muscle relaxant) and onabotulinumtoxina (Botox®). These medications aren’t used in children with nystagmus.
• Eye muscle surgery
In rare instances, eye muscle surgery may be recommended. During this procedure, your surgeon repositions the muscles that move the eyes. This type of surgery doesn’t cure nystagmus, but it allows you to keep your head in a more comfortable position, thereby limiting eye movement.
• Vision correction surgery
If you have nystagmus and are nearsighted, laser vision correction surgery — such as LASIK — may be beneficial. While laser eye surgery doesn’t cure this condition, it improves your vision. As a result, symptoms may be reduced.
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