Nystagmus: causes, test and surgery


Cause of nystagmus

Known causes of nystagmus include:

  • Heredity. Nystagmus may be congenital. If at least one family member has this disorder, the risk of developing it increases as well.
  • Albinism (lack of pigment of the skin).
  • Various eye diseasescataractsstrabismus and severe refractive disorders.
  • Diseases such as Meniere’s diseaselabyrinthitis, multiple sclerosis or strokeStroke is a common cause of acquired nystagmus in the elderly.
  • Lesions of the nervous system (cerebellum and brainstem). This is a common cause of acquired nystagmus in younger people.
  • Taking some medications such as lithium or antiepileptic drugs.
  • Consumption of alcohol or drugs.
  • Problems with the inner ear (organ of balance).

Symptoms of nystagmus

The main symptoms of nystagmus are involuntary eye movements.

The movement is usually lateral (horizontal nystagmus), but can also go from top to bottom (vertical nystagmus) or circle (rotational nystagmus).

The movement can alternate between slow and fast, usually affecting both eyes.

In addition to eye movements, nystagmus causes:

Diagnosis of nystagmus

Nystagmus can be diagnosed in newborns or infants (younger than 3 years) during a comprehensive ophthalmological examination.
Children who have a nystagmus phenomenon should be presented to a specialist to determine the cause, for example, strabismus or cataracts.

The following tests can be performed for nystagmus diagnosis:

  • Medical history of the patient to determine any symptoms that the patient has and determine the presence of diseases, medication intake or environmental factors that may cause the symptoms.
  • Videonystagmography – in this examination method, a dark mask is put on, which is connected to a computer. In this way, quality and quantity can be assessed, one can determine what type of nystagmus it is and what frequency (gravity) it has.
  • Position maneuvers – to determine nystagmus, the doctor asks the patient to perform certain movements or take certain positions.

By using the information from the examinations, the optician can identify an existing problem and recommend effective treatment.

Therapy of nystagmus

Nystagmus can not be cured.
Some conditions that cause nystagmus can be treated to improve symptoms.
Scientists around the world are studying this phenomenon to find an effective treatment.
Many of these researchers focus on controlling eye movements, an area that is still little studied.
Not all developed treatments are supported by good scientific results.

Glasses and contact lenses
Glasses and contact lenses ensure that vision is corrected. They do not correct the problem, but they can help reduce it: improved vision can slow eye movements. Special magnifying lenses can help with reading.

Surgery for nystagmus

Rarely, surgery is performed to change the position of the muscles that move the eyes.
In saccadic nystagmus, the nystagmus decreases significantly or disappears completely when the pupil is in an eye area, the so-called “zero point”.

The aim of the procedure is:

  • move the zero point from a peripheral position to a priority position;
  • to prolong the time in which the light signal remains in the visual pit of the retina;
  • improve neck posture;
  • the improvement of vision.

However, surgery cannot correct or cure the nystagmus.
Eye surgery is performed so that the eye muscles correct the nystagmus.
Science in this field is still at an early stage.

Sometimes drugs are used to treat acquired nystagmus (for example, in a person with multiple sclerosis who develops nystagmus).
The drugs help control eye movements and reduce awareness of constant eye movement.
This is a very specific and still not very commonly used treatment for congenital nystagmus.

Biofeedback consists of trying to decrease the movements of the eye muscles by making the patient aware of eye movements enough to control them.
This technique is based on audio and video signals known as biofeedback.
An intermittent photopic stimulation (IPS) approach has not shown significant improvement.
There is no clear evidence that biofeedback produces good results, but some people with nystagmus have seen improvement.

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