Nystagmus
What is Nystagmus?
Types of Nystagmus: Congenital and acquired
Congenital Nystagmus
Congenital nystagmus normally occurs in infants at the age of 6 weeks to 3 months old. It likely affects both eyes by moving horizontally (side by side). Congenital nystagmus causes are yet unknown, but sometimes it might be due to inheritance.
Acquired Nystagmus
Cause of Nystagmus
In some cases, the cause of nystagmus is still unknown. In other cases, nystagmus can be caused by other eye conditions.
Possible nystagmus causes :
- Family history of nystagmus
- Albinism
- Certain eye disorders in infants or children (etc. congenital cataracts and binocular anomalies such as strabismus)
- Multiple sclerosis
- Inner ear problems (etc. Meniere’s disease)
- Trauma or head injury (common happens in younger people)
- Stroke (common happens in older people)
- Alcohol or drug consumption
- Use of certain medications (etc. lithium or anti-seizure medications)
Common Signs & Symptoms
The main symptom of nystagmus is that eyes move rapidly and are unable to control. The movement usually is side to side. It also can be up and down or circular motion. The speed of movement can vary fast or slow and shake more in a certain direction.
In addition, other nystagmus symptoms may include:
- Dizziness
- Photophobia (sensitive to light)
- Having difficulty seeing in dark environment
- Blur of vision
- Turned or tilted head position to see
- Shaking environment
Nystagmus Treatment
Nystagmus are treated based on the underlying causes. Those who are born with nystagmus usually are not able to be cured. However, refractive correction with glasses or contact lenses is able to provide them a clearer vision which may help slow down the rapid movement.
Surgery repositioning the eye muscles that move the eyes is rarely done, and it does not correct or cure nystagmus. It only helps people with nystagmus to keep their head in a more comfortable position by limiting eye movement.
In acquired nystagmus sometimes it can go away by treating the underlying causes of nystagmus. For instance by treating the medical condition or stopping drug or alcohol intake.
Nystagmus can be diagnosed by an ophthalmologist. The ophthalmologist will examine the eyes to rule out any eye condition which relates to nystagmus conditions including binocular anomalies, cataract and any retina disease including optic nerve. Sometimes they also refer to an ear examination ,a neurological examination and brain imaging (computerised tomography (CT) and magnetic resonance imaging (MRI)) if necessary to rule out the underlying causes.
Therefore, it is advisable to visit an ophthalmologist as soon as possible if you notice any unusual sign or symptom of nystagmus especially for parents with infants or children. In addition, an eye screening can also be beneficial.
FREQUENTLY ASKED QUESTIONS
Nystagmus is an eye condition characterized by repetitive, uncontrolled eye movements (horizontal, vertical, or rotary). It is caused by disruption in the neurological signals between the brain, inner ear, and extraocular muscles that control eye alignment.
- Congenital Nystagmus: Appears in early infancy (typically between 6 weeks and 3 months old), affects both eyes, and is often linked to genetic factors or early visual impairment. Children usually do not perceive the environment as shaking.
- Acquired Nystagmus: Develops later in life due to underlying medical issues such as stroke, multiple sclerosis, head trauma, inner ear disorders, or medication side effects. Adults often experience oscillopsia (the sensation that their surroundings are constantly moving).
While congenital nystagmus cannot be completely cured, its symptoms can be managed using corrective lenses, vision therapy, or surgical realignment of eye muscles to improve visual acuity and reduce comfortable head-tilt angles. Acquired nystagmus may resolve if the underlying cause (such as a medication reaction or inner ear condition) is treated.
Patients often tilt or turn their head to find their “null point”—a specific angle of gaze where involuntary eye movements slow down or stabilize, allowing for clearer vision and reduced eye strain.
Diagnosis involves a comprehensive ocular exam by a specialist ophthalmologist, including visual acuity tests, binocular vision assessments, and eye tracking evaluations. If neurological or systemic causes are suspected, patients may be referred for brain imaging (MRI/CT scans) or neurological and ear examinations.
Yes. Prescription glasses or contact lenses correct refractive errors (such as astigmatism or nearsightedness), improving visual clarity. Contact lenses are often particularly helpful because the lens moves with the eye, providing clearer vision than glasses during movement.
Parents should consult a paediatric ophthalmologist immediately if they notice rapid, uncontrolled eye movements, lack of visual fixation, or persistent head tilting in infants older than 6 weeks. Early assessment is vital to rule out serious underlying ocular or neurological conditions.