Nystagmus Overview

Nystagmus is a condition that causes involuntary, rapid movement of one or both eyes. It often occurs with vision problems, including blurriness. This disease is also known as “dancing eyes.”

Symptoms of Nystagmus

The symptoms include fast, uncontrollable eye movements. The direction of movement determines the type of nystagmus:

  • Horizontal nystagmus involves side-to-side eye movements
  • Rotary, or torsional, nystagmus involves circular movements
  • Vertical nystagmus involves up-and-down eye movements.

These movements may occur in one or both eyes depending on the cause.

Types of Nystagmus

Nystagmus occurs when the part of the brain or inner ear that regulates eye movement and positioning doesn’t function correctly.

The labyrinth is the outer wall of the inner ear that helps you sense movement and position. It also helps control eye movements. The condition can be either genetic or acquired.

Infantile Nystagmus Syndrome

Congenital nystagmus is called infantile nystagmus syndrome (INS). It may be an inherited genetic condition. INS typically appears within the first six weeks to three months of a child’s life.

This type of nystagmus is usually mild and isn’t typically caused by an underlying health problem. In rare cases, a congenital eye disease could cause INS. Albinism is one genetic condition associated with INS.

Most people with INS won’t need treatment and don’t have complications later in life. In fact, many people with INS don’t even notice their eye movements. However, vision challenges are common.

Vision problems can range from mild to severe, and many people require corrective lenses or decide to have corrective surgery.

Acquired Nystagmus

Acquired, or acute, nystagmus can develop at any stage of life. It often occurs due to injury or disease. Acquired nystagmus typically occurs due to events that affect the labyrinth in the inner ear.

Causes of Acquired Nystagmus

Possible causes of acquired nystagmus include:

  • Certain medications, including sedatives and antiseizure medications like phenytoin (Dilantin)
  • Brain tumors
  • Excessive alcohol consumption
  • Diseases of the eye
  • Head injury or trauma
  • Stroke
  • Diseases of the inner ear
  • B-12 or thiamine deficiencies
  • Diseases of the central nervous system, including multiple sclerosis


Diagnosis of Nystagmus

If you have congenital nystagmus, you’ll need to see an eye doctor called an ophthalmologist if the condition worsens or if you’re concerned about your vision.

Your ophthalmologist can diagnose nystagmus by performing an eye exam. They’ll ask you about your medical history to determine if any underlying health problems, medications, or environmental conditions may be contributing to your vision problems. They may also:

  • Conduct a refraction test to determine the correct lens power you’ll need to compensate for your vision problems
  • Measure your vision to determine the type of vision problems you have
  • Test how your eyes focus, move, and function together to look for problems that affect control of your eye movements or make it hard to use both eyes together

Treatment of Nystagmus

Treatment for nystagmus depends on whether the condition is congenital or acquired. Congenital nystagmus doesn’t require treatment, although the following may help improve your vision:

  • Contact lenses
  • Eyeglasses
  • Increased lighting around the house

Sometimes, congenital nystagmus lessens over the course of childhood without treatment. If your child has a very severe case, their doctor may suggest a surgery called a tenotomy to change the position of the muscles that control eye movement.

Such surgery can’t cure nystagmus, but it can reduce the degree to which your child needs to turn their head to improve their vision.

Acquired Nystagmus

If you have acquired nystagmus, treatment will focus on the underlying cause. Some common treatments for acquired nystagmus include:

  • Antibiotics for infections of the inner ear
  • Brain surgery for central nervous system disorders or brain diseases
  • Changing medications
  • Botulinum toxin to treat severe disturbances in vision caused by eye movement
  • Correcting vitamin deficiencies with supplements and dietary adjustments
  • Medicated eye drops for eye infections
  • Special glasses lenses called prisms


Seeking Medical Help

See your doctor if you begin to notice symptoms of nystagmus. Acquired nystagmus always occurs due to an underlying health condition. You’ll want to determine what that condition is and how best to treat it.

Outlook of Nystagmus

Nystagmus may improve over time with or without treatment. However, nystagmus usually never goes away completely.

The symptoms of nystagmus can make daily tasks more challenging. For instance, those with severe nystagmus may not be able to get a driver’s license, which can limit their mobility and require them to make transportation arrangements on a regular basis.

Sharp eyesight is also important if you’re handling or operating potentially dangerous equipment or equipment requiring precision.

Nystagmus can limit the types of occupations and hobbies you have.

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