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Nystagmus
What is nystagmus?
Nystagmus is a repetitive involu
ntary movement of the eyes. The ey
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e movements can be horizontal/side to si
de, vertical/up and down or a swinging/r
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otary motion.
Nystagmus can vary between
slow and fast eye movements and is usual
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ly in both eyes.
Many individuals with n
ystagmus will have a null point, a parti
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cular head and eye position where the be
st vision is obtained because the nystag
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mus eye movements are the smallest and s
lowest. The null point is where the eyes
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are in their most stabilised position.
For most individuals, the nystagmus will
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increase if the eyes are positioned out
side of the null point. The use of a nul
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l point and head posture should not be d
iscouraged.
Individuals with nystagmus of
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ten have fluctuations in their vision th
roughout the day, especially when they a
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re ill, stressed or fatigued.
Visual deve
lopment is quite variable between childr
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en with nystagmus. It is difficult to pr
edict what the visual acuity will be in
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adulthood. Most people with nystagmus wi
ll have some reduced visual function.
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What are the main types of nystagmus?
Congenital motor nystagmus: is noticed
in infants, usually between 6 weeks and
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several months. It is usually present i
n both eyes with side to side/horizontal
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eye movements. There is no known cause
of congenital nystagmus, though sometime
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s it is inherited. Generally, children w
ith congenital motor nystagmus have blur
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ry vision and do not see things as “shak
ing”.
Sensory nystagmus or acquired nysta
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gmus: occurs later, usually after 6 mont
hs of age. Acquired nystagmus can be cau
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sed by a disease (for example, Meniere’s
inner ear disease), head injury, stroke
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, neurological problem or side effect of
a medication. Individuals with late ons
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et acquired nystagmus often see things a
nd their environment as “shaking”, this
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is known as oscillopsia.
Children born wi
th reduced vision often develop sensory
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nystagmus. For example, conditions such
as albinism, aniridia, optic nerve hypop
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lasia, coloboma and congenital cataracts
can result in nystagmus. Generally, chi
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ldren with sensory nystagmus have blurry
vision and do not see things as “shakin
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g” if the nystagmus onset was early in l
ife.
What can help?I
f your child needs glasses, ensur
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e they wear them all the time. Correctin
g their refractive error by wearing glas
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ses or contact lenses will give them the
best vision possible. Contact lenses ca
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n be more visually beneficial than glass
es as the contacts are directly on the e
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ye and move with the nystagmus.
The use o
f a null point and head posture should n
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ot be discouraged.
Some individuals may b
enefit from eye muscle surgery if their
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null point is in an extreme gaze. This h
elps to reduce a significant head postur
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e or decrease the size of the nystagmus.
Surgery does not eliminate nystagmus.
So
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me individuals may benefit from glasses
with prisms to help reduce their head po
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sture.
Low vision aids (for example, bino
culars, monoculars and magnifiers) can a
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ssist a child to access distance and nea
r information by enlarging details and r
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educing eye fatigue.
Individuals with nys
tagmus may not develop a fine level of d
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epth perception. Depth perception is the
ability to judge distances and determin
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es how far away objects are. Children wh
o lack depth perception usually develop
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compensatory skills and strategies that
allow them to function well. However, ca
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re should be taken when a child with nys
tagmus is travelling on uneven, unfamili
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ar surfaces.
Ensure your child attends r
egular eye examinations with an Ophthalm
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ologist to mainta
in ocular health.
Referenceshttps://www.aapos.org/terms/conditions/80
http://www.lowvision.org/nystagmus.htm
http://www.nystagmus.org/aao.html
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