Involuntary, rhythmic eye movement that can affect clarity, depth perception, tracking and reading. Here is what nystagmus is, the patterns clinicians look for, and how it is evaluated.
Nystagmus is a rhythmic, involuntary oscillation or movement of the eyes — repetitive, uncontrolled eye movements that the person cannot stop by concentrating. It can occur in both eyes at the same time, or in just one eye.
Nystagmus can affect vision, and may lead to reduced visual acuity or reduced depth perception. In some cases it can be a sign of an underlying health condition that requires medical attention — which is why abnormal eye movements are worth having looked at rather than watched.
Treatment depends on the underlying cause. Depending on what is found, a care plan may involve addressing the primary condition, specific medications, or eye muscle surgery in severe cases. Nystagmus also varies from person to person in intensity, frequency and duration, so what helps one patient may not be what another needs.
Nystagmus itself may not always be curable. Its underlying causes, however, can often be addressed, and interventions can be used to improve visual function and quality of life. Anyone experiencing nystagmus should have a comprehensive evaluation with a developmental optometrist so the condition can be understood and managed appropriately.
Nystagmus can manifest in various patterns, and the specific pattern of eye movement helps clinicians identify the underlying cause and diagnose the type. These are the common ones.
The eye movements are rhythmic and equal in speed in both directions. Pendular nystagmus often occurs as a result of visual impairment early in life, or as a congenital condition. It can also be seen in certain neurological disorders.
A slow, drifting movement of the eyes in one direction (the “slow phase”) followed by a rapid corrective movement in the opposite direction (the “fast phase”). It is the most common type of nystagmus, and is categorized further by the direction of the fast phase:
Typically seen in individuals with strabismus (misalignment of the eyes). It occurs when one eye is covered, and the uncovered eye shows nystagmus as it tries to fixate on a target.
Both eyes show nystagmus, whether the eyes are open or closed. It can be present at all times, and is often associated with neurological conditions or certain medications.
Occurs when the eyes move to the extreme positions of gaze — looking to the far left or far right, for example. Gaze-evoked nystagmus can be a sign of neurological disorders or vestibular (inner ear) problems.
Present from birth and typically persists throughout life. It often follows a pendular pattern and is usually horizontal. The exact cause varies, but it is often related to abnormal development of the visual pathways in the brain.
Develops later in life and is often associated with an underlying medical condition — neurological disorders, vestibular dysfunction, drug toxicity, or head injury. The specific pattern and characteristics vary with the underlying cause.
A rare form of nystagmus that occurs in infants and young children. It involves a combination of head nodding, head tilt and nystagmus, and typically resolves on its own as the child grows older.
The type of nystagmus and its associated pattern provide valuable diagnostic information, helping health professionals determine the underlying cause and the appropriate treatment or management strategy. If you or someone you know is experiencing nystagmus or any abnormal eye movements, consult a medical or eye care professional for a comprehensive evaluation and diagnosis.
Care starts with a comprehensive developmental and binocular vision evaluation. We look at how the nystagmus is affecting function and comfort — visual acuity, steadiness of fixation, tracking across a line of print, depth perception, head posture and reading stamina — rather than at the eye movement alone.
From there, Dr. Murray optimizes any glasses prescription and, where appropriate, uses vision therapy strategies and supports to help patients use their vision more effectively. For patients whose nystagmus followed a head injury or another neurological event, vision rehabilitation may be the right framework. When a medical cause is suspected or already being managed, we coordinate with your physician or specialist rather than working in isolation.
Evaluations are available at our Boynton Beach and Boca Raton offices. If you are not sure whether what you are seeing warrants an appointment, the free symptom checklist is a good place to start, and our signs of a vision problem guide covers what else can look like a learning or attention issue.
When eye movements are inefficient — losing your place, skipping lines, effortful tracking across a page.
Eye misalignment and reduced vision in one eye — the setting in which latent nystagmus is usually seen.
Making the most of remaining vision when standard glasses or contacts are not enough.
Head injury is one of the causes associated with acquired nystagmus and other post-injury visual changes.
Testing adapted to the child in front of us, including children who cannot respond to a standard eye chart.
What a developmental and binocular vision evaluation measures, and how long it takes.
How eye movements are supposed to work, what happens when they are inefficient, and how that is assessed.
Unusual eye movements are one of the signs listed for the first eighteen months — here is the rest of the list.
A comprehensive evaluation tells you what is actually happening and what to do next — at our Boynton Beach and Boca Raton offices.