Introduction  

Nystagmus is an eye disorder that causes rapid, involuntary movement of one or both eyes. The eye movement could be:

  • Up and down in vertical nystagmus
  • Side to side in horizontal nystagmus
  • In a circle in rotary nystagmus

In most cases, the eye movement happens in both eyes and may vary between slow and fast. The shift may be more pronounced when one is looking in specific directions. Individuals with this disorder may tilt or turn their head for a better view. It helps to slow down the eye movements.

Also Known As

Dancing eyes

Sub-Types

  • Congenital nystagmus is also referred to as infantile nystagmus syndrome (INS)

Often, it starts in infants between six weeks and three months old. The condition tends to affect both eyes, causing them to move side to side. 

  • Acquired nystagmus is also known as acute nystagmus

It can occur at any stage of life. In most cases, it develops due to disease or injury. People with this condition tend to see things around them appearing shaky.

Causes and Risk Factors

It is not clear what causes the disorder in children. Sometimes congenital nystagmus is an inherited genetic defect. Usually, infantile nystagmus syndrome is mild and isn’t caused by underlying health conditions. On rare occasions, a congenital eye disease could cause it.

In adults, it is not always clear what causes dancing eyes. At times the disorder is linked to other eye conditions. Most cases of acquired nystagmus are related to events or acts that impact the labyrinth in the inner ear.
Risk factors include:

  • Albinism
  • Eye disease 
  • Certain medications
  • Alcohol abuse
  • Drug use
  • Genetics, a family history of nystagmus
  • A wide range of eye disorders in infants and children including misaligned eyes, focusing problems and cataracts.
  • Head trauma, a common cause of acute nystagmus in younger people
  • Inner ear problems like Meniere’s disease
  • Diseases of the central nervous system such as multiple sclerosis
  • Stroke, a common reason for acquired nystagmus in older people
  • Other severe medical conditions such as a brain tumor
     

Signs & Symptoms

Rapid and uncontrollable eye movements characterize nystagmus. 
The symptoms of the condition may include:

  • Blurred vision 
  • Dizziness
  • Eye misalignment
  • Difficulty reading 
  • Sensitivity to light
  • Difficult seeing at night or in dark places
  • Abnormal body posture 
  • The sensation that the world is shaking
  • Holding the head in a tilted or turned position
  • Vision problems
     

Diagnosis

The eye care professional can diagnose nystagmus by taking the patient’s history and performing an eye exam. He/she will also check for other eye conditions that may be associated with nystagmus including misaligned eye, cataracts, and retinal and optic nerve disorders.
The professional may also conduct other tests for a definite diagnosis including:

  • Eye movement recordings- To get details of the eye movements and confirm the type of nystagmus 
  • Blood test 
  • A neurological exam
  • An ear exam
  • Imaging techniques like X-rays, MRI and CT scans
     

Treatment 

Treatment is focused on the underlying cause.

Medical Treatment

In the case of congenital nystagmus, the eye doctor may prescribe eyeglasses, contact lenses or magnifying glasses. It doesn’t cure the condition, but a more precise vision may slow down the eye movements.

For acquired nystagmus treatment options include:

  • Watchful waiting, sometimes the condition may improve or go away without treatment
  • Medical treatment for the situation that causes it such as: 

-   Dietary adjustments and supplements for vitamin deficiencies
-   Eye drops for eye infections
-   Antibiotics for inner ear infections
-   Changing medication
-   Special lenses 

  • Avoiding alcohol and drug abuse
     

Surgical Treatment

In severe cases of congenital nystagmus, the eye surgeon may use a procedure known as tenotomy.  The surgery repositions the muscles responsible for eye movement.  It reduces the degree to which the patient needs to turn their head for a better vision.

In some case of acquired nystagmus, the surgeon may recommend laser therapy or surgery to correct the underlying cause.

Alternative Treatment

 

Prognosis/Long-term outlook

The symptoms of the disorder can make daily tasks very challenging.

Nystagmus may get better over time. There is no cure for the condition thus it never goes away completely.

Prevention/Follow Up

Using protective gear for hazardous work and sports can prevent injuries.
Regular exercise and a healthy diet may help to prevent some diseases that cause it.
One should use alcohol in moderation and avoid drugs.