Do your eyes flutter uncontrollably? Let's learn about Nystagmus!

Have you ever felt your eyes moving back and forth, up and down, or in circles, uncontrollably? Maybe you feel like the objects you're looking at are shaking or moving. This can be a scary experience. But don't worry. Today we're going to talk about this condition. In medicine, we call it nystagmus. Let's take a look at what it is, why it happens, and what you can do about it.

Simply put, what is Nystagmus?

Nystagmus, simply put, is an uncontrolled, rapid, repetitive movement of our eyes. This can occur in one eye or both eyes. These eye movements can be in different directions.

• Side to side: The eyes move rapidly from side to side, like the wipers of a car. We call this horizontal nystagmus.
• Up and down: Rapid movement of the eyes up and down. This is vertical nystagmus.
• Circular: A movement that seems to make the eyes move in a circular motion. This is called rotary nystagmus.

The pattern of these movements can also vary.

• Jerk Nystagmus: This is a sudden, rapid movement of the eyes, as if they are trying to correct a mistake.
• Pendular Nystagmus: This is when both eyes move side to side at the same speed, like the pendulum of an old clock swinging back and forth.

This uncontrolled movement of the eyes can cause problems with vision , depth perception , body balance , and limb coordination .

What are the main types of nystagmus?

Nystagmus can affect both children and adults. We divide it into two main types, depending on the age at which the condition begins.

1. Congenital or Infantile Nystagmus

This is the most common type. As the name suggests, it can be present at birth or develop within the first few months of life, usually between 6 weeks and 3 months. Sometimes it can be hereditary. However, there is no clear cause for it. Children with congenital nystagmus have this movement in both eyes. And the eyes often move from side to side. The main problem for these children is blurred vision .

2. Acquired Nystagmus

This type can develop later in life, usually after 6 months of age. It is most common in adults. Acquired nystagmus is often a symptom of another underlying condition. This means it can be caused by a condition that affects your brain , eyes , or ears . It can also sometimes be caused by alcohol or drug use. Adults with this type of nystagmus often say, "Doctor, I feel like things are moving or shaking."

Is this situation serious?

This is a problem that many people have. Nystagmus alone is not dangerous. However, it can be a symptom of other serious conditions, especially brain-related conditions. For example:

• Stroke
• Brain tumor
• Head trauma
• Toxicity
• Inflammatory diseases of the brain

What are the symptoms of nystagmus?

The main symptom is the uncontrolled eye movements we discussed earlier. However, there may be a number of other symptoms depending on the cause.

Why does this happen? What are the causes of nystagmus?

To understand this, you need to have a little idea of ​​how our eyes move. The movement of our eyes is controlled by a very complex system. This involves the brain , the eyes , and the vestibular system, which is the part of the inner ear that controls balance . It's like the 'image stabilizer' in a good camera. Even when we move our heads, what we see remains stable because of the functioning of this system. In nystagmus, there is a problem somewhere in this connection.

Here are some of the main causes of nystagmus:

• Problems with brain or eye development.
• Diseases of the retina or optic nerve.
• Inner ear balance disorders, such as Benign Paroxysmal Positional Vertigo (BPPV) and Ménière's disease .
• Stroke.
• Brain tumor.
• Injuries to the eye or head.
• Use of alcohol or certain drugs.
• Albinism - This is a condition in which the skin lacks pigment.
• Vision problems, such as nearsightedness or astigmatism.
• Certain medications, especially antiseizure drugs.
• Diseases that affect the central nervous system, such as Multiple Sclerosis (MS) .
• Eye problems in young children. For example, conditions such as strabismus and cataracts.

Sometimes no clear cause can be found for this. We call it Idiopathic Nystagmus .

How to recognize this?

If you have symptoms of nystagmus, you will likely be examined by an ophthalmologist . He or she will examine your eyes carefully, ask about your symptoms, and check for other eye conditions that may be associated with it.

But to find the cause, you may need to see other specialists.

• Neurologist: Check for a brain-related problem.
• Otorhinolaryngologist or ENT doctor: Check for balance issues in the inner ear.

To find the exact cause, you can do the following tests:

• A complete neurological exam.
• Ear exam.
• Special tests that record eye movements, such as Electronystagmography (ENG) and Video-nystagmography (VNG) .
• Brain imaging tests, such as a CT scan (Computed Tomography scan) or MRI (Magnetic Resonance Imaging) .
• Genetic tests to identify genetic defects that cause congenital nystagmus.

What are the treatments for nystagmus?

The treatment for this depends entirely on the underlying cause of the nystagmus. That is, we treat the underlying cause, not just the symptom.

Treating the underlying condition

In Acquired Nystagmus, when we identify and treat the underlying condition, the symptoms of Nystagmus may decrease or disappear completely. For example, if Nystagmus is caused by a problem in the inner ear, treating that will reduce the dizziness and eye twitching.

Glasses or contact lenses

As your vision improves, rapid eye movements can be controlled to some extent. So your doctor may recommend glasses or contact lenses. They may also prescribe a special type of lens called prism lenses . These reduce the amount of strain your eyes have to exert to see.

Medications

There are several medications that can help reduce the symptoms of nystagmus in adults. For example, Gabapentin , Baclofen , and Onabotulinumtoxina (Botox®) . Your doctor will determine if these are helpful for you.

Eye muscle surgery

This is done very rarely. This surgery involves changing the position of the muscles that move the eyes. This surgery cannot completely cure nystagmus, but it can make it easier to move the eyes. This reduces the amount of turning and tilting your head to see clearly.

Vision correction surgery

If you have nystagmus and nearsightedness, you may benefit from laser surgery such as LASIK . Keep in mind that this surgery will not cure nystagmus. However, as your vision improves, the symptoms of nystagmus may decrease.

When should you see a doctor?

This is very important. If you suddenly notice any changes in your vision, eye twitching, problems with balance, or difficulty with coordination, see your doctor immediately.

Remember, nystagmus can be the first sign of a serious medical condition, so it's important to get a diagnosis and start treatment quickly.

If you have already been diagnosed with nystagmus, and your symptoms are getting worse, let your doctor know.