Dr. Orwa Nasser MD MPH - What is Nystagmus?

What is Nystagmus?

Nystagmus is an involuntary movement of the eyes without the ability to control it. The eyes can move horizontally, vertically, or circularly. Nystagmus usually occurs in both eyes and the speed and range of movement can vary depending on the cause of the nystagmus. In addition, the speed and range of movement in nystagmus may vary depending on the direction of the eyes or the position of the head. For this reason, some patients adopt a certain head position in order to slow down the nystagmus. Nystagmus can be congenital (from birth), and appear between 6 weeks and 3 months of age, or it can be acquired and appear later in life, and is usually caused by some problems in the nervous system or brain.

Nystagmus is usually accompanied by poor vision and quality, and most patients with nystagmus wear glasses. These patients also have sensitivity to light, feel that the world is shaking, suffer from dizziness and other vision problems.

In addition to the poor vision that nystagmus patients suffer from, there are two other important things that bother nystagmus patients. First, most patients cannot obtain a driving license due to their poor vision, which means that they are not independent in their mobility. Second, the damage to the self-image of some patients due to nystagmus. Here, in fact, our intervention as nystagmus doctors is very important and necessary to help these patients obtain a driving license and live a normal lifestyle without restrictions and with complete independence. In addition, our intervention also helps to improve self-image and increase self-confidence.

What causes Nystagmus?
The brain is responsible for eye movement. If there is any problem in the control center of the brain, nystagmus is likely to occur. The mechanism by which the brain loses control over eye movement is still not fully understood. Nystagmus can appear in many medical and eye conditions such as albinism, hereditary eye diseases and retinal degeneration, among others, and a wide range of eye problems in infants and children such as cataracts, strabismus, stroke, head injury, use of certain medications, alcohol or drug abuse.

What are the symptoms of Nystagmus or Nystagmus?
The most important symptoms of Nystagmus are rapid and involuntary eye movements that cannot be controlled. Nystagmus can lead to poor vision, an incorrect head position (tilting or turning the head, raising or lowering the head and chin), a feeling that the world is shaking, sensitivity to light, dizziness, and some other vision problems.

How is Nystagmus diagnosed?
In general, nystagmus is noticed by the patient himself, parents or relatives. The condition can be definitively diagnosed easily with a simple examination by an ophthalmologist. Finding out the cause of nystagmus requires several tests, such as a comprehensive eye examination, recording eye movements ERG, VEP, CT or MRI.

How is nystagmus treated?
The treatment of Nystagmus depends on its cause and the condition itself. Glasses or contact lenses can be used, but this is not enough to treat the condition. Surgery is very helpful in treating congenital or acquired nystagmus.

Nystagmus surgery:
The goal of the surgery is to significantly reduce the frequency and range of eye movement, thus significantly improving the condition of the eyes. In addition, if the head position is abnormal due to nystagmus (tilting or turning the head, raising or lowering the head and chin), surgery can solve this problem and provide the patient with a normal position and normal growth. If the disease includes Strabismus in addition to Nystagmus, strabismus can also be treated in the same surgery. 
Studies have shown that the vibration and range of Nystagmus movement are significantly reduced after the surgery, and the vision problem is reduced, and surgery even leads to an improvement in vision in some cases. It should be noted that the surgical procedure does not remove Nystagmus, but it significantly reduces the speed of vibration and the range of eye movement, thus improving the condition of the eyes.