Dealing with Eye Disorders: Nystagmus
Nystagmus is a complex eye disorder that can significantly impact your quality of vision and life. It’s believed that it affects about 1 in every 1000 people. Unlike glaucoma, macular degeneration, and other eye disorders, there isn’t much research on Nystagmus.
Nystagmus, also known as “dancing eye syndrome,” is a sudden, constant, and involuntary eye movement. In most common cases, sufferers’ eyes will dart from side to side. However, in some cases they will also move vertically or in a circular motion.
The physical characteristic of this disorder can create significant social challenges for the patient. At the time, there is no known cure for nystagmus, but there are some treatments that make living with the condition easier.
Causes of Nystagmus
Nystagmus occurs when there is a miscommunication between the brain and the eyes. Our vision relies on our brain’s ability to control our eyes, and our eyes’ ability to transmit images to the brain.
When the part of the brain that regulates eye movement is underdeveloped or disrupted, it can harm the normal function of the eyes and cause nystagmus. Nystagmus can be genetic or chemically induced.
- Hereditary: Caucasians are more likely to develop the disorder. However, there’s no correlation to gender, with the exception of X-linked infantile nystagmus, which is more common in boys ¹.
- Neurological disorders: Oftentimes, dancing eye syndrome arises from brain damage and neurological disorders. It’s not uncommon for people to experience this eye disorder after suffering from a stroke, seizure, or head trauma. This is considered acquired nystagmus.
- Drugs: Excessive alcohol consumption, drug use, and certain prescription medications are also linked to the development of nystagmus. However, symptoms of the condition usually disappear when substances wear off ². We’ll talk about this more in-depth later.
What is Nystagmus?
There’s a reason congenital nystagmus appears in this cycle. Your visual system develops during the first 3 years of your life. As your brain and eyes are stimulated by your visual field, your visual system becomes more and more complex.
Reduced visual stimulation as a child can cause your visual system to be underdeveloped. Usually, this lack of visual stimulation occurs in children who are born with eye conditions, like glaucoma or cataracts. This leads to the inability to control eye movements, and eventually a diagnosis of nystagmus.
It’s not uncommon for people born with inherited neurological conditions, like Down’s Syndrome, to develop nystagmus.
It is also possible for a child to have nystagmus without any other obvious eye or health problems, and the cause is simply unknown. In this instance, the condition is often referred to as ‘idiopathic nystagmus’.
Acquired nystagmus, also known as sensory or manifest nystagmus, usually occurs later in life. Acquired nystagmus can be the direct result of a number of factors:
- Underlying medical conditions: Multiple Sclerosis (MS), stroke, or ataxia can all lead to nystagmus. All of these neurological diseases negatively affect the nerve cells in the cerebellum, which is the part of the brain that controls muscle coordination, including the muscles that control your eye movement ⁴. In some cases, acquired nystagmus may come and go, depending on the severity of the underlying cause of the disease. Unfortunately, for some patients, the effects of nystagmus are permanent.
- Trauma. Acquired nystagmus can also occur as a result of an accident or trauma, particularly when damage occurs to the head, ears, or neck. Again, this causes disruption to the communication pathway between the brain and the eyes.
- Chemically-induced. Excessive alcohol consumption, as well as illegal and prescription drugs are known to cause nystagmus. A variety of “uppers” can cause involuntary eye wobbles, because they disrupt your brain’s ability to effectively fire neurons. This is common in people who abuse the recreational drug MDMA and cocaine abusers 4. Usually, chemically induced nystagmus will disappear when the drugs wear off.
- Inner-ear issues. Some people with inner-ear problems, like Meniere’s Disease, can develop ‘jerk nystagmus’. Jerk nystagmus occurs when the eyes slowly drift in one direction, then jerk back the other way. In these instances, the condition is temporary. Sometimes doctors prescribe decongestants to help inner-ear problems.
If you think you’ve developed nystagmus or feel like you have shaky eyes, it’s important to consult your ophthalmologist and get to the bottom of the condition, because there might be a severe underlying condition.
Diagnosing Nystagmus Early
To diagnose the type of nystagmus, your Ophthalmologist will monitor your eye movements by closely looking at their direction, frequency, and various other factors. Sometimes this test is carried out under anesthetic. In young children, a test might be given to determine their ability to see clearly.
Does Nystagmus Affect Your Vision?
The extent that nystagmus affects someone’s vision varies from patient to patient. Some patients only have minimally blurred vision, while others are severely impaired and recognized as legally blind. For the most part, people who suffer from nystagmus see the world in an entirely different way.
Children with congenital nystagmus have trouble with distance vision, but they’re able to easily see things up-close. Even though their eyes are moving in a constant horizontal motion, patients are still able to focus on a normal up-close image.
In acquired nystagmus, the speed with which the eyes move can vary. They can move horizontally, vertically, or in a circular motion. In some cases, the eyelids may also involuntarily flutter. Patients with this type of nystagmus often report that the world appears to be moving in their vision. This is known as oscillopsia, and make patients feel dizzy, off-balance, and in some cases, suffer from vertigo.
Oftentimes, people with this form of nystagmus use a technique called “finding the null point” to deal with visual issues. This involves turning your head to an angle where your eyes move the least, which then stabilizes your vision, making it easier to see.
How to Treat Nystagmus
There isn’t a known cure for nystagmus, but there are ways you can alleviate symptoms. Eyeglasses and contact lenses are a simple solution to improve vision. Studies show that as many as 85% of children are able to improve their condition with prescription eyeglasses⁵.
At the same time, contact lenses are considered more effective, because the lens is able to move with the eye. Contact lenses allow your vision to remain consistent.
With eyeglasses, the involuntary movement of the eye can cause you to look outside of the field of the lens, which can cause moments of blurred vision.
You can also find temporary relief from nystagmus with drugs, like Botox or Baclofen, which work by freezing muscle impulses.
However, the results of these treatments are temporary, and there are a variety of undesirable side effects, like double vision and facial drooping.
If the nystagmus is a result of excessive alcohol consumption or drugs, then the symptoms can be treated by discontinuing use.
Nystagmus can also be a side effect of some prescription medications, including those used to control seizures. In instances where prescribed medication is causing involuntary eye movement, you should speak to your doctor to discuss alternative medication to lessen or eliminate the effects of nystagmus.
In some cases, you can alleviate the negative effects through surgery by altering the position of the muscles that move the eye. This way, patients are able to improve their vision, while keeping their heads in a comfortable position.
Using Biofeedback to Treat Eye Movements
Recent clinical studies found that biofeedback techniques can be successful in helping patients regain control of their eye movements6.
Biofeedback is often used in conjunction with other therapies, like relaxation techniques and stress avoidance. These are particularly useful for patients with nystagmus, who often find that the symptoms of the condition become exacerbated in times of stress, anxiety, or upset.
Social Implications of Nystagmus
Since the condition is widely misunderstood, patients tend to struggle socially and professionally. It might also cause confidence and self-esteem issues with the patient, as they struggle to have a “normal” appearance.
Bringing attention and education to the condition can help society understand and accept it.
Resources For Dancing Eye Disorder
Despite the challenges that living with nystagmus presents, many patients with the condition are able to live fulfilling and happy lives.
When it comes to treating the condition, early and accurate diagnosis of congenital nystagmus is important - especially since it’s not uncommon for children with nystagmus to be falsely diagnosed with a learning disability. This false diagnosis can often make it difficult to receive adequate support with their education.
With the correct diagnosis and a supportive learning environment, patients with nystagmus can succeed in their education, careers, and personal lives.