What is nystagmus?

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From the Guidelines

Nystagmus is a rapid, involuntary oscillatory movement of the eyeball. This condition can be characterized by repetitive, uncontrolled movements of the eyes in various directions, including horizontal, vertical, rotary, or a combination of these directions 1. Nystagmus can be congenital, present at birth, or acquired later in life due to various causes, such as inner ear disorders, certain medications, neurological conditions, or brain injuries.

Key Points About Nystagmus

  • The condition affects depth perception, balance, and coordination, often resulting in reduced visual acuity and sometimes dizziness.
  • People with nystagmus may tilt or turn their head to find a "null point" where the eye movements are minimized.
  • Treatment depends on the underlying cause and may include medications, corrective lenses, vision therapy, or sometimes surgery.
  • For congenital nystagmus, management typically focuses on maximizing remaining vision rather than eliminating the eye movements completely.

According to the most recent study on vision rehabilitation preferred practice pattern, nystagmus can be a symptom of various underlying conditions, including congenital structural abnormalities, genetic disorders, acquired abnormalities, and neurologic visual impairment 1. If you experience sudden onset of nystagmus, seek medical attention promptly as it could indicate a serious neurological condition requiring immediate evaluation.

From the Research

Definition and Effects of Nystagmus

  • Nystagmus is an involuntary, to-and-fro movement of the eyes that can result in a reduction in visual acuity and oscillopsia, a disabling subjective sensation of movement of the visual world 2, 3.
  • Acquired and congenital nystagmus often causes decreased visual acuity as a direct result of the inability to maintain stable foveal vision 2.

Types of Nystagmus

  • Acquired nystagmus can be caused by various factors, including multiple sclerosis and stroke 4.
  • Congenital nystagmus, also known as infantile nystagmus, is a type of nystagmus that is present at birth or develops in early childhood 5, 6.
  • Other types of nystagmus include downbeat nystagmus, periodic alternating nystagmus, and acquired pendular nystagmus 2, 6.

Treatment Options

  • Pharmacological treatment options are available to reduce nystagmus, particularly in acquired nystagmus and, more recently, infantile nystagmus 2, 3.
  • Gabapentin, baclofen, and clonazepam are commonly used medications to treat nystagmus, with gabapentin showing significant improvement in visual acuity and reduction of nystagmus in patients with acquired pendular nystagmus 2, 5, 6, 4.
  • Memantine is also a promising treatment option for pendular nystagmus, and may be effective as an alternative drug in treating patients with nystagmus 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Current Treatment of Nystagmus.

Current treatment options in neurology, 2005

Research

The pharmacological treatment of nystagmus: a review.

Expert opinion on pharmacotherapy, 2009

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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