Nystagmus

What is nystagmus?

A jerky, spontaneous, involuntary movement of the eyes, a kind of rhythmic, rapid oscillation.

Nystagmus can be normal in certain situations, such as when looking at the landscape through the window of a moving train. The gaze focuses on a point in the landscape, follows it for a brief moment as it scrolls to a maximum on the side, then settles on another point in the landscape and follows it. Another situation in which normal nystagmus is observed is when a person is placed on a chair and the chair is turned. The nystagmus is then triggered by the inner ear.

Nystagmus is pathological when it is constantly present.

• In children, nystagmus most often appears in the first 2 to 3 months of life. This early nystagmus can be isolated, or associated with a visual problem. In exceptional cases, nystagmus can be linked to a neurological problem, which is suspected if nystagmus appears after the first 4 to 6 months of life.
• In adults, acquired nystagmus is often linked to a neurological or vestibular problem (inner ear).

What are signs of nystagmus in children?

The eyes may exhibit constant rapid horizontal or vertical jerking movements, which may resemble a constant “shaking” of the gaze. These movements may be regular or irregular, identical and simultaneous in each eye or not. 

The nystagmus can sometimes be relieved by looking in a particular direction. In this case, the patient’s head is constantly turned to use the calmest gaze direction for the best vision. 

If the nystagmus is acquired, that is to say new, the patient may have the impression that their environment is constantly moving. This is most often not the case in children.

How can screening be carried out?

The presence of involuntary spontaneous movements, or oscillations, requires an ophthalmological examination, most often combined with an orthoptic examination, in order to determine the type of nystagmus, and to decide whether additional examinations are necessary. 

Acquired nystagmus requires immediate care, as it could occur as a result of a tumour, head trauma or a vascular accident.

What are the risk factors?

The presence of nystagmus in the family is a risk factor, since some cases are of genetic origin.

What are the treatments for nystagmus?

Glasses or contact lenses may be needed to improve vision.

In the case of torticollis, an operation on the extra-ocular muscles (which allow the eyes to move) may be indicated in order to shift the area of calm gaze from a lateral position to looking straight ahead. The aim is to allow the patient to have the best possible vision while looking straight ahead.

If close-up vision is significantly better, an operation on the extra-ocular muscles can sometimes be proposed in order to improve far vision.

Drugs (for example, Baclofen) may be useful in certain types of nystagmus.

Find out more about children's visual disorders

Do you want to learn more about a particular visual condition or conditions? Discover our pages on amblyopia, hyperopia, strabismus, and astigmatism. We explain these visual disorders and tell you how to treat them to preserve your children’s visual acuity.