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Nystagmus is an eye condition with uncontrolled eye movements and it is due to their nature that there are several types of the disease. Nystagmus may be a congenital or acquired disease. They are treated with appropriate glasses, but surgical intervention is also possible.
Definition of nystagmus
Nystagmus is a disease in which the eyes make involuntary, rhythmic movements of the eyes in all directions (e.g. left, up, down). If this movement is performed at the same pace, we are dealing with pendulum nystagmus. In the case when the eye movement in one direction is faster than the other, it is called jumping nystagmus. Nystagmus can be a congenital or acquired disease, usually treated with appropriate glasses, but sometimes surgical intervention may be necessary. The ailment can significantly worsen visual acuity.
When talking about the features of nystagmus, one should remember about its type, speed, form, direction and intensity. Nystagmus can be slow or fast, rhythmic, vertical, horizontal or rated on a three-point scale.
Nystagmus – causes
Nystagmus occurs in the course of brain diseases, damage to the labyrinth, and also when taking certain medications. It can also be caused by alcohol poisoning and muscle insufficiency in the eyeball. It occurs in various diseases of the central nervous system and in eye malformations associated with severe visual impairment. It may also be congenital of unknown etiology.
Nystagmus may have physiological origin, e.g. oculomotor nystagmus – occurs when a person observes objects moving at a very high speed (e.g. a moving train or car). The ailment may also appear as a result of diseases of the labyrinth in the inner ear, then it is referred to as pathological labyrinthine nystagmus.
The disease can also be of an ocular origin. Then nystagmus is diagnosed in people with a congenital defect of the eyeball, e.g. in vitiligo, cataracts or abnormal development of the macular retina. It can often be observed in people with nodules in the optic nerves or visually impaired, involuntary constant movement of the eyes and head, and sometimes even the whole body. The condition may gradually decrease or completely disappear by the age of three in children whose vision improves.
As mentioned at the beginning, nystagmus can occur in diseases of the central nervous system. This happens most often in the case of skull base injuries, diseases of the cerebellum or due to damage to the nerve nucleus. Injury to the midbrain can lead to:
- intermittent nystagmus due to a brain stem defect or vascular diseases;
- convergence-retraction nystagmus, often occurring due to damage to the posterior fossa of the skull and taking certain medications;
- Swing-alternating nystagmus – often resulting from damage to the optic crossing, then one eye rises and assumes a convergent position, while the other one drops and positions itself divergently.
In practice, nystagmus is quite rare, although there is no specific information on this.
Nystagmus – symptoms
A characteristic symptom of nystagmus is the involuntary movement of the eyeballs of different speed, direction, form and intensity. These movements reduce visual acuity and cause vision problems.
Congenital type of nystagmus is characterized by a significantly reduced visual acuity and does not attack during sleep. Typically, near vision acuity is better than far away, because the convergent positioning of the eyes while reading results in less nystagmus movement. There may also be a compensatory head position when the intensity of nystagmus depends on the direction of the gaze. We are then talking about the so-called the neutral zone, which concerns the field of vision, where the movement of the eyeballs is the least or completely disappears – then the patient turns his head to the side. People whose nystagmus is the largest when looking to the right and the smallest when looking to the left – turn their head towards the greater nystagmus and their eyes turn to the left to the neutral zone (this helps to maintain visual sharpness by moving the neutral zone straight ahead).
Nystagmus diagnosis
During the diagnosis of nystagmus, the doctor conducts a thorough medical interview with the patient and performs a thorough ophthalmological examination. Other additional tests, such as magnetic resonance imaging and consultation with another specialist (for example an ENT or neurologist) who can help determine the cause of the disease, are also helpful.
Nystagmus – treatment
The treatment of nystagmus does not depend only on one doctor, it is the cooperation of a neurologist, ophthalmologist, neurosurgeon and sometimes even an oncologist.
1. In patients with nystagmus of unknown origin, accompanied by improper head positioning, doctors recommend prismatic glasses.
2. Some people are given botulinum toxin A, which is applied to the smooth motor muscles.
3. Sometimes smooth movement muscles are needed. Its purpose is to shift the eyeballs towards the most intense nystagmus. This action makes the so-called the neutral zone is shifted straight ahead, and the incorrect (compensatory) head position subsides. Moreover, the treatment improves visual acuity. Important: the operation does not guarantee XNUMX% that the disease will not come back.
After completing the treatment of nystagmus, patients should remain under the supervision of an ophthalmologist and undergo checkups by specialists.
Can nystagmus be prevented?
There are no ways to prevent nystagmus diseases, and even less so, it is impossible to prevent congenital nystagmus of unknown cause. However, it is worth performing preventive examinations and balance examinations in children in particular months and years of life.
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