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Nystagmus

Nystagmus is a condition in which the pupils of the eyes involuntarily move about. There are many different types of nystagmus, with equally as many causes.

The eyes can also move in a variety of directions. The most common motion is side to side. Usually, the pupils will move to one direction then move quickly back the other way. In some cases the eyes move up and down. Sometimes the eyes move from the center to only one side. Sometimes the movements are completely random.

Most cases of nystagmus are due to a communication error between the eye, brain, or the vestibular system. The vestibular system is the sensory organs that are responsible for coordinating movement, keeping balance, and spatial awareness. This includes parts of the brain that process sensory information and the cochlea, a canal in the inner ear that helps maintain balance.

When the head moves while focusing on an object, your vestibular system sends signals to your brain that tell it which way you moved. The brain then tells the eye movements that will counteract the movement of the head in order to keep the eyes in the same place.  When this system malfunctions, improper signals will be sent to the eyes. This is what causes the irregular motion of the eyes.

Different triggers can set off the movements. Gaze induced nystagmus is when the eyes begin to move after looking in a specific direction without moving your head. Other cases occur after moving your head in a specific direction or holding in a specific direction. These are called positional nystagmus. Movements could be triggered if the head moves or turns quickly. This is called post rotational. Spontaneous nystagmus is when movements occur for seemingly no reason or constantly; this is also called manifest nystagmus. Manifest-latent is also always present but gets worse when one eye is closed.  All of these are pathological, sometimes indicating a deeper underlying cause.

Sometimes nystagmus presents itself at birth, which is called congenital nystagmus. The most common motion for this condition is for the eyes to swing back and forth at even pace. This is normally a sign of another congenital disease, examples being albinism, cataracts, or other physical problems of the eye.

Acquired nystagmus can occur when incurring certain diseases, such as multiple sclerosis or brain cancer. Getting nystagmus from a stroke is common among senior citizens.

Nystagmus can also be a sign of certain toxins in the body. Some hallucinogenics, like PCP, have nystagmus as a side effect of the drug. Checking nystagmus is a part of a field sobriety test to check for alcohol intoxication.

Nystagmus is particularly hard to treat, especially when it is caused by a neurological disorder. Only in recent years has treatment been shown to be effective in hindering nystagmus. Certain medications can be prescribed to help reduce excessive motion. Surgery on the ocular muscles has been shown to reduce motion as well. In other cases it expands the range of motion one has with their head in the case of positional nystagmus. Physical therapy has similar effects. Contact lenses are recommended for those with nystagmus as they move with the eye. Wearing glasses could cause blurred vision because looking through different areas of the glasses causes blurring.

Nystagmus also occurs naturally as a reflex of the vestibular system. For example, when observing a moving, repeating pattern the eye will jump from one instance of the pattern to the other in order to remain fixated on the moving image. This is called the opticokinetic reflex. After rotating or spinning in a circle, the eyes will dart in the opposite direction of motion in order to stabilize sight.