Nystagmus (pronounced nis-tag-mus) is a condition that causes uncontrolled, constant rapid movement of the eyes. This movement is likely to cause vision problems. The underlying cause of nystagmus is often neurological, involving how the eye and brain work together to produce vision.
Nystagmus can occur in infants and adults, although the causes may be different. It is a common cause of vision impairment in children, who will benefit from early help and support to make the most of their eyesight. For adults, nystagmus can be a sign of another underlying condition that needs treatment.
The signs and symptoms of nystagmus include:
- Involuntary and constant eye movement. Others may notice this, but not always.
- Vision impairment. The severity of this can vary greatly between people, though most people have some useful vision.
- Variable quality of vision. Your overall wellbeing can influence this. For example, when you’re stressed or tired, nystagmus tends to become more rapid, worsening vision.
- Difficulty judging depth, making it harder to assess distances.
- A sensation of the world moving around you, known as ‘oscillopsia’. Particularly for adults, this can feel disorientating and cause dizziness, balance issues, and even nausea.
- Nystagmus signs in infants include eyes not fixing on or following objects at the expected developmental stage and noticeable rapid eye movements.
The causes of nystagmus can vary depending on whether you are born with it (infantile nystagmus syndrome) or develop it later in life (acquired nystagmus).
Sometimes, in both children and adults, no underlying reason for nystagmus can be found. This is known as ‘idiopathic nystagmus’.
Causes of infantile nystagmus (which is also called congenital nystagmus) include:
- A developmental issue with the eye or brain, or the way they interact.
- Genetics, as it can be hereditary.
- Other conditions, including albinism and Down’s syndrome.
Acquired nystagmus can be caused by:
- Neurological conditions, such as multiple sclerosis and stroke.
- Inner ear conditions such as Meniere's disease.
- Brain tumour
- Head injury
- Some prescription medications
- Alcohol and recreational drug use
- Vitamin B-12 deficiency
The brain and eyes work together to provide our ‘visual system’. If this doesn’t work correctly, it can lead to nystagmus. There are two main forms of nystagmus.
There isn’t currently a cure for infantile nystagmus, but a range of treatments can help manage the symptoms. Acquired nystagmus may improve if the condition that has caused it is treated.
Nystagmus diagnosis in children
If you suspect your baby has signs of nystagmus, speak to your health visitor or GP. They can refer your child for assessment by an ophthalmologist (eye doctor) and orthoptist to confirm a diagnosis.
Tests to diagnose nystagmus are painless and can be adapted for children so they won't be distressed. The ophthalmologist will monitor the eye’s movements and aim to confirm the type of nystagmus, including the direction the eyes move and whether they move together or independently of each other.
Further tests might be needed to find any underlying cause of nystagmus. For example, a CT or MRI can check for neurological causes. Children should also have an orthoptic assessment. Understanding more about why your child has nystagmus can help doctors give you a better idea of the effect it's likely to have on their vision.
Nystagmus diagnosis in adults
Adults may notice the symptoms of acquired nystagmus themselves. See your GP or optician if you experience symptoms such as seeing things moving despite them being still, accompanied by dizziness, coordination problems, and sometimes nausea. Occasionally the condition can be picked up by your optician at a routine eye test.
You may see an ophthalmologist for investigation to try to find the cause. They might refer you to a neurology department for further tests, which could include MRI or CT scans, blood, and genetic tests. You could also see an Ear, Nose, and Throat (ENT) specialist to assess the condition’s impact on your balance and coordination.
Getting diagnosed is the first important step, but what happens next? Find out more about living with nystagmus and the support available for children and adults.
When to get medical advice
Speak to your health visitor or GP if your baby isn’t fixing their eyes or following objects as expected between six weeks and three months old, or if their eyes seem to be moving all the time.
Adults who experience nystagmus symptoms, such as things around them appearing to move even when still (‘oscillopsia’), issues with balance, dizziness, and nausea, should speak to their GP. It’s important to get help, especially as nystagmus can be caused by an underlying condition that may require treatment.
Living with nystagmus
Children with nystagmus are likely to have a visual impairment, but this doesn't mean they won't see at all. They'll benefit from help at an early age to learn about managing their symptoms and to ensure their visual development is supported in the right ways.
Living with nystagmus can have its challenges, but with the right support, children and adults will be able to live independently.
Frequently asked questions
Medically reviewed by: The Royal College of Ophthalmologists on 18/10/2022
Edited by: Nick Astbury FRCS FRCOphth FRCP
Clinical Associate Professor
The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.