Uncontrolled eye movements: how nystagmus can affect your vision and how a neuro-optometrist can help

At our optometry clinic, we specialize in the diagnosis and management of Nystagmus, a condition that causes involuntary eye movements.

Uncontrolled eye movements: how nystagmus can affect your vision and how a neuro-optometrist can help Optometrist
Specialty Vision

What is Nystagmus?

Nystagmus is a condition that affects the eyes and causes them to make involuntary and repetitive movements. These movements can be side-to-side, up-and-down, or in a circular pattern and can result in reduced vision, depth perception, balance, and coordination. People with nystagmus may also experience symptoms such as dizziness, headaches, and difficulty focusing. They may also nod and hold their heads in unusual positions to try and compensate for the condition.

While nystagmus is generally a symptom of another eye or medical problem, it can have a significant impact on a person's daily life. In addition to the visual disturbances, people with nystagmus may have difficulty with activities such as reading, driving, or working on a computer. They may also experience increased fatigue and stress, which can make the condition worse.

For these reasons, it is important to visit an optometrist that specializes in neuro optometry or low vision. These specialists can provide advanced treatment options such as neuro-optometric rehabilitation therapy, which refines and improves visual skills by strengthening the brain’s control over the eyes. Additionally, low vision aids such as special lenses and prisms can be used to help patients with nystagmus see more clearly. In rare cases, surgery may also be an option to improve vision by changing the position of the eye muscles that control movement.

Improving visual outcomes for patients with Nystagmus: How neuro optometrists enhance vision and quality of life for patients with nystagmus

Improving visual outcomes for patients with Nystagmus: How neuro optometrists enhance vision and quality of life for patients with nystagmus

A wide variety of optics, therapies, prisms, filter lenses, and computerized low vision aids may be prescribed to reduce the symptoms of nystagmus.

Using Prisms to Improve Nystagmus Symptoms: How Neuro-Optometrists Utilize this Technique

Prisms are a powerful tool in the arsenal of neuro-optometrists for treating nystagmus. These specialized lenses, when added to eyewear, can improve the patient's appearance by changing the null position, the position in which the nystagmus is least severe, to a more normal position. Additionally, prisms can be used to induce more convergence, or turning in of the eyes, which can reduce nystagmus symptoms.

Magnification

Magnification can help to slow eye movements for many patients which may assist in tasks like writing or reading. There are many types of magnification available including handheld magnifiers, stand magnifiers, digital CCTV magnifiers that are both portable and desktop, and magnification that is worn in glasses. 

Adjusting brightness and reducing glare

Light sensitivity is common among people with nystagmus. You can often improve your vision quality by adjusting the brightness, changing font size, and adding filters to enhance visual contrast on your computer screen.

Electronic devices to enable reading and reduce dizziness

There are a variety of technologies that use OCR technology to read text without needing to strain the visual system. One of the most advanced options is OrCam which incorporates cutting-edge technology that helps adults and kids with nystagmus have text read to them in their ear. This can lead to a dramatic improvement in the quality of life for a patient with nystagmus who struggles to read, use a cell phone, or do other reading tasks, and may also lessen headaches and dizziness when reading, using a digital device, or copying from the classroom board.

Contrast sensitivity training

A recent clinical study presented at the annual meeting of the European Strabismus Association found that 80% of patients with congenital nystagmus who underwent treatment with the RevitalVision program experienced an average improvement of 2 lines on a visual acuity chart. This substantial progress allowed some patients to even qualify for a driving license.

Vision Therapy for Nystagmus

Nystagmus is an eye condition in which one or both of the eyes make involuntarily repetitive eye movements, which can result in reduced vision, depth perception, and difficulty with balance and coordination. Vision therapy is a personalized program that can help remediate these symptoms by addressing the underlying causes of nystagmus.

One form of vision therapy that has been found to be effective in treating nystagmus is Syntonics. Syntonics is a type of therapy that utilizes colored filters to send coded signals to the brain, which can help to slow down or stop the involuntary eye movements associated with nystagmus. This therapy can also help to improve focus and clarity, restore the electrical connection between the brain and eyes, improve binocularity and alignment, and establish depth perception.

Vision therapy and syntonics can impact the vision and quality of life of a person with nystagmus by: 

  • Slowing down the involuntary rhythmic motion of the eyes in order to regain proper fixation.
  • Improving focus and clarity. 
  • Restoring the electrical connection and fostering improved communication between the brain and eyes. 
  • Improving binocularity and alignment
  • Establishing stereopsis (depth perception)

Prescription lenses

Prescription eyeglasses or contact lenses can help reduce refractive errors, such as myopia, hyperopia, and astigmatism in patients with nystagmus. This can improve their vision and make daily tasks, such as reading and driving, easier to perform. Additionally, some special types of glasses and contact lenses are designed specifically for people with nystagmus that may help reduce the symptoms of the condition.

Refractive surgery

It is important to note that while strabismus surgery may help to improve the alignment of the eyes and reduce head tilts, it is not a complete treatment for nystagmus. Additionally, it is important to note that not all cases of nystagmus are suitable for surgery and it is important to consult with our eye doctor and an ophthalmologist to determine if surgery is an appropriate option for you.

It's also worth mentioning that even if surgery is performed, it's not a guarantee to completely stop the eye movements and it's not able to improve the visual acuity. It's important to have realistic expectations and to consider all the options for treatment before making a decision.

Discontinuing medication

While discontinuing certain medications may improve nystagmus symptoms, it should only be done under the guidance and supervision of a healthcare professional. Medications may be essential to the treatment of other underlying conditions, and stopping them abruptly could have serious consequences. It is important to work closely with your healthcare team to determine the best course of treatment for your specific condition.

Improving visual outcomes for patients with Nystagmus: How neuro optometrists enhance vision and quality of life for patients with nystagmus

Improving visual outcomes for patients with Nystagmus: How neuro optometrists enhance vision and quality of life for patients with nystagmus

  • Decreased visual acuity
  • Loss of balance
  • Poor depth perception
  • Vertigo which could lead to nausea, vomiting
  • Light sensitivity
  • Oscillopsia
  • Problems with posture
  • Blurred vision

Consultation with our neuro optometrist

Nystagmus can have various underlying causes such as genetics, brain injury, or inner ear problems, so it's important to consult with a neuro optometrist to determine the underlying cause of the condition. Our neuro-optometrists specialize in the rehabilitation of patients with visual disorders caused by neurological conditions and can work with patients to develop a personalized treatment plan to manage their nystagmus and maximize their vision. They can use various techniques such as prisms, therapies, filters and special glasses to reduce the symptoms and improve the quality of life for patients with nystagmus.

Types of Nystagmus: understanding the different forms of Nystagmus

Types of Nystagmus: understanding the different forms of Nystagmus

There are two main types of nystagmus. It can be genetic or acquired.

Congenital motor nystagmus

This type of nystagmus occurs shortly after the birth, under the age of 6 months, and affects the child throughout their life. Children with this type of nystagmus have normal vision. It can be caused by abnormalities in the structures of your eye like cornea, lens, retina, underdeveloped optic nerves or absence of the colored part of the eye called iris. Another cause of it is abnormalities in the visual pathways in the brain. To find the exact cause of nystagmus, an MRI scan of the brain may be required. 

Congenital sensory nystagmus

Sensory nystagmus is the type of nystagmus in which the child has impaired vision. The onset of this type of nystagmus usually occurs around 2-3 months of age and lasts for the rest of the child's life. Nystagmus in this form is characterized by uncontrolled repetitive movement of the eyes in a horizontal direction.

Acquired nystagmus

This form of nystagmus does not develop until late in childhood or adulthood. It could be due to due to the following neurological and medical causes:

  • Stroke
  • Brain injuries
  • Tumors
  • Central nervous system disorders
  • Metabolic disorders
  • Alcohol
  • Drug toxicity
  • Cancer
  • Genetic disorders
  • Functional brain abnormalities
  • Diseases of the vestibular system
  • Damage to brainsteam
  • Damage to cerebellum
  • Albinism

How common is Nystagmus in the United States?

Nystagmus has a reported incidence rate of at least 1 in 1,000 individuals in the United States. Among school-aged children, it is considered one of the most common forms of visual impairment. However, it is worth noting that the actual incidence rate may be higher as not all cases are diagnosed or reported.

Improving visual outcomes for patients with Nystagmus: How neuro optometrists enhance vision and quality of life for patients with nystagmus

Common Questions

Improving vision with nystagmus often involves a multi-faceted approach, including optical aids like glasses or contact lenses, certain eye exercises, and occasionally, surgery. Neuro optometric rehabilitation might be recommended to help manage the condition and improve quality of life.
Nystagmus is typically treated by an eye specialist like an ophthalmologist or optometrist. These healthcare professionals can diagnose the condition through a comprehensive eye exam and then provide appropriate treatment options. However, since nystagmus can be associated with neurological conditions, patients might also need to see a neuro optometrist, who has specific training in neuro optometric rehabilitation. The collaboration of these specialists often ensures the most effective management of nystagmus.
Various neurological problems can cause nystagmus, including multiple sclerosis, stroke, or brain tumor. Other conditions, such as Meniere's disease or certain types of medication, can also lead to nystagmus. Comprehensive evaluation by a neuro optometrist or a neurologist can help determine the root cause.
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Schedule a Neuro-Optometric Evaluation for Nystagmus

To schedule a neuro optometry exam, contact the listed practice by calling or visiting them in person. They are prepared to provide the care you need.

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