Bright Sight

Oliver Backhouse, Consultant Eye Surgeon www.cataract.org.uk

Nystagmus

Nystagmus is a problem with the movement of the eyes and is characterised by an involuntary oscillatory movement. These movements may be jerky or pendular and their characteristics can change when one looks in another direction. Vision is often reduced.

About 1 in every 1,000 people have nystagmus. There are many different types. The age of onset, characteristics of the movements, associated eye or general health problems and family history can often identify the cause of the nystagmus. This is a condition that should be accurately diagnosed by an Ophthalmologist or Neurologist as new onset nystagmus can be the first sign of a serious disorder. A Neuro-Ophthalmologist is a specialist who combines these two specialty interests. Children with Nystagmus will have their eye care looked after by a Paediatric Ophthalmologist. If the Nystagmus if felt to be genetic then the involvement of a Clinical Geneticist is arranged.

Because poor vision is associated with Nystagmus one may be able to get additional help by being registered as having sight difficulty. Low vision aids such as a magnifier and other such devices are available from the Visual Aid Clinic. This is particularly important with regard to children at school who therefore may need extra time studying. Sometimes the eye movements are less in certain head positions. This improves the sharpness of the vision and this head positioning should not be discouraged. It is important to realise that people with poor vision find that the vision can change from day to day. This is due to other factors such as anxiety, fatigue and unfamiliar surrounds.

The treatment of Nystagmus depends a lot of what the ‘cause’ is. The Visual Aid Clinic is important to see how one can maximise the vision that one has and try the different vision aids that there are. Sometimes surgery can reduce the amount of head position change needed to keep the eyes as still as possible. Many medications have been tried but are unfortunately not that successful. Occasionally some do help a lot – an example would be the use of Baclofen in periodic alternating nystagmus.
Sometimes people with Nystagmus can drive if the vision is not too bad. The final decision regarding the legality of driving is the licensing authority and not the doctor although they may be able to advise. As Nystagmus may be caused by purely an eye condition, it is wrong to presume that somebody with nystagmus has ‘learning difficulties’. It should be stressed again the importance of correctly identifying the cause of the Nystagmus so appropriate help and treatment can be arranged.