Nystagmus

Nystagmus causes involuntary rhythmic shaking of the eyes

Have you ever seen a person’s eyes dancing or jerking? If he has nystagmus, then it is possible. Nystagmus is an eye condition that causes involuntary rhythmic shaking of the eyes. It came from the Greek word nmstagmos, which was used to describe the wobbly head movements of an inebriated or sleepy person. The involuntary movements of the eyes may either be horizontal, vertical or rotary.

There are different kinds of nystagmus. The first kind is congenital nystagmus, is presented at birth. In this type, the eyes seem to swing together like a pendulum. The second kind is manifest nystagmus where nystagmus is present at all times. On the other hand, the third kind is latent nystagmus, happens when one eye is covered. There is also a manifest-latent nystagmus in which nystagmus is usually present, but worsens when one eye is covered. Lastly, there is acquired nystagmus, which may be caused by an accident, neurological problem or a disease, like brain tumor or multiple sclerosis.

In treating nystagmus, the most important factor is identifying the underlying cause. For mild cases, the eye doctor may recommend the use of eyeglasses or contact lenses to improve the vision. Contact lenses help to focus because they move with the eyes. The null position of the head can also be used to correct nystagmus. To help the discomfort that the null point may cause, prisms can be put in eyeglasses to assist it.

There are also cases of nystagmus treatment using Botox. The eye doctor injects Botox into the muscles of the eye to paralyze them. The said method is sometimes effective in being able to diminish the troublesome symptoms of nystagmus. However, the patient needs to repeat the procedure every few weeks to maximize its effect.

People with nystagmus may also opt for surgical treatment, depending if their eye doctor deems it safe and necessary. Nystagmus surgery has the goal of improving visual acuity or reducing bothersome head posture in null position. Since there are different kinds of nystagmus, there are also different surgical approaches to it. Let us take a look to know what to expect in each surgery.

For congenital nystagmus, there are four main surgical strategies. The first and the most popular surgery is the Kestenbaum Surgery wherein the goal is to rotate the eyes in the direction of the head turn. The second surgical strategy is Artificial Divergence Surgery which aims to dampen nystagmus by inducing a latent divergent ocular position which the patient will overcome through exertion of fusional convergence. The third surgical strategy is Maximum Recession of Horizontal Rectus Muscles designed to reduce the amplitude of nystagmus and weaken systematically the horizontal rectus muscles. The last surgical strategy is Anterior Tenotomy of Rectus Muscles which has been tested on Belgian sheepdogs and has been found successful in abolishing nystagmus in these animals.

For both latent and manifest-latent nystagmus, surgery is geared towards fixing the eye to prevent it from drifting. Typical surgery usually involves the posterior and recession fixation of the medial rectus of the prevailing eye. There is also surgery for cases of esotropia and face-turn in this type of nystagmus. If patient is still not satisfied with the surgery on the good eye, an injection of botulinum may be done to the medal rectus of the dominant eye.

On the other hand, in cases of acquired nystagmus, there is little that can be done surgically. Usually, the surgical approach is for removing lesions. There were also cases of visual improvement following a sub occipital decompression and chin elevation in people with nystagmus. However, there is still much research to be done to find a breakthrough surgical method for acquired nystagmus.

To sum it up, nystagmus is a condition that makes a person’s eyes jerk or dance. It has different types and can be treated through a variety of ways like the use of eyeglasses, contact lenses or surgical interventions like Kestenbaum surgery.

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