home Audience 4 Who has a child with horizontal nystagmus? Nystagmus - types, causes, symptoms, methods of diagnosis and treatment. Nystagmus in newborns

Who has a child with horizontal nystagmus? Nystagmus - types, causes, symptoms, methods of diagnosis and treatment. Nystagmus in newborns

is a pathology characterized by involuntary oscillatory eye movements. Clinical symptoms include rapid oscillations of the eyeballs in a vertical, horizontal, and, less commonly, oblique or circular direction. Accommodative ability is impaired, which is manifested by visual dysfunction. For diagnosis, objective examination, microperimetry, electronystagmography, visometry, refractometry, and computed tomography of the brain are used. Conservative therapy is based on the use of anticonvulsants and antiepileptic drugs. Surgical correction of the position of the eyeball is less often indicated.

General information

Nystagmus is a widespread nosology in practical ophthalmology. According to statistics, among visually impaired children, a congenital form of pathology is diagnosed in 20-40% of patients. It is often possible to establish the etiology of involuntary oscillatory eye movements. The idiopathic type occurs with a frequency of 1:3000. Horizontal nystagmus is the most common, while oblique and rotational variants are extremely rare. In the general structure of damage to the organ of vision, the horizontal type occupies 18%. Geographical features of epidemiology are absent.

Causes of nystagmus

Congenital nystagmus occurs against the background of neurological disorders. The hereditary nature of the disease is evidenced by the appearance of clinical symptoms against the background of Leber's congenital amaurosis or albinism. The main reasons for the development of the acquired form:

Brain pathology. Nystagmus in adulthood can be one of the symptoms of multiple sclerosis or malignant neoplasm. The sudden onset of symptoms may indicate a stroke.
Traumatic brain injury. Involuntary eye fluctuations are associated with damage to the optic nerves or the occipital lobe of the cerebral cortex.
Intoxication. The disease occurs due to the toxic effects of alcoholic beverages, overdose of anticonvulsants and sleeping pills.
Damage to the vestibular apparatus. Clinical manifestations are preceded by damage to the central or peripheral parts of the vestibular analyzer. Often, the development of the acquired form provokes damage to the semicircular canals of the inner ear.
Decreased visual acuity. Nystagmus may develop due to a marked decrease in visual acuity in patients with mature cataracts, a history of traumatic damage to the organ of vision, or complete blindness (amaurosis).

Pathogenesis

When the peripheral and central parts of the vestibular analyzer are damaged, the appearance or change in the severity of clinical manifestations is noted when changing position. This is due to the secondary involvement of the semicircular tubules in the pathological process. The molecular mechanism of development of congenital idiopathic nystagmus is not fully understood. Scientists believe that it is based on a mutation in the FRMD7 gene, which is inherited in an X-linked manner. However, cases of autosomal dominant and autosomal recessive inheritance have also been observed in clinical practice.

Classification

Depending on the time of onset of the first symptoms, congenital and acquired nystagmus are distinguished. The congenital form includes latent and manifest-latent types. The acquired variant is classified according to etiology into neurogenic and vestibular. From a clinical point of view, there are:

Pendulum-shaped (undulating). It is characterized by phases of oscillation of the eyeballs that are identical in magnitude and speed.
Jerky. It is distinguished by rhythmic eye movements, in which the eyeball is directed slowly in one direction and quickly in the other. If in the fast phase the eyes are directed to the left, then we are talking about a left-sided form, movements to the right indicate a right-sided version.
Mixed. This variant of the disease combines jerky and undulating forms.
Associate. The eyeballs move in a friendly manner with the same amplitude in a pendulum-like or jerk-like manner.
Dissociated. The nature of the movements of one eye does not coincide in direction and amplitude with the other eyeball.

Symptoms of nystagmus

In most cases, the first manifestations of the disease occur in early childhood or from the moment of birth. Symptoms of the acquired form develop immediately after the action of the etiological factor. Patients complain of repetitive oscillatory eye movements. The direction of vibrations can be horizontal, vertical, less often - oblique or circular. The patient is unable to focus on the object in question. The ability to adapt to changes in external conditions is impaired. The decrease in visual functions is caused not by pathology of clinical refraction, but by a reduced reserve of accommodation.

The patient cannot completely stop the manifestations of nystagmus, but the magnitude of the oscillations decreases somewhat when changing the direction of gaze, the position of the head, or maximum focusing of attention on a specific object. To reduce the severity of clinical symptoms, the patient takes a forced position with the lowest frequency of movements. Turning the head to the side or torticollis (tilting) is common. The choice of position is determined by the zone of relative rest, in which the amplitude of movements decreases and accommodative ability improves.

Symptoms are most noticeable under stressful conditions, anxiety or fatigue. The duration of manifestations is influenced by the nature of movements. With the pendulum type, the duration of nystagmus is longer than with the jerky variant of the disease. The properties of oscillatory movements can change. A change in manifestations is provoked by the appearance of an object in the field of view, a change in its size or brightness. A certain role is assigned to the factor of visual concentration and even mood. The form of the disease is determined by eye movements that dominate the clinical picture.

Complications

A common complication of nystagmus is secondary alternating convergent strabismus, which often develops in patients with the dissociated form. The characteristics of strabismus are determined by the course of the underlying disease. The pathology is accompanied by reversible visual dysfunction - amblyopia and mixed astigmatism. The acquired variant is complicated by a number of vestibular disorders (dizziness, lack of coordination, headache). Due to the need to often hold the head in a forced position, the development of compensatory torticollis is possible. Individuals with a history of vestibular nystagmus are prone to recurrent labyrinthitis.

Diagnostics

An objective examination of the patient is sufficient to make a diagnosis. During an external examination, it is possible to visualize involuntary eye movements. To determine the direction of nystagmus, the patient is asked to focus his gaze on a pen or a special pointer. The ophthalmologist moves the instrument up, down, right and left. The shape of the lesion is determined in the direction of the fast component. To study the etiology of the disease and select further management tactics, the following is used:

Microperimetry. The technique allows you to determine the point of fixation on the inner shell of the eyeball, record the parameters of optical nystagmus and study the sensitivity of the retina. The method makes it possible to monitor the condition of patients to assess the effectiveness of treatment measures.
Electronystagmography (ENG). The study is based on recording biopotentials that arise between the cornea and retina. In individuals with involuntary eye movements, the electrical axis shifts, which is accompanied by an increase in the difference in corneoretinal biopotential to 100-300 μV.
Conservative therapy. Used if clinical manifestations develop against the background of central vestibulopathy. The use of neurotropic drugs from the group of anticonvulsants and antiepileptic drugs is recommended.

Surgery. The goal of surgical treatment is to create a position of relative rest of the eyes by restoring the physiological position. To do this, the structural characteristics of the extraocular muscles are changed.

Symptomatic treatment is based on spectacle or contact correction of visual acuity. The use of contact lenses is recommended, since when the eye moves, the center of the lens moves with it, and visual dysfunction does not develop. In some cases, Botox injections are performed into the orbital cavity to limit small-scale eye movements.

Prognosis and prevention
The prognosis for life and visual functions with nystagmus is favorable. Correct therapy of the underlying disease allows you to completely eliminate the clinical manifestations of the pathology. Specific prevention has not been developed. Nonspecific preventive measures boil down to timely diagnosis and treatment of lesions of the brain, vestibular apparatus and organ of vision. If involuntary movements of the eyeballs are detected in patients taking anticonvulsants or sleeping pills, it is necessary to adjust the dosage of the medications.

Nystagmus is an involuntary, repetitive oscillatory movement of one or both eyeballs. Movements can be either jerk-like or pendulum-like. Nystagmus often causes low visual acuity. This pathology is not very widespread - one case occurs in approximately 10,000 people. Congenital nystagmus is even less common. There are physiological and pathological nystagmus.

Physiological nystagmus

Physiological eye nystagmus appears in healthy people under the influence of any irritants; it is divided into three types. Let's look at them in detail.

Optokinetic nystagmus occurs when a person watches fast-moving objects, such as when looking out of a train window. In this case, the movements of the eyeballs are directed in the opposite direction to the movement of objects.

Nystagmus with extreme abduction of the eyes is another type of physiological nystagmus. With the maximum abduction of the eyes to one side, small-scale oscillatory movements of the eyeballs are noted. The reason for this is rapid fatigue of the eye muscles.

Voluntary nystagmus - most often occurs with severe nervous tension. In children it may appear during a tantrum.

Pathological nystagmus

Pathological nystagmus is a disorder in the mechanism of visual fixation, which can be congenital, or also result from disorders in the labyrinth of the inner ear or in areas of the brain responsible for regulating eye movement.

Depending on the nature of the movements of the eyeballs, pendulum-like, rhythmic and mixed types of nystagmus are distinguished. With pendulum-like nystagmus, the phases of oscillatory movements are equal in magnitude, while with rhythmic nystagmus, one phase is fast and the other is slow. The mixed type is characterized by pendulum-like oscillations when looking forward and rhythmic ones when looking to the side.

Nystagmus is classified by type and depending on the direction of vibration of the eyeball. There are horizontal, vertical, rotatory and diagonal nystagmus. The most common occurrence is horizontal oscillation of the eyeballs.

Causes of nystagmus in children

The main causes of nystagmus in children are:

hereditary diseases, such as albinism;
trauma received during childbirth;
disorders in the central nervous system.

If the cause of nystagmus is a hereditary disease, they speak of congenital nystagmus. It usually appears in the second or third month of a child's life. Nystagmus in newborns does not appear immediately. During the first month after birth, babies' eyes wander and they cannot focus on an object, but after a month the situation changes. If the baby’s eyes continue to wander, this is a pathology, in which case they speak of congenital nystagmus.

Doctors often perceive nystagmus in children under one year of age as temporary deviations from the norm or as a cosmetic problem, linking this with underdevelopment of the visual apparatus. Therefore, on the issue of early treatment for nystagmus, the opinions of doctors differ. Among the recommendations of neurologists, you can hear that nystagmus will go away on its own. This is the reason that children under one year of age are not treated, but only observed by both specialists - an ophthalmologist and a neurologist.

Nystagmus in children - treatment

Before starting treatment on a child, he must be thoroughly examined. The ophthalmologist examines not only the fundus of the eye, assesses the condition of the optic nerve, but also carefully examines the visual-nervous apparatus from the retina to the cerebral cortex itself. This is possible thanks to the so-called electrophysiological study. Collaboration between the ophthalmologist and the neurologist plays a huge role. To assess the state of the central nervous system, a neurologist may recommend undergoing additional studies - MRI, EEG and others, which will help determine the appropriate treatment tactics.

If during the examination it turns out that there are concomitant pathologies, the child is prescribed to wear glasses. In parallel with this, hardware treatment is carried out to improve visual acuity, which includes various methods of stimulating the visual system. Hardware treatment is carried out in a hospital setting twice a year. A surgical method for treating nystagmus can significantly reduce the frequency and amplitude of ocular oscillations. Children with nystagmus are under the supervision of an ophthalmologist until adolescence.

Although nystagmus in a child is a rather serious eye pathology, if you start treatment on time, you can achieve good results. In almost 90% of cases, treatment of horizontal nystagmus is successful.

Diseases of the visual system are dangerous not only because of the loss of vision, but also because they often signal a serious disruption in the functioning of the body. Vision is often impaired in diseases of the brain, and nystagmus is no exception. Nystagmus is a pathology of the visual organs that provokes constant and uncontrollable twitching of the eyeballs, which leads to a severe decrease in visual acuity.

Causes of nystagmus

Oscillatory eye movements can be pathological and physiological. If you focus your eyes on an object and move, the pupil will move to maintain focus. Involuntary movements of the pupil indicate the presence of pathology.

Congenital nystagmus most often manifests itself at 2-3 months of a baby’s life, although it begins already at 15-20 weeks of fetal development. One child in ten thousand today is born with this disorder.

Causes of nystagmus:

eyeball injuries;
dystrophic changes in the retina;
brain pathologies;
inflammatory processes in the inner ear;
(cataract);
genetic predisposition and hereditary diseases;
poor vision;
diseases of the central nervous system;
encephalitis;
stroke;
multiple sclerosis;
drug poisoning.

Nystagmus often occurs in adolescents against the background of a significant decrease in visual acuity.

Classification of pathology

Pathological nystagmus develops against the background of various diseases and pathologies, while physiological nystagmus is caused by irritation of the nervous system.

Types of pathological nystagmus:

ocular, when the pathology occurs at an early age and is caused by acquired or congenital impairments of visual function, or associated with congenital pathology of the visual apparatus;
neurogenic (central), when the deviation is associated with damage to the vestibular element of the oculomotor system.

Types of nystagmus according to the nature of movements:

Jerky. Slow defofing and faster refoving movements. Oscillations have different speeds.
Undulating (pendulum). Oscillations equal in phase magnitude.
Mixed. Includes signs of both types of nystagmus.

Most often, nystagmus has a horizontal direction.

Classification of nystagmus according to the magnitude of oscillations:

large-caliber (above 15 degrees);
medium caliber (5-15 degrees);
small-caliber (up to 5 degrees).

Based on the direction of movement, nystagmus is divided into the following types:

vertical;
horizontal;
vertical;
rotational.

Forms of nystagmus:

Physiological. Jerky oscillatory movements, which are provoked by changes in pressure in the vestibular nuclei.
Latent. Oscillatory movements of closed eyelids. Often this type of nystagmus is the result of overwork and increased stress.
Installation. Jerky movements that occur when the pupil is moved to the side.
Motor imbalance nystagmus. Movements that include all of the listed characteristics. Occurs when the tone of the oblique muscles of the eyeballs is weak.
Vestibular. Jerky movements that occur with inner ear infections and Meniere's disease.
Optokinetic nystagmus. Jerky movements of the eyeballs.
Sensory deprivation nystagmus. This form of nystagmus occurs when visual function is severely impaired. There are vertical and horizontal vibrations. As the pathology develops, vision deteriorates greatly. The cause of sensory deprivation nystagmus is a severe defect in central vision that arose at an early age. This form is often diagnosed in children aged two years and older.
Reciprocating nystagmus. This form of pathology provokes oscillatory movements of the eyes, which move them in opposite directions. The most common cause is a parasellar tumor, which also causes hemianopia (blindness in half the visual field). Symptoms of reciprocating nystagmus: photophobia (the cornea ceases to perceive sunlight) and turning the head to reduce eye strain.

An ophthalmologist is able to determine the presence of nystagmus even with a detailed examination. To clarify the diagnosis, they resort to an electroretinogram.

Nystagmus does not always indicate the presence of pathologies. Sometimes people with normal vision develop optokinetic nystagmus. This is a normal reaction of the eyes to moving objects. Labyrinthine nystagmus begins suddenly due to overstrain of the eye muscles. It is noteworthy that this form manifests itself exclusively in horizontal movements.

Nystagmus in albinism

Albinism is a genetic disease that causes the absence of melanin in the human body. This is the pigment responsible for the color of the skin, hair and iris of the eye. The mechanism of development is the disruption of the formation of melanin from tyrosine.

With albinism, the visual system suffers greatly. Patients may develop photophobia, the iris may atrophy, the color of the fundus changes, and the vascular pattern of the choroid (choroid of the eye) appears. Visual acuity is also reduced due to hypoplasia or aplasia of the macula.

Nystagmus in albinism is a very common phenomenon. Treatment is carried out according to the same principle as the correction of congenital nystagmus. The patient is prescribed light-protective or perforated optical systems, as well as dark contact lenses with a special transparent center.

The danger of nystagmus in infants and young children

Nystagmus is usually associated with defects in the central nervous system. The congenital form is observed in newborns and is caused by developmental abnormalities. The disease is often diagnosed in children with genetic pathologies (albinism, Leber's disease, etc.).

Acquired nystagmus in most cases is combined with optic nerve atrophy and refractive pathologies (myopia, farsightedness, astigmatism).

At the age of 3-4 weeks, the baby learns to focus his eyes. If there is no fixation and oscillatory movements of the pupils are noticeable, you should urgently consult an ophthalmologist.

You should always be attentive to your child, because babies cannot complain about discomfort. In older age, patients report dizziness, a feeling of instability and a distorted vision of the world.

Nystagmus can be identified by an unnatural head position (ocular torticollis). The patient unconsciously turns his head so that the oscillatory movements decrease or disappear. With nystagmus, it is indeed possible to stop the defect in a certain position of the head.

Having found this position, a person begins to see better, since visual acuity increases without movement.

Nystagmus when taking medications

Sometimes the use of certain medications causes nystagmus. A similar phenomenon is observed during treatment with large doses of barbiturates, phenothiazines, tranquilizers and anticonvulsants. In this case, nystagmus is often combined with dizziness, dysarthria and ataxia. Symptoms will intensify with severe intoxication.

If the patient notices symptoms of nystagmus during therapy with these substances, their concentration in the blood must be determined. Naturally, all drugs that provoke the disorder are discontinued or, as a last resort, the dosage is reduced.

Diagnosis of nystagmus

You can notice the primary symptoms of nystagmus yourself. Uncontrolled eye movements are pronounced, so parents can notice the defect even in a small child. But only a doctor can accurately determine the cause of the pathology.

Timely diagnosis of nystagmus helps prevent complications and severe deterioration in visual function. To make a diagnosis, your doctor may order electrophysiological tests. makes it possible to obtain an image of the retina and use it to determine changes in the structure of cells and layers.

Often, if nystagmus is suspected, genetic tests are prescribed. Additionally, you should undergo MRI and CT of the brain, Echo-EG and EEG.

You cannot hesitate to diagnose a deviation when it comes to a child. The pathology will certainly worsen as the baby grows, but nystagmus develops most quickly in young children. For this reason, many children with congenital nystagmus have very poor vision.

Principles of treatment of nystagmus in children and adults

With nystagmus, visual acuity needs to be maximized, so a comprehensive approach is required. The patient is prescribed surgical correction, glasses and a course of medication.

If the cause of nystagmus is albinism, retinal dystrophy or partial atrophy of the optic nerve, the patient needs protective color filters that increase visual acuity. Light filters come in neutral, yellow, orange and brown. They are selected depending on the degree of vision impairment.

Medicines for nystagmus help improve the nutrition of the tissues of the eyeball. For these purposes, vasodilators and vitamins are prescribed.

Surgical correction of nystagmus

For nystagmus, surgery can block or reduce oscillatory movements during direct gaze. This is necessary so that the patient does not turn his head and so that his vision does not decrease. In this case, surgery is the only way to block movements.

It is recommended to begin the course of treatment for nystagmus with surgery, since it sets the foundation for rehabilitation. Modern technologies and methods make it possible to preserve the integrity of the vessels and nerves of the eyeball. The intervention technique will depend on the type of pathology, so a full diagnosis is very important.

Surgical treatment makes it possible to reduce involuntary eye movements. With jerky nystagmus, surgery allows you to move the zone in which visual acuity is the highest to the median position. This area is called the "quiet zone".

To achieve this effect, the doctor weakens the strong muscles on the side of the slow phase of nystagmus and strengthens the muscles on the fast side. This makes it possible to straighten the position of the head, reduce the frequency of movements and increase visual acuity.

Usually the operation is carried out in two stages. The first involves resection of the muscles on the slow phase side, and if the nystagmus weakens, the second is not performed. If no effect is observed, bilateral resection is performed on the side of the fast phase.

Optical correction of nystagmus

It is possible to improve visual function with nystagmus only through optical correction of near and far vision. The prescription of glasses for nystagmus is carried out according to generally accepted rules. The main thing is to carefully check the visual system and clarify the power of the lenses (especially the astigmatic component).

Sometimes patients are prescribed glasses separately for working at close range, when accommodation sharply weakens. In such cases, lenses of +1-2 diopters are added to the correction of distant vision. This helps improve visual performance. In cases where spectacle correction does not produce results, it makes sense to try contact lenses.

Pleoptic therapy for nystagmus

Often, with nystagmus, accommodation is disrupted and amblyopia (lazy eye syndrome) develops, so the patient is shown exercises to train this ability. Pleoptic treatment includes stimulation of the central zone of the retina using a monobinoscope, color and contrast-frequency tests. Sometimes binocular exercises and diploptic therapy are also prescribed, which help reduce the amplitude of nystagmus.

Amblyopia is often found in patients with nystagmus. Pleoptic therapy (techniques that help stimulate the macula, the most sensitive area of the retina) helps correct this condition.

In the absence of albinism, methods of general or local irritation of the retina with light according to Avetisov are used. When nystagmus is combined with strabismus or abmlyopia, it makes sense to use the occlusion method.

Pleoptics involves systematic repetition of the course every six months. Sometimes these procedures are combined with laser pleoptics. The optimal effect for nystagmus and amblyopia can be expected with simultaneous stimulation of the visual channels, which are responsible for brightness, contrast, colors and frequency of perception. For these purposes, computer programs (EUE-R) are used.

Pleoptic exercises also help because binocular vision is often impaired in patients with nystagmus, and therapy helps stabilize it. Due to the fact that nystagmus is often accompanied by various eye pathologies, color filters will be useful. They come in three types, but for this pathology a combination of them is recommended.

If your baby has been diagnosed with nystagmus, do not despair. Many people live fully with visual impairments if they grew up in a calm environment and were brought up in such a way as not to succumb to complexes. Therefore, it is very important to support the child and provide him with a comfortable existence.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Introduction

Nystagmus called repetitive, uncontrolled, oscillatory and rapid movement of the eyeballs. Its development can be caused by a variety of factors of local or central origin. It can appear in healthy people, for example, when rapidly rotating the body or when observing quickly moving objects; or be a symptom of a disease of the inner ear, visual system or brain damage of various origins.

In various diseases, this symptom is almost always accompanied by a significant deterioration in visual acuity.

Causes of nystagmus

The main cause of nystagmus is the unstable functioning of the oculomotor system. Many factors can cause such instability. These include:

Uncharacteristic movement of the eyeballs becomes a consequence of significant tension in the central nervous system during disorientation. For example, when riding various extreme rides, disorientation occurs in space, which is accompanied by nystagmus.

After orientation in space is restored, uncharacteristic movements of the eyeballs completely disappear. The appearance of nystagmus in a calm state always indicates that the nervous system cannot recover on its own due to pathology.

Symptoms of nystagmus

Nystagmus almost always develops against the background of an underlying disease, and its symptoms run parallel to the signs of the underlying disease. The patient may notice the appearance of excessive photosensitivity, frequent dizziness, decreased visual acuity, and what he sees seems to blur or tremble.

When examining the patient's eyes, uncharacteristic oscillatory movements of the eyeballs are observed, which can be different in direction.
Nystagmus in the direction of movement of the eyeballs can be:

horizontal (most common) – left-right;
vertical – down and up;
diagonal - diagonally;
rotational (rotatory) - in a circle.

There are also types of nystagmus:

associated - identical movements of both eyes;
dissociated – eyes move differently and in different directions;
monocular - movements appear in only one eye.

The nature of movements of the eyeballs during nystagmus is:

pendulum-shaped - the amplitude of movements is the same;
jerky - the amplitude of movements is different (slow in one direction and fast in the other);
mixed - the range of movements combines the characteristics of the previous types.

Jerky nystagmus, depending on the direction of the fast phase of movements, can be right- or left-sided. With this type of nystagmus, the patient experiences a forced turn of the head, which is aimed at the phase of rapid movement. In this way, the weakness of the extraocular muscles is compensated, and the symptoms of nystagmus are more easily tolerated.

According to the intensity of oscillatory movements, nystagmus can be:

small-caliber – range of motion less than 5 o;
medium-caliber – range of motion 5-15 o;
large-caliber – range of motion exceeds 15 o.

In rare cases, nystagmus is detected, in which the amplitude of movements is different in each eye.

Each type of nystagmus has its own characteristic symptoms.

Types of nystagmus

Nystagmus is classified according to various parameters. He can be:

physiological – appears in adults and healthy people in response to various stimuli of the nervous system;
pathological – caused by pathological conditions and diseases.

Nystagmus occurs:

congenital – abnormalities of visual motor skills manifest themselves soon after the birth of the child and persist throughout life; usually jerky and horizontal;
acquired – visual motor disorders are caused by disorders of the central or peripheral nervous system; can appear at any age.

Congenital nystagmus divided into:

optic– is a consequence of serious visual impairment and begins to manifest itself at 2-3 months of life; in most cases, pendulum-like and weakens with convergence (an attempt to focus the gaze on one object);
latent– often occurs in children with amblyopia and strabismus, manifests itself only when one eye is closed with an eyelid, is jerky, and its fast phase is directed towards the open eye;
sternocleidomastoid spasm – occurs very rarely at the age of 4-14 months, accompanied by torticollis, head nodding and nystagmus; in most cases, the nodding movements of the head do not coincide in speed, direction and frequency with the movements of the eyeballs, which can be different in direction.

Acquired nystagmus has the following varieties:

central– caused by diseases of the central nervous system (strokes, tumors, demyelination of the brain stem or cerebellum, etc.); symptoms are varied, may be accompanied by dizziness, change and appear constantly or periodically;
peripheral– caused by lesions of the vestibular analyzer in its peripheral part (usually due to infections of the labyrinth or vestibulocochlear nerve, injuries or Meniere’s syndrome); movements of the eyeballs are horizontal, transient, occur abruptly and occur against the background of dizziness, last several days and then completely disappear; May be accompanied by hearing and balance problems.

Some types of nystagmus can only be determined by specialists (neurologist, ophthalmologist or otolaryngologist). Among them: converging, periodic alternating, downward or upward vertical, opsoclonus, retractor and reciprocating Maddox nystagmus.

Some types of nystagmus indicate the location of a particular lesion, while others indicate a specific disease.

Physiological nystagmus

Physiological nystagmus is observed in healthy people when exposed to various stimuli.

It can manifest itself in several forms:

installation nystagmus – low in frequency, small and jerky, in the fast phase it is directed in the direction of gaze, manifests itself at extreme abduction of gaze;
vestibular– appears when rotating or performing a caloric test (cold water is poured into the left or both ears, warm water is poured into the right or both ears), is jerky;
optokinetic – in the slow phase, the eyes move behind the object, and in the fast phase, saccadic (jump-like) movements appear in the opposite direction; nystagmus is jerky, caused by repeated movement of an object in the field of view.

Studies of physiological nystagmus can be useful in diagnosing various pathologies. For example, optokinetic nystagmus can be used to determine the quality of vision in children or to identify malingerers that mimic blindness.

Pathological nystagmus

Pathological nystagmus is observed in lesions and diseases of various origins.

It can manifest itself in the following forms:

ocular (or fixation);
professional;
labyrinthine (or peripheral);
neurogenic (or central).

Ocular nystagmus

This type of nystagmus develops with early acquired visual impairment or is congenital. Oscillatory movements of the eyeballs are caused by a disorder of the function of visual fixation or the mechanism that regulates this fixation.

Movements of the eyeballs during ocular nystagmus vary in amplitude and nature. Visual acuity in most cases is significantly reduced (0.3 or less). Sometimes the patient has a forced position of the head. Damage to the visual system occurs either from birth or at an early age. Over the years, his character remains virtually unchanged. When examined, in the case of acquired nystagmus, opacities of the lens and cornea, albinism, macular coloboma, pigmentary retinal degeneration or optic nerve atrophy are revealed.

Professional nystagmus

This type of nystagmus is typical for mine workers with many years of work experience. It is caused by constant tension in the visual system, chronic intoxication with various gases (methane, carbon monoxide), poor lighting and ventilation of mines.

The movements of the eyeballs in this nystagmus are rotatory or mixed, intensified when bending over, and may be accompanied by photophobia and trembling of the eyelids and head, narrowing of the visual fields and deterioration of adaptation. As a rule, this type of nystagmus progresses with increasing work experience in the mine and leads to significant deterioration of vision.

Labyrinthine nystagmus

This type of nystagmus develops against the background of damage to the inner ear. It is rotatory or horizontal, and its fast phase is directed towards the affected labyrinth. In most cases, movements of the eyeballs have a large-caliber (sweeping) amplitude. The eye vibrations are rhythmic and jerky. It does not last long - a few days or weeks.

Neurogenic nystagmus

Develops when the vestibular oculomotor reflex is impaired. Neurogenic nystagmus can be caused by injuries to various parts of the central nervous system; inflammatory, tumor or degenerative pathologies.

The severity of its manifestation depends on the nature of the lesion itself. Its typical varieties are:

abduction nystagmus – jerky, observed when the eyeball moves to the temple, characteristic of internuclear ophthalmoplegia;
Jeroens nystagmus– jerky, horizontal; its low amplitude is observed when the eyeball moves in the opposite direction, and its high amplitude is determined when looking towards the side with the lesion; characteristic of tumors of the cerebellopontine ganglion.

Nystagmus in children

Nystagmus in children is manifested by the fact that the child is not able to fix his gaze, and his eyes constantly make oscillatory movements of an involuntary nature (as if “running”).

The cause of the appearance of pathological nystagmus in childhood can be various congenital or acquired disorders. The most common reasons may be:

birth injury;
disorders in the central nervous system;
albinism.

Manifestations of nystagmus in children depend on the cause of its occurrence.

Characteristic features of nystagmus are observed in such hereditary diseases as albinism. It is manifested by a decrease or complete absence of pigment in the hair, skin and eyes. There is also an ocular form of albinism, in which pigment is absent only in the eyes. This leads to disruption of the activity of nerve cells in the retina and optic nerve. These changes cause nystagmus.

Nystagmus in newborns

Nystagmus in newborns does not appear immediately, because at birth their visual system is not fully developed: the eyes cannot fix the object, visual acuity is still low, and the eyes still “wander.” This condition cannot be classified as nystagmus. Already by the first month of life, a child can normally clearly fix an object and follow a toy. If this does not happen, the doctor may suspect the appearance of nystagmus.

As a rule, nystagmus fully manifests itself at 2-3 months of a child’s life, and up to a year, doctors perceive it as a temporary deviation, a cosmetic defect and a variant of the norm. In most cases, the appearance of nystagmus is associated with immaturity of the visual apparatus, which can be eliminated naturally within a year and does not require treatment. Such children are observed by a neurologist and ophthalmologist for up to a year. Treatment is prescribed only if a pathology is identified that can cause pathological nystagmus.

Diagnostics

Diagnosis of nystagmus is always versatile. During an ophthalmological examination, the doctor evaluates the characteristics of nystagmus. A number of additional studies are carried out below:

visual acuity (with and without glasses, with normal and forced head position);
condition of the fundus, retina, optic nerve and oculomotor system;
state of the optical media of the eye;
visual evoked potentials;
electroretinogram.

To identify the cause of nystagmus, a consultation with a neurologist is scheduled. The patient may be prescribed:

electrophysiological studies - electroencephalogram (EEG), echo-encephalography (Echo-EG);
MRI of the brain.

If necessary, a consultation and examination by an otolaryngologist is scheduled.

Treatment

Treatment of nystagmus in most cases is complex, complex and lengthy. It is carried out against the background of treatment of the underlying disease or pathology.

Optical vision correction

To improve visual acuity, careful optical correction is carried out - selection of glasses or contact lenses for near and distance.

When detecting albinism, optic nerve atrophy and dystrophic changes in the retina, it is recommended to use glasses with special light filters (orange, neutral, yellow or brown) of a density that can provide the greatest visual acuity. In addition, light filters perform a protective function.

Pleoptic treatment

To normalize amblyopia and the accommodative abilities of the eye, which accompany nystagmus, pleoptic treatment (retinal stimulation) and special eye exercises are prescribed. The patient is recommended:
1. The monobinoscope is illuminated through a red filter, which stimulates the central part of the retina.
2. Stimulation with color and contrast-frequency tests (computer exercises “Cross”, “Zebra”, “Spider”, “EYE”, device “Illusion”).

The exercises are performed sequentially for the right and left eyes, and then with the eyes open.

Good results are obtained by using diploptic treatment (binarimetry or the “dissociation” method) and binocular exercises. They help improve vision and reduce the amplitude of nystagmus.

Drug therapy

Drug treatment of nystagmus is auxiliary. Usually, medications are used to improve the nutrition of eye tissue. Vasodilators (Cavinton, Trental, Angiotrophin, Theobromine, etc.) and multivitamins may be prescribed.

Surgery

Surgical treatment of nystagmus is aimed at reducing the amplitude of oscillations of the eyeballs. For this purpose, special operations are performed on the eye muscles. The surgeon weakens the stronger muscles on the slow phase side and strengthens the muscles on the fast phase side. This correction not only reduces nystagmus, but also straightens the forced position of the head, which helps improve visual acuity.

Nystagmus in children: causes, types, symptoms, treatment - video

Nystagmus is a fairly severe form of oculomotor dysfunction, manifesting itself as spontaneous oscillatory eye movements, as well as poor vision.

It is an involuntary and systematically repeated pendulum-like oscillation of the eyes associated with physiological or pathological factors.

So, normally, nystagmus appears when an optokinetic object or body rotates in space. It helps maintain good vision. Eye movements that fixate on a specific object are called foveating, and those moving the fovea away from the object are called defoving.

Pathological nystagmus is distinguished by the fact that each cycle of movements begins with an uncontrolled deviation of the eye from the object with a further reverse refixation movement of a spasmodic type.

Depending on the direction, nystagmus is classified as horizontal or vertical, as well as torsional or nonspecific. According to the amplitude of the disease, it can be small-caliber or large-caliber, and its frequency is high, medium and low.

Causes

The development of nystagmus can be caused by central or local factors.

The disease is observed in congenital or early-onset visual impairment associated with various eye diseases, due to which the process of vision fixation is disrupted.

Jerky nystagmus has such a sign as a slow defveating “drifting” movement, as well as a fairly fast corrective refloating jerky movement.

The direction is determined by the direction of the fast component. This type of disease is divided into vestibular and slow.

Pendulum-shaped Nystagmus is characterized by slow foveating and defoving movements.

Congenital pendular nystagmus is horizontal with a characteristic tendency to become jerky when looking to the side.

Acquired pendular nystagmus is characterized by the presence of horizontal, vertical and torsional components.

If the horizontal and vertical directions of pendular nystagmus are in phase, the perceived direction is oblique. When they are out of phase, it has an elliptical or rotatory appearance.

Mixed type nystagmus consists of pendulum-like nystagmus in the primary position and jerk-like nystagmus when looking to the side.

Installation nystagmus is a slight jerky nystagmus of low frequency in the case of extreme gaze aversion.

Optokinetic nystagmus is a jerky type observed with repeated movements of an object in the field of view. Slow phase – tracking movement behind the object; fast phase - saccadic movement in the opposite direction, the eyes fixate another object.

If objects moved towards the left, the left parietal-occipital part is responsible for the slow phase to the left, and the left frontal zone is responsible for the fast phase to the right.

Optokinetic nystagmus is used to identify malingerers that simulate blindness and to determine visual acuity in a child. It is used to determine the factor that caused isolated homonymous hemianopsia.

Vestibular nystagmus is a jerk-like type of disease that develops when the input from the vestibular nuclei changes to the center of the horizontal movements of the organ. The slow phase is regulated by the vestibular nuclei, and the fast phase by the brain stem and frontomesencephalic pathway.

Rotary nystagmus occurs in diseases of the vestibular system.

It can occur with caloric stimulation:

When cold water enters the right ear, a left-sided jerk-type nystagmus occurs;

If warm water enters the left ear, right-sided jerky nystagmus is observed;

When cold water enters both ears at the same time, a jerky nystagmus appears, characterized by a rapid upward phase; warm water promotes the development of the disease with a rapid downward phase.

Nystagmus of motor imbalance develops with primary defects of efferent mechanisms.

Congenital nystagmus can be X-linked recessive or autosomal dominant. It is detected some time after birth and does not disappear throughout life.

Nodule spasm is a condition that occurs infrequently between 3 and 18 months.

Its symptoms:

Unilateral or bilateral nystagmus of horizontal type with small amplitude and high frequency, accompanied by head nodding;

Nystagmus is usually asymmetrical and has increased amplitude during abduction;

Vertical and torsional components are distinguished.

Latent nystagmus is directly related to infantile esotropia and is not accompanied by vertical deviation. It is characterized by the fact that when both eyes are open, there are no symptoms of the disease.

Periodic alternating Nystagmus is diagnosed by the following signs:

Friendly horizontal jerky nystagmus, changing direction from time to time;

The cycle is divided into an active phase and a stationary phase;

During the active phase, the amplitude and frequency at the speed of the slow phase first increase sharply and then decrease;

Then there is a short, calm interlude, which lasts up to twenty seconds, while the eyes make low-amplitude, pendulum-like movements;

Then a similar sequence of movements occurs in opposite directions, one cycle lasting several minutes.

Convergence-retraction the type of disease is observed with simultaneous contraction of the extraocular muscles (medial rectus).

Nystagmus, “beating” downwards, has the same characteristics as the vertical type with a fast phase, “beating” downwards.

Nystagmus, “beating” upward, is characterized by the following symptoms: vertical type with a fast phase, “beating” upward.

Reciprocating Maddox nystagmus manifests itself through a pendulum-like nystagmus, with one eye rising and rotating internally while the other eye simultaneously descends and rotating externally; the eyes move in opposite directions.

Ataxic Nystagmus is a horizontal type of nystagmus that is observed in the abducted eye of a person with internuclear ophthalmoplegia.

Nystagmus with sensory deprivation is thought to result from deterioration of visual function. The patient's condition is determined by the degree of deterioration of visual functions. The horizontal and pendulum variety decreases with convergence.

To reduce its amplitude, a certain head position is usually adopted. The factor causing sensory deprivation disease is called severe pathology of central vision suffered at an early age.

It usually develops in people under two years of age with bilateral visual impairment.

Horizontal nystagmus.Horizontal type nystagmus belongs to the vestibular type. It occurs quite often, manifesting itself in disorders in the middle parts of the rhomboid fossa.

Often horizontal nystagmus indicates changes in the central nervous system, as well as in the periphery. This type of disease can also be diagnosed with primary inflammatory, infectious, intoxicating inflammation of the labyrinth.

It is also caused by pathologies of the middle ear, which spread secondarily throughout the labyrinth.

In children under one year old

Ophthalmologists call the main reasons for the development of nystagmus in young children:

Hereditary diseases (albinism);

Trauma caused during childbirth;

Disorders in the central nervous system.

If the cause is a hereditary disease, then congenital nystagmus is diagnosed. It usually appears in the first months of a child's life. The disease in newborns is not immediately noticed.

During the first weeks of life, the baby's gaze constantly wanders and does not focus on one object, but after a few weeks the situation changes.

If his eyes continue to wander, this is considered a pathology - congenital nystagmus.

Experts perceive nystagmus in children under one year of age either as temporary deviations from the generally accepted norm, or as a cosmetic problem, linking it with incomplete development of the visual apparatus.

Regarding the topic of timely treatment of this disease, opinions do not coincide.

Among the advice of neurologists, you can hear that the disease will go away on its own. This serves as an excuse for not treating a child under one year of age, but only monitoring his condition.

A set of measures that enhance visual functions in this disease includes correctly composed optical correction of the required type.

For albinism, retinal tissue dystrophy and incomplete optic nerve atrophy, protective and vision-enhancing color filters should be used with a density that allows for the highest visual acuity.

Nystagmus is also accompanied by impaired accommodative ability and relative amblyopia, so pleoptic treatment is carried out and a set of exercises aimed at training accommodation is performed.

Illumination using a red filter, which selectively stimulates the central zone of the retina, and exposure using contrast-frequency and color test objects are beneficial. The recommended exercises can be done sequentially for each eye, and then for both at the same time.

Binocular exercises with diploptic treatment are very useful, helping to reduce amplitude and improve vision.

Drug treatment is used to enhance the nutrition of the eye tissues and retina (medicines that dilate blood vessels, a complex of microelements and vitamins).

Surgical treatment is performed to reduce the number of oscillatory movements. In case of a jerk-type disease, when a forced rotation of the head is detected with improved vision and a decrease in amplitude in the chosen position, the purpose of the operation is to transfer the “rest zone” to the middle position.

It is necessary to weaken the stronger muscles and strengthen the weaker ones. As a result, the head position straightens, the signs of nystagmus decrease and visual acuity noticeably improves.

Before starting treatment on a child, a complete examination must be carried out. The doctor examines the fundus of the eye, tests the condition of the optic nerve, and also fully examines the visual-nervous system. This is carried out through the so-called electrophysiological study.

An important role is played by the joint work of the ophthalmologist with the neurologist. To study the state of the central nervous system, a neurologist may insist on additional examinations - MRI, EEG and others, which will help determine the optimal treatment tactics.

If during the examination it turns out that there are concomitant pathologies, the child wears glasses. In parallel, hardware treatment is carried out to improve visual acuity, which consists of several methods for improving the visual system.

Hardware treatment is carried out in a hospital every six months.

The surgical method makes it possible to significantly reduce not only the frequency, but also the amplitude of eye vibrations. A child with nystagmus should be constantly monitored by an ophthalmologist until adolescence.

Although this disease is a rather dangerous eye pathology, if proper therapy is started in a timely manner, positive dynamics can be achieved. In approximately 90% of patients, treatment of horizontal type nystagmus is successful.

Nystagmus

Causes of nystagmus

Brain pathology. Nystagmus in adulthood can be one of the symptoms of multiple sclerosis or malignant neoplasm. The sudden onset of symptoms may indicate a stroke.

Traumatic brain injury. Involuntary eye fluctuations are associated with damage to the optic nerves or the occipital lobe of the cerebral cortex.

Intoxication. The disease occurs due to the toxic effects of alcoholic beverages, overdose of anticonvulsants and sleeping pills.

Damage to the vestibular apparatus. Clinical manifestations are preceded by damage to the central or peripheral parts of the vestibular analyzer. Often, the development of the acquired form provokes damage to the semicircular canals of the inner ear.

Decreased visual acuity. Nystagmus may develop due to a marked decrease in visual acuity in patients with mature cataracts. history of traumatic damage to the organ of vision or complete blindness (amaurosis).

Pathogenesis

Spontaneous movements of the eyeballs are based on decompensation of the tone of the membranous part of the labyrinth of the inner ear. Normally, nerve impulses are generated simultaneously from both sides and are transmitted at the same speed, which allows the eyes to be at rest or to carry out cooperative movements. An increase in tone in the labyrinth on a certain side leads to the development of nystagmus. When the peripheral and central parts of the vestibular analyzer are damaged, the appearance or change in the severity of clinical manifestations is noted when changing position. This is due to the secondary involvement of the semicircular tubules in the pathological process. The molecular mechanism of development of congenital idiopathic nystagmus is not fully understood. Scientists believe that it is based on a mutation in the FRMD7 gene, which is inherited in an X-linked manner. However, cases of autosomal dominant and autosomal recessive inheritance have also been observed in clinical practice.

Classification

Pendulum-shaped (undulating). It is characterized by phases of oscillation of the eyeballs that are identical in magnitude and speed.

Jerky. It is distinguished by rhythmic eye movements, in which the eyeball is directed slowly in one direction and quickly in the other. If in the fast phase the eyes are directed to the left, then we are talking about a left-sided form, movements to the right indicate a right-sided version.

Mixed. This variant of the disease combines jerky and undulating forms.

Associate. The eyeballs move in a friendly manner with the same amplitude in a pendulum-like or jerk-like manner.

Dissociated. The nature of the movements of one eye does not coincide in direction and amplitude with the other eyeball.

Symptoms of nystagmus

Complications

Microperimetry. The technique allows you to determine the point of fixation on the inner shell of the eyeball, record the parameters of optical nystagmus and study the sensitivity of the retina. The method makes it possible to monitor the condition of patients to assess the effectiveness of treatment measures.

Electronystagmography (ENG). The study is based on recording biopotentials that arise between the cornea and retina. In individuals with involuntary eye movements, the electrical axis shifts, which is accompanied by an increase in the difference in corneoretinal biopotential to 100-300 μV.

Visometry. Patients experience decreased visual acuity due to functional disorders of the visual analyzer.

Refractometry. Diagnostics are carried out to establish the type of clinical refraction. Patients with nystagmus often experience impaired ability to accommodate, myopia. Hypermetropia is rarely diagnosed.

CT scan of the brain. Computed tomography is used to identify pathological neoplasms or signs of dislocation of brain structures, which may underlie the occurrence of pathology.

Treatment of nystagmus

Therapeutic tactics depend on the severity of symptoms and the form of nystagmus. Etiotropic therapy is determined by the underlying disease. To eliminate nystagmus the following is used:

Conservative therapy. Used if clinical manifestations develop against the background of central vestibulopathy. The use of neurotropic drugs from the group of anticonvulsants and antiepileptic drugs is recommended.

Surgery. The goal of surgical treatment is to create a position of relative rest of the eyes by restoring the physiological position. To do this, the structural characteristics of the extraocular muscles are changed.

Symptomatic treatment is based on spectacle or contact correction of visual acuity. The use of contact lenses is recommended. Since when the eye moves, the center of the lens moves with it, visual dysfunction does not develop. In some cases, Botox injections are performed into the orbital cavity to limit small-scale eye movements.

Prognosis and prevention

The prognosis for life and visual functions with nystagmus is favorable. Correct therapy of the underlying disease allows you to completely eliminate the clinical manifestations of the pathology. Specific prevention has not been developed. Nonspecific preventive measures boil down to timely diagnosis and treatment of lesions of the brain, vestibular apparatus and organ of vision. If involuntary movements of the eyeballs are detected in patients taking anticonvulsants or sleeping pills, it is necessary to adjust the dosage of the medications.

Nystagmus

Nystagmus is rapid, repetitive eye movements that occur independently of a person's conscious commands. This condition can normally occur if a person watches an object moving at high speed, cold water gets into his ear, or his body rotates in space (on a carousel or other attractions). Also, a large number of diseases of the nervous system, inner ear and organ of vision can lead to the appearance of this symptom. Diagnosing the pathology is quite easy, but it is difficult to treat.

What it is

The development of nystagmus is based on a violation of either a peripheral organ (the eye, nerves innervating the extraocular muscles, the labyrinth - the peripheral part of the vestibular analyzer or the nerve coming from it), or the brain itself.

With the long-term existence of nystagmus, even if it appears as a result of a pathology of the central nervous system or the vestibular apparatus, visual acuity inevitably decreases, since the brain does not receive a normal image from the eye.

Causes

Depending on the causes, nystagmus can be divided into congenital and acquired.

Congenital – the pathology is quite rare. It can develop as a result of birth injuries, intrauterine infections, which give impetus to the development of pathologies of the visual system: partial atrophy of the optic nerve. strabismus, retinal dystrophy, farsightedness, astigmatism, myopia.

There is also a congenital type, which is inherited.

In the video there is a girl with congenital nystagmus:

Acquired nystagmus develops due to:

brain tumors;
multiple sclerosis;
brain contusion;
encephalitis;
inflammation of the inner ear;
cracks in the temporal bone;
tumors of the cranial nerve, which carries information from the auditory and vestibular analyzers (vestibular-cochlear);
taking medications (carbamazepine, barbiturates, lithium compounds);
exposure to certain toxins and drugs;
stroke;
ophthalmological diseases.

What parts of the brain are affected by nystagmus?

Pendulum-like eye movements can appear with pathology:

In this case, the level of damage can be judged by the direction of rapid eye movement:

horizontal movements: the middle parts of the rhombencephalon or the inner ear are most likely affected;
vertical or diagonal: the problem is in the upper parts of the rhomboid fossa;
rotational: the lower parts of the rhombencephalon are affected;
Converging movements: they speak of midbrain pathology.

For a more accurate diagnosis of the level of damage, the neurologist also evaluates the speed and amplitude of movements of the eyeball.

Kinds

According to the direction of oscillation of the eye, it is divided into:

Horizontal - eye movements are directed along the horizontal axis;
Vertical – the eye moves vertically (up and down);
Rotatory – rotational movements around the sagittal axis;
Diagonal – move diagonally;
Converging: rapid movement of the eyes towards each other.

The direction in which the nystagmus is directed is judged by its rapid phase.

If the movements of both eyes are of the same type, the nystagmus is associated; if they are different, it is dissociated.

Depending on the location of the lesion, nystagmus occurs:

Vestibular. It has 2 reasons: a pathology of the part of the brain that receives information from the vestibular apparatus, and a disease of the labyrinth itself (that is, the peripheral vestibular apparatus). It can be caused by body rotation and a caloric test (pouring cold or warm water of a certain temperature into the ear). It can also occur spontaneously. Accompanied by nausea and dizziness.
Central. It develops with traumatic, degenerative, tumor or inflammatory lesions of the cerebellum, structures of the posterior cranial fossa, subcortical and cortical regulatory centers of ocular movements

There are also other classifications.

Symptoms

Movements of the eyeballs occur spontaneously or after a certain provocation. They can be pendulum-like, when the same amount of time moves back and forth with horizontal, diagonal or vertical eye movements. If the eye moves faster to the right than to the left (or up faster than down), then such nystagmus will be called jerky.

There is also a mixed type, when when a person looks forward, pendulum-like movements are observed, and when looking to one side, jerky movements are observed.

Features in children

There are several types of the symptom in question in children.

If the child does not fix his gaze by the 4th week of life, he is suspected of having nystagmus. This type of pathology is congenital in nature, caused by the impact on the child’s brain in the prenatal period of various unfavorable factors or a disorder in the genes responsible for the innervation of the oculomotor muscles. Its characteristics are as follows:
appears at 2-3 months of life and persists throughout life;
not visible during sleep;
has a horizontal orientation, jerky;
There is a direction of view in which the symptom does not appear.
There is also early acquired nystagmus, caused by pathology of both eyes, due to which central vision is reduced. In terms of symptoms, it is similar to congenital, but appears a little later. The child already notices (as opposed to congenital nystagmus) twitching of his eyes, this bothers him.
Nodule spasm is a condition accompanied by nystagmus that develops between the ages of 3 and 18 months. It may be of unknown etiology (then it goes away by the age of 3), or it may be caused by pathology (including tumor) of the brain or cranial nerves. In this condition, the nystagmus is small-amplitude, high-frequency, horizontal (there may also be vertical components), accompanied by nodding of the head.
Latent - develops as a result of infantile strabismus, is not accompanied by paresis of upward or downward gaze. Such nystagmus is absent with open eyes and appears when the brightness of one eye decreases. Has a horizontal orientation.
Nystagmus can also be observed with albinism - the absence of pigment in the iris of the eye.

Involuntary eye movements are characteristic of post-traumatic encephalopathy.

Also, this symptom may be the first sign of Meniere's disease. Details here.

Diagnostics

If nystagmus occurs, a person must be examined by the following specialists: neurologist, ENT doctor, ophthalmologist, neurosurgeon. The following research methods are used:

Electronystagmography is a method that allows you to record the direction and amplitude of eye movements;
electroretinography - examination of the retina;
assessment of visual acuity;
MRI of the brain with contrast.

Treatment

Therapy depends on the type of pathology detected:

in case of inflammation of the labyrinth or eye, conservative treatment of these diseases is carried out;
for albinism, wearing sunglasses/perforated glasses or dark contact lenses is used;
in some cases, surgical vision correction is required;
according to indications – removal of brain tumors;
medications are used, the purpose of which is to improve the nutrition of the retina and other structures of the organ of vision (vitamin complexes, drugs that dilate blood vessels and reduce blood viscosity).

How to treat ocular nystagmus in children and adults

Ocular nystagmus is a disease that is manifested by spontaneous movement of the eyeballs. In this case, the eye randomly deviates from the observation point and then returns. In this case, vision does not fixate on the object of observation. Spontaneous nystagmus can be horizontal, vertical or rotatory (rotational). The disease is not only an aesthetic problem; As a result of the disease, in some cases vision is affected. Nystagmus is often not an independent disease, but a symptom of more serious pathologies in the body. It is very important to undergo timely diagnosis and determine the causes of the pathology. The disease is quite rare.

Classification of nystagmus

By origin they are distinguished:

congenital nystagmus, which develops in children under one year of age;
acquired during life as a result of pathology of the vestibular apparatus or brain damage.

The disease can develop at any age.

Based on the type of movement of the main apple, there are:

Horizontal nystagmus (left-sided and right-sided) - eye movement to the right and left. This is the most common type of disease.
Vertical - eye movement up and down.
Rotational or rotatory - rotation of the eyeballs.

According to the nature of the movement of the eyeball, they are distinguished:

pendulum - oscillatory eye movements occur;
jerky - the eyes move with a push in one direction, and then slowly return to their original position.

Development of the disease in children

The disease is very rare and occurs no more often than 0.05% of all newborns. Most often, horizontal nystagmus develops with jerky eye movements. The disease develops between the ages of two months and one year.

Newborn children have low visual acuity and cannot concentrate on one object, so their eyes wander around the room rather than looking at one point. However, after the first month, the baby should be able to focus his gaze on a specific object. If this does not happen within 1–2 months, they speak of congenital nystagmus. In this case, consultation with a pediatric ophthalmologist is necessary.

Treatment of nystagmus in children must begin immediately, since this pathology very quickly leads to a decrease in the baby’s vision.

Causes of nystagmus

The development of congenital nystagmus is often determined genetically. Both congenital and acquired spontaneous nystagmus are a symptom of some pathological process in the body. It is very important to conduct an accurate diagnosis to determine what caused the development of this disease. Most often, the congenital form of the disease develops in children under 1 year of age.

In adults and newborns, spontaneous nystagmus develops if there are malfunctions of the oculomotor system. Such failures can occur due to a number of reasons.

Possible factors that lead to the development of the disease:

brain injury or tumor, stroke;
cerebrovascular accident;
multiple sclerosis or other demyelinating diseases;
Meniere's disease is a pathology of the inner ear;
ear infections;
malformations of the brain and skull;
intoxication;
injury to the baby during childbirth;
hydrocephalus is a disease in which fluid accumulates in the ventricles of the brain;
pathologies of the vestibular apparatus;
inflammation or swelling of the vestibular nerve.

Signs of illness

The main symptom of the disease is spontaneous eye movements that are visible to the naked eye.

In addition, the patient exhibits the following symptoms:

photophobia;
the feeling that surrounding objects are shaking;
dizziness and a feeling of unsteadiness often occur;
nausea.

Often, along with these symptoms, other signs appear that indicate damage to the central nervous system or vestibular apparatus:

decreased hearing acuity, often unilateral;
strabismus;
impaired coordination of movement and gait;
muscle weakness.

Over time, spontaneous nystagmus causes a decrease in visual acuity. If the disease develops in adults, they do not immediately notice deterioration in vision. To maintain your ability to see, it is very important to consult a doctor promptly and get diagnosed.

Diagnostics

Diagnosis of the disease in both newborns and adults is carried out by an ophthalmologist. He determines the patient’s vision condition, studies the condition of the fundus, retina and optic nerve.

The diagnosis is made based on a history and the results of a number of studies:

neurological research;
laboratory blood test;
computed and magnetic resonance imaging.

It is almost impossible to cure nystagmus. This pathology is not amenable to either medication or traditional therapy. A disease is only a symptom of one or another disruption of the normal functioning of the body. In order for nystagmus to go away, it is necessary to undergo a thorough diagnosis, determine the causes of the disease and treat the pathological condition that led to nystagmus.

To correct deteriorating vision, glasses or contact lenses are used. To restore visual acuity, it is useful to adhere to a diet containing vitamins that are beneficial for the eyes. Some folk recipes are very useful for the eyes:

Parsley. Take 1 tbsp of freshly squeezed parsley juice. l. twice a day.
Dill water. Steam 1 tbsp in 200 ml of boiling water. l. dill seeds, leave for 2 hours, strain. Adults drink 100 ml twice a day. It is useful to give dill water to infants 1 tsp. 2–3 times a day.
Caraway. Steam 1 tbsp in 1 glass of boiling water. l. caraway seeds, leave for 1 hour, then filter. Adults also drink half a glass twice a day. This remedy is not used for the treatment of newborns.
Alfalfa. In 1 glass of boiling water, infuse 1 tbsp. l. alfalfa seeds, filter and take half a glass three times a day.

Nutrition

Introducing certain foods into your diet will help maintain visual acuity, since these foods contain vitamins that are beneficial for eye health. The most beneficial substances are found in fresh vegetables and fruits. Vitamins A, C and B vitamins are beneficial for eye health, as well as substances such as lutein, carotene, and zeaxanthin.

Blueberries contain vitamins B1 and C and lutein. This berry is useful not only fresh, but also frozen or grated with sugar.
Orange vegetables: carrots, pumpkin.
Broccoli;
Spinach.
Fruits: oranges, tangerines, peaches, grapes, kiwi and others.

Write in the comments about your experience in treating diseases, help other readers of the site!