Nystagmus is a complex eye condition characterised by uncontrolled movement of the eyes.

The movement can be from side to side, up and down or in a circular motion. It’s kind of like the pendulum in a grandfather clock.

“Did you know, children with nystagmus can have perfect vision?”

Several conditions can cause nystagmus in infants and children.

1. Congenital Nystagmus: This is the most common form. This condition may be inherited and is usually evident by two months of age. A squint occurs commonly, but fortunately, the effect on vision is usually mild.
2. Retinal Conditions: The second type occurs when the child is suffering from a retinal condition. Here, the damage to the retina at the back of the eye means that the light from the outside world is being poorly transmitted to the brain. This, in turn, means that the child does not see well. Their eyes move in an erratic, roving way as though they are looking for something.
3. Latent or manifest latent nystagmus: When one eye is covered, abnormal eye movements suddenly appear, or if they are already present, they become more pronounced. This condition is often associated with both eyes turning inwards at the same time (esotropia).

You need to have your child assessed by a doctor specialising in the eyes (ophthalmologist). They will examine your child carefully and be able to assess which type of nystagmus your child has and how to progress further.

There are certain genetic conditions which can be associated with nystagmus, such as albinism, and these will be identified too if present. The ophthalmologist will also check which medications your child is on as some drugs can cause nystagmus. If your child is on any medication, remember to bring the labeled containers with you to the appointment.

Your ophthalmologist will carefully test how well your child can see and identify if astigmatism is present. The retina and nerve at the back of your child’s eyes, will also be examined carefully to establish if a retinal or nerve lesion could be the cause of the nystagmus.

In rare cases, your ophthalmologist may want to exclude brain pathology and therefore order an MRI scan to be done.

Nystagmus cannot be cured, however, there are many things that can be done to minimise the effect it has on a person’s daily living. This includes correcting other issues with the visual system and reducing symptoms that may occur (such as light sensitivity).

The visual acuity in children with nystagmus can range from 20/20 to legally blind.

After a thorough examination, your ophthalmologist will prescribe the most effective treatment for your child’s age, function and needs.

If your child has a refractive error, spectacles will be prescribed. If the child has a mild head-tilt or chin-tilt, prisms can be added to the prescription.

Contact lenses are also helpful.

It is important to attend all follow-up appointments as your child grows. The degree of refractive error will change as they age, and so they will need new prescriptive lenses to cope with the alterations in their developing eyes.

Depending on the degree of correction that is needed, children with nystagmus can read well. They may read more slowly than their classmates, but comprehension is usually good.

If your child still has reading difficulties after their vision has been assessed and corrected by an ophthalmologist, causes other than the nystagmus need to be looked for.

In children with poor vision, low vision aids need to be employed. These can range from using large print books or increasing the font size on their tablets, to using specialized magnifying devises. Specific accommodations need to be made for them in their school environment to optimize their scholastic performance.

Surgery can be performed for patients who have an abnormal head-tilt, or in those in whom it would improve visual acuity, but this is usually done after the age of 7 years.

The use of medication in children has not been found to be very effective.

In rare cases, the nystagmus may resolve spontaneously. But in most patients, no treatment can completely stop it.

This means that the psychosocial effects need to be addressed too. Nystagmus is an easily identifiable condition, which can open your child up to teasing and ridicule. Education and support both at school and within in the home are vital for building your child’s self-esteem.

Once diagnosed and treated correctly, children with nystagmus can go on to become fully functional adults who positively contribute to the world around them.