Navigating nystagmus

CPD
1
2 August 2024
Summer 2024

Kaye McIntosh on managing patients with nystagmus in the consulting room – patience is key in examinations.

Domains covered

Communication Clinical practice

Nystagmus – involuntary, repetitive eye movements that can cause visual loss (also known as “wobbly eyes” or “jerky eyes”) - is one of the more common causes of visual impairment in school-age children in the UK (Nystagmus Network, 2024). Estimates of prevalence vary, but the widely cited Leicestershire study calculated it was 24 per 10,000 (Sarvananthan et al, 2009).

There are two major types of nystagmus: infantile or congenital (sometimes known as early-onset) and acquired. Babies with nystagmus usually show symptoms between six weeks and three months of age. One study estimated there are 6.72 paediatric cases per 100,000 population (Nash et al, 2017).

It’s often associated with visual deprivation in infancy caused by congenital cataracts or optic nerve hyperplasia. Other causes include ocular albinism, neurological conditions such as Down syndrome, retinal dystrophies or aniridia.

Infantile nystagmus is a lifelong condition that is often picked up by child health practitioners. One type, fusion maldevelopment nystagmus syndrome (FMNS), is strongly associated with strabismus, and this is often the reason parents come forward. Latent FMNS is only visible when one eye is covered. 

A form of acquired nystagmus called spasmus nutans is usually diagnosed between six months and three years. It typically improves without treatment between the ages of two and eight.

Simon Frackiewicz MCOptom, an optometrist at Robert Frith Optometrists and Yeovil District Hospital, says: 

“In acquired nystagmus, community optometrists would often be the first port of call.” 

Sign in to continue

Forgotten password?
Register

Not already a member of the College?

Start enjoying the benefits of College membership today. Take a look at what the College can offer you and view our membership categories and rates.

Related further reading

The Westminster government has launched a consultation on its 10 Year Health Plan to fix the NHS in England.

They are also calling for urgent implementation in Phase One of the 10 Year Plan.

We have responded to a green paper on prevention public from the Department of Health and Social Care.