Nystagmus (eye tremors)

The Nystagmus, so that Eye tremors It even occurs in healthy people and is therefore not always pathological. A distinction is to be made between nystagmus and eye twitching and flickering.

What is nystagmus?

Eye tremors (nystagmus) are generally understood to mean involuntary eye movement in a horizontal direction.

Eye tremors (nystagmus) are generally understood to mean involuntary eye movement in a horizontal direction. It is not always a disease, because eye tremors also occur in everyday life.

If a point in the distance is sighted during a train ride, the eye deflects to the maximum position and is then jerked back. The so-called latent nystagmus (end position nystagmus) is assumed to be poor in gaze retention. Here an object in motion cannot be fixed long enough without the eye moving back to its original position.

This form of eye tremors often occurs in patients who have strabismus in the first two years of life. Another manifestation of eye tremors is primary congenital nystagmus. It is innate, but weakens during childhood. It occurs more intensely when the patient fixates an object.

Ocular nystagmus, on the other hand, is an acquired form of eye tremors that occurs as a result of another eye disease. Here the eye oscillates in the first months of life. These movements gradually weaken. If this form occurs after the sixth month of life, jerky eye tremors are more common.

causes

The causes of primary congenital and latent eye tremors are largely unknown. Both forms are congenital or acquired in early childhood. In congenital nystagmus, recessive inheritance can occur. However, this rarely occurs.

The ocular nystagmus is caused by a previous disease of the eye. This includes cataracts or cataracts, which mean that the lens of the eye is cloudy. In addition, there is optic atrophy. Here, there is a regression of the tissue on the optic nerve.

Aniridia is a congenital eye disease. The patients lack the iris. In albinism, a genetic pigment deficiency leads to limitations in visual acuity.

A scar on the retina also leads to visual disturbances and impaired visual acuity, which is associated with eye tremors.

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Diseases with this symptom

• Cataract
• Aniridia

• Ataxia
• Color blindness

• concussion
• Retinitis pigmentosa

Diagnosis & course

The ophthalmologist uses Frenzel glasses to diagnose the eye tremors. With it he can see the eye in a considerably enlarged representation and thus assess the horizontal deflections. The frequency of the tremor as well as the amplitude and the direction of impact of the eye are decisive.

The doctor can provoke the nystagmus through a thermal test. To do this, the ear is rinsed with cold and warm water. Another method of provocation is the swivel chair test. To do this, the patient is set in motion on a swivel chair. His attempts to fixate on a point trigger the eye tremors and occur in the opposite direction after the chair is stopped.

The deviating activity of the eye muscles must also be assessed. Electrooculography (EOG) is used for this. Due to the trembling of the eyes, the patient can have forced head positions. In addition, untreated nystagmus leads to a reduction in visual acuity in both eyes.

Complications

Nystagmus, i.e. stiffness, tremors or poor coordination of the eyes, is not only considered to be a visual impairment. If no countermeasures are taken in the case of nystagmus, complications can arise that can affect the entire ophthalmic apparatus. Normally, nystagmus is only temporary and subsides when the source of stress disappears permanently, for example when you leave your computer workstation, with sufficient recreational leave or regular eye exercises.

However, this overload syndrome can lead to a permanent reduction in eyesight. Therefore, eye tests and examinations should be carried out in good time and regularly, which ideally are even financed by the employer or the necessary visual aids. Nystagmus can not only be triggered by strenuous work in front of a screen or, for example, strenuous night driving in the car, but also by drug abuse.

Long-term complications of substance abuse, as far as the eyes are concerned, include not only nystagmus but also visual hallucinations, which must be considered together depending on their course. Purely cognitively, nystagmus manifests itself in the fact that focusing with the eyes is difficult or, in extreme cases, painful or no longer precisely possible. This is why headaches or migraines are often associated with the symptoms, which can become chronic in the long term. Complications are aggravated when various sources of stress add up, such as strenuous night work under poor lighting conditions.

When should you go to the doctor?

If the nystagmus occurs only temporarily, a doctor's visit is not necessary. In the case of nystagmus (physiological nystagmus) that is not pathological, the eye function returns to normal after a short time. However, the pathological form of this eye disease (pathological nystagmus) should not be left untreated, as otherwise the visual acuity is permanently reduced. A suitable contact person is initially an ophthalmologist. Depending on the cause of the disease, a neurologist or ENT doctor can also be called in.

If eye tremors often occur both at rest and when moving, it is advisable to see a doctor soon. Dizziness and a trembling perception of the surroundings are signs of pathological nystagmus. The cause can lie in the brain and should therefore be clarified.

Eye injuries can also be the cause of eye tremors. If the symptoms occur in connection with an injury, a doctor should be consulted. This can prevent any further complications.

Drug use, such as ecstasy, can also trigger nystagmus. Since both the sense of balance and vision can be disturbed here, the ophthalmologist will make a comprehensive diagnosis together with other specialists and work out possible therapies.

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Treatment & Therapy

The treatment of the eye tremors should bring the patient a clear improvement in his visual acuity. This can be achieved through integrated prismatic glasses in normal glasses.

In the case of congenital forms of eye tremors, it is sometimes more advantageous to have an additional operation. Compulsive head posture can also be corrected here. To calm the eye tremors when looking sideways, the eye muscles are shifted so that patients can look straight ahead in the future.

If the eye tremors in patients calm down at close sight, there are also surgical procedures for correcting the eye muscles. The combined fitting with prism glasses can then bring the necessary relief.

Outlook & forecast

If the nystagmus is weak, the use of the healthy eye can have a compensatory effect in some people. The existing visual acuity is completely sufficient in this case, so that no further measures have to be taken.

Without medical help, people who suffer from a congenital or acquired disorder will not see any improvement in their health. The use of a visual aid often relieves the symptoms. However, the use of glasses or contact lenses does not lead to a permanent reduction in symptoms, as the visual aid only supports the eyes.

A long-lasting improvement in nystagmus can be achieved through an operative intervention. The prospects for this are rated as quite good. Eye muscle surgery helps many sufferers to get a good prognosis and a permanent increase in visual acuity. Good results are also achieved with drug treatment. However, as soon as the drug is stopped, there will be a relapse and recurrence of the eye tremors.

In the case of people who do not have permanent eye tremors, it is often sufficient if a gentle behavior takes place. Sufficient sleep and the avoidance of certain stimuli sometimes lead to spontaneous healing. Situations where an object cannot be fixed long enough due to movement taking place should be avoided entirely.

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prevention

There are no preventive measures against eye tremors, which are usually congenital or acquired in early childhood. In view of the deteriorating visual acuity, it is important to consult your ophthalmologist immediately in the event of abnormalities in order to clarify the cause of the eye tremors.

You can do that yourself

If nystagmus is not a severe case, it can easily be counteracted with conscious behavior. Caution: The following tips will not help with pathological nystagmus. In this case, medical treatment is necessary.The instructions for self-help are only intended for spontaneous eye tremors.

If little sleep is the cause in the days before the eye tremors appear, a longer night's sleep provides rapid relief. A stress-free environment can also help the symptom to resolve quickly. Stress can best be reduced with relaxation techniques such as yoga or autogenic training, which in turn contribute to a reduction in nystagmus.

Certain stimuli can also trigger nystagmus. With sufficient rest and recovery, you will soon see an improvement. It is often enough for patients, for example, to reduce screen work and take a rest instead. Certain eye gymnastics exercises can also help against the tremors.

It should also be avoided to focus on a distant point - for example, when looking at the landscape while driving. This can worsen the nystagmus or trigger it again, as the eye cannot fixate on a particular object in this situation. The patient should not look out of the window while driving so that the eye can relax.