Nystagmus examination method

Eye disease is a type of health problem that everyone may face. When you feel that your eyeballs are swinging back and forth rhythmically, whether horizontally, vertically or in circles, it means that there may be some pathology in your eyeballs, most likely nystagmus. What examination methods do doctors use when facing this disease? Let us pay attention to it together.

1. What is nystagmus?

Nystagmus is an involuntary, rhythmic, back-and-forth eye movement. The directions are divided into horizontal, vertical, rotational, etc., with the horizontal type being the most common. The direction of nystagmus is usually indicated by the fast phase direction, and the fast phase is the compensatory movement to restore the gaze position. It is called nystagmus for short. It is often caused by diseases of the visual system, extraocular muscles, inner ear labyrinth and central nervous system. Nystagmus is not an independent disease, but a clinical manifestation of certain diseases, so treatment should be targeted at the cause.

2. Causes

1. Ocular nystagmus

It refers to the central vision disorder of the macula, which is the nystagmus caused by difficulty in forming the gaze reflex.

(1) Physiological gaze nystagmus includes oblique nystagmus, visual dynamic nystagmus and latent nystagmus. (2) Pathological fixation nystagmus includes blinding nystagmus, amblyopic nystagmus, occupational nystagmus, etc.

2. Vestibular nystagmus

3. Central nystagmus

4. Congenital idiopathic nystagmus

3. Clinical manifestations

1. Jumping type

The eyeball moves back and forth at significantly different speeds. After slowly turning to the other direction to a certain extent, it suddenly returns in a jerky motion. This type of tremor has chronic and fast phases. The chronic phase is the physiological phase, and the fast phase is the corrective movement of the slow phase. The direction of the fast phase is the direction of nystagmus, and the fast phase is related to the cause.

1. Swing type

The movement of the eyeball is like a pendulum, with no fast or slow phases. Its speed and amplitude are equal. It is more common in patients with binocular amaurosis and amblyopia.

4. Inspection Methods

1. General examination

Ask the patient to look straight ahead and observe the nystagmus as he follows the examiner's finger moving in a certain direction. Some examinations require covering one eye. To this end, the following points should be noted during inspection:

(1) Is the nystagmus latent or manifest?

(2) Whether the nystagmus is combined—the movements of the two eyes are in sync with each other—or dissociated.

(3) Type, direction, degree, frequency, amplitude, etc. of nystagmus.

(4) Whether there is an endless eye position.

2. Special inspection

Electronystagmography and other instrumental examinations.

5. Treatment

1. First of all, symptomatic treatment should be carried out according to the cause of the disease.

2. Surgical treatment: Congenital idiopathic nystagmus can be treated with surgery to move the resting eye forward to improve vision and reduce or inhibit the occurrence of nystagmus.