Congenital Nystagmus in Babies- Causes, Symptoms And Treatment

Congenital nystagmus accounts for almost 80% of the cases and can be seen during 6-12 weeks of life of the baby. This can, however, be not only congenital but acquired as well. The acquired nystagmus can develop anytime.

Types of Congenital Nystagmus in Babies

The eyes make different motions under this condition. Nystagmus can be of two types: jerk and pendular. These can further be defined by the movement direction by the doctors.

1. Horizontal or Pendular Nystagmus

Under this, the eyes move in the pendulum motion that is back and front.

2. Vertical Nystagmus

As the name suggests the eyes move in a vertical direction; upwards and downwards.

3. Jerk Nystagmus

Under this eye can move in any one direction and then jerk or move in the other one.

4. Rotary Nystagmus

Under this the eyes move in an oscillation. They have involuntary movement in circular form. In case the baby is affected by congenital nystagmus, it is best to show a health practitioner at the earliest.

Causes of Dancing Eye in Infants

The term congenital nystagmus indicates the muscular and skeletal disorders that lead to weakness of muscles and loss of muscle mass as well. This is usually seen in babies but in some cases, the symptoms become only visible once the baby grows old.

Some causes for congenital nystagmus include

• Genetics where the condition passes from the parent to the child.
• Visual problems due to cataracts, optic nerve disorder, glaucoma, retinal detachment etc.
• Result of a deficiency of vitamins or due to prolonged use of any medicine or some side effects of the same.
• Result of central nervous system strokes and related issues.
• Coloboma, where the eye formation is not proper.
• Head injuries.

Symptoms of Congenital Nystagmus in Babies

The foremost symptom of nystagmus in babies is involuntary, rapid, jerky eye movements. The movements can be pendulum, horizontal, vertical, or oscillation. This can have varying intensity and frequencies for different babies. This can occur in either one or both eyes. These movements, however, are not visible when the baby is sleeping.

For a baby who has nystagmus, has normal eyes but there is a specific zone where the number of oscillations is different than normal, yet the vision is better. It is seen that in most cases the babies who have zones of null oscillations end up in abnormal positioning of head to see in a better way.

Few more symptoms of congenital nystagmus in babies are:

• Problems using the eyes to follow any object.
• Extreme sensitivity towards light.
• Keeping the head in tilted manner.

Diagnosis of Dancing Eye

Congenital Nystagmus is a common condition which gets passed to the infants genetically. There is no set cure for the same, yet its diagnosis can be done in several ways:

Using imaging methods like MRI to detect the uncharacteristic nystagmus

• A thorough pediatric checkup to rule out any systemic issues.
• An ophthalmic check-up to check any abnormalities resulting in sensory nystagmus
• Electroretinogram examination to rule out any chances of retina or optic malfunction.

The steps given below help in diagnosing congenital nystagmus in babies. Some of them are

• Proper physical check-up.
• Family history
• Creatine Kinase levels of blood assessed through blood tests, higher the levels, higher are the chances of muscle injury
• Biopsy of muscles to ascertain any underlying disease
• Studies related to nerve conduction to detect the weakened areas
• MRI of the brain is done to detect any basic defects in the functioning of the brain
• Genetic testing to check for and assess any genetic defects

[Read : Congenital Ptosis in Babies]

Treatment of Congenital Nystagmus in Babies

Medical science has still not curated any definite cure for this condition. Doctors can do corrections in case the baby has symptoms of a squint, refractive defects etc. It is important for the visual system to have optimal development. Squint needs immediate treatment for reducing ocular movement.

Surgery is performed for correcting the abnormal position of the head by adjusting the extraocular muscles. A common defect associated with nystagmus is long or short-sightedness, which is taken care of by providing glasses. It is important to have a proper clinical and ocular analysis that has a family history as this condition is congenital.

Children suffering from this condition cannot comprehend if the visual power is less but with growth, they do face some limitations.

There are many kinds of treatment that can be done to reduce the frequency and intensity of this condition. Some of them are.

1. Surgical Treatments

Many surgical treatments are done to improve the head posture and even reduce the frequency of the movements of the eyes. Like Kestenbaum- Anderson, muscle removal, reattachment of muscles, extraocular muscle resection or surgery which has a mix of these.

2. Pharmacological Treatments

Treatments are done by using several drugs for reducing the frequency and improving visual sharpness. Few of these drugs are gabapentin, baclofen, diethyl propionate etc.

3. Using Eyeglasses or Contact Lenses

The most common way to correct a refractive error is by providing contact lenses or eyeglasses. These can only help to improve the vision and not for correcting nystagmus. Some treatments use eye patches for the prevention of complications related to refractive issues such as lazy eye, squint etc.

[Read : Squint and Amblyopia in Babies]

4. Vision Rehabilitation

This treatment is ideal for babies who have vision impairment issues by birth. This treatment enables a baby to use optic or electronic magnifying devices and other alternatives as well.

When to See a Doctor?

If any baby has congenital nystagmus, it is important to keep the doctor informed. It is, however, important to consult a doctor in case the symptoms worsen, or any new symptoms are seen. Some of these are

• Inflammation in the inner ear
• Problems with the developing eye control movement.
• Any illness in the central nervous system
• High myopia, or refractive issues
• Cataract issues
• Albinism
• Any effects of medicines or anti-seizure drugs used

Thus, this condition is a lifelong disease which is due to the genetic disorders inherited from the parents. It shows in the form of weakness in muscles and flabbiness in a newborn. Mobility and feeding issues are also commonly seen. This can be treated by medicines or relief therapy that also helps in improving the strength of the muscles.

FAQ’s

1. Can a Baby be Born With Nystagmus in Both Eyes?

People are born with nystagmus. It is genetic and can be carried from the parent to the child. The real reason though is not known. This condition is seen in both eyes and features blurred vision.

2. Is Congenital Nystagmus a Brain Disorder?

Congenital nystagmus refers to a condition in which there are repetitive involuntary movements made by the eyes. It is a brain disorder that has been proved by researchers as its cause is a retinal one.

3. What is the Reason For Decreased Visual Acuity in Congenital Nystagmus?

Decreased visual acuity in congenital nystagmus can result from related conditions or by itself. It can result from similar conditions like ocular albinism and optic nerve disorder.

Read Also: Neonatal Abstinence Syndrome – Symptoms, Causes and Treatment